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How To Tell If You Have Low Stomach Acid (And Why It's Important)

July 5, 2017

You might be intrigued to read this if you’re someone who experiences uncomfortable digestion. However, digestive distress is not the only symptom associated with an imbalance in your stomach acid. Do you have acne? An autoimmune disease? Are you anemic? Food allergies? If you answered yes to one (or all of these symptoms), then this is also for you!

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What's stomach acid and why do we need it?

Stomach acid, also known as hydrochloric acid (HCl), is made in the stomach and used to break down our food. This acid is so strong that if we poured it onto our skin, we would get burned. Stomach acid isn't only used to break down food, it also breaks down the proteins that we eat, aids in mineral absorption, activates intrinsic factor that is needed to absorb B12, and much more.

Stomach acid also acts as the first line of defense against foreign "friends" that get in through our food (bacteria and parasites). If stomach acid levels are low, it may cause imbalances in GI bacteria, nutritional deficiencies, and general digestive discomfort.

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I have heartburn...That means I've got too much stomach acid, right?

Not necessarily. More often than not, when someone comes to me with symptoms like heartburn, reflux, indigestion, or GERD, they actually don’t have enough stomach acid. As a result, food will get into the stomach but won't be fully broken down. This causes fermentation and gas production that feels like too much acid but is actually due to not having enough. Taking an antacid will help for the time being by neutralizing these gases, but long-term use can actually worsen the problem.

What are the other symptoms of low HCl?

Low stomach acid can cause a feeling of fullness after eating, bloating and discomfort, and even lower your appetite (this is oftentimes the case in the elderly). You may also have irregular bowel movements and dysbiosis in the gut (an imbalance in your gut bacteria). You may notice that you’re developing allergies or sensitivities to foods that you used to be able to tolerate. You may have been diagnosed with anemia or other nutrient deficiencies like B12 and folate. These can often lead to chronic fatigue and mood imbalances like depression and anxiety. You may also be experiencing acne or other skin conditions like eczema, psoriasis, hives, or rosacea. Low HCl can also coexist with autoimmune conditions like Hashimoto’s thyroiditis, rheumatoid arthritis, lupus, or celiac disease.

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How does my stomach acid get low anyway?

Stomach acid declines with age, which is why many elderly people experience low appetite, feelings of fullness, and are generally uninterested in eating. Stomach acid can also lower due to stress, gum chewing, nail biting, and other habits that "trick" your body into thinking that food is on its way. Chlorine and fluoride in our drinking water can lower acid levels. Chronic use of antacids will also deplete stomach acid, ultimately making symptoms worse.

How can I find out if I actually have low HCl?

Testing for stomach acid levels is tricky because there's no (easy) way to measure stomach acid levels directly. In my functional nutrition practice, we will often determine low stomach acid based on symptoms during a patient’s consultation. You can also try the "beet test." This is done by literally just eating a beet; if you notice that your urine or stool turns pink or magenta within one day of consumption, your stomach acid levels may be in the tubes. The theory is that stomach acid plays a major role in breaking down the pigments in foods, so if there are still pigments left at the end of digestion, you may not have enough HCI.

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I live on antacids; what can I do?

If you suspect that you’ve got low levels, there are several ways to naturally boost them. For starters, you might try apple cider vinegar on an empty stomach, as some anecdotal evidence supports this theory. Mix 1 tablespoon in a small glass of water and take it before meals. Betaine HCl supplements can also be used to perk up HCl production. Start with one capsule before meals and increase until you feel a warming sensation. If you take the supplement and notice a warm or burning sensation (like heartburn), your levels may actually be high enough!

Of course, if symptoms persist, you might choose to visit a functional medicine practitioner or functional nutritionist to help determine what might be the root cause!

If you're looking for more info on stomach acid, here's exactly what to eat to control reflux and 10 ways to cure your heartburn—without taking drugs.

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Brooke Scheller, DCN, CNS
Brooke Scheller, DCN, CNS
Board Certified Nutrition Specialist

Brooke Scheller, DCN, CNS is a Doctor of Clinical Nutrition and Board Certified Nutrition Specialist. She specializes in functional nutrition to support gut health, mood and mental health, and alcohol use. As a sobriety advocate, she regularly offers programs to help engage others on changing their relationship with alcohol through nutritional practices and offers one-on-one individual coaching. Scheller has over 12 years of training and experience in nutrition and functional medicine and has worked with both individuals and large organizations building nutrition programs to scale. She is also the founder of Condition Nutrition, a nutrition consultancy working with start up organizations in personalized nutrition, supplements, and health-tech.