The Reasons Why You May Not Have Enough Stomach Acid

And the actionable steps you can take to improve your stomach acid status

Americans spend in excess of $10 billion/year on proton pump inhibitors (PPIs), and two of the top five selling drugs in the United States are PPIs.¹ However, contrary to what many believe, insufficient stomach acid is a more widespread problem than having too much stomach acid.

 Stomach Acid Impacts Digestion

Stomach acid, aka hydrochloric acid or HCl, plays a crucial role in the digestion of food and absorption of nutrients.  Insufficient stomach acid increases one’s susceptibility to bacterial or fungal overgrowth, parasites, and/or other pathogenic bacteria.  Stomach acid is also essential for denaturing protein into amino acids and liberating nutrients from the foods we consume.  Without sufficient stomach acid, proper digestion is impaired and symptoms can be experienced.

What causes our stomach acid level to become insufficient? 

Diet, lifestyle, and medications can all negatively affect the amount of stomach acid the parietal cells are able to produce. Check out these 7 factors that may be contributing to low stomach acid.

1. Low Zinc Status

Zinc and stomach acid have a symbiotic relationship.  Zinc is needed for the creation of stomach acid and zinc is a nutrient that is liberated from the food we eat by stomach acid.  Without zinc, you can’t create stomach acid and without stomach acid, you won’t have enough zinc to create stomach acid.  

2. Stress

When your body is in a fight or flight state, blood is shunted away from the digestive system and into your muscles so you can run from the stressor.  The secretion of gastric juices are inhibited as digestion is not imperative to your survival when in fight or flight mode.  But you don’t have to be running from a bear in order for your body to be in fight or flight mode. Stress can be physical stress like bodily harm, infections, inadequate sleep, consumption inflammatory foods, or psychological like encountering a threatening situation - ie. being chased by a bear, toxic or unhealthy relationships, or negative self-talk.  

3. Helicobacter Pylori Infection (H.pylori)

H.pylori is a contagious bacteria that can be spread through saliva, fecal material, contaminated water, and/or poor hand washing.  It is believed that 50% of the population has h.pylori but not everyone may experience symptoms. This bacteria secretes an enzyme called urease.  H.pylori is dependent on a near-neutral pH to thrive; the urease activity of increases pH in the vicinity, thus making it possible for H.pylori to survive at a more acidic place.² H. pylori can also contribute to gastritis, peptic ulcer disease, and gastric cancer.  Having sufficient stomach acid discourages the overgrowth of h.pylori.  

4. Medications

Proton pump inhibitors (PPIs) block the protein needed for stomach acid production while H2 blockers block the histamine receptor to generate stomach acid production.  While both are FDA-approved for short-term use, many people are utilizing acid-blocking medications long-term.  Conversations with your medical provider should occur to determine if you are a candidate to discontinue the use of your prescription medication. If the drug is removed, there is a potential risk of rebound hypersecretion, creating a sort of dependency on the drug because the body is acclimated to having acid suppressed.³  Work with a qualified provider to ensure proper upper gastric healing occurs to avoid rebound effects.

5. Age

People over the age of 65 have a decreased production of stomach acid as the function of the digestive tract appears to decrease with age.  This can increase nutritional deficiencies as absorption also becomes impaired.  

6. Surgeries

Having a surgery in which a portion of the stomach is removed decreases the number of parietal cells present.  Parietal cells are responsible for the secretion of stomach acid and intrinsic factor.  Intrinsic factor is a protein that enables the absorption of B12.

7. Vegeataian/Vegan Diet

Plant-based diets do not require as much stomach acid to digest as diets that included animal proteins.  Without the stimulation required for the parietal cells to create stomach acid to aid in animal-protein digestion, the body slowly decreases its production.  Plants also contain an anti-nutrient, phytic acid.  Consumption of PA (phytic acid) rich diet leads to a deficiency of minerals such as iron and zinc among human population.⁴  As noted earlier, zinc is one of the key nutrients needed for stomach acid production.  Soaking and sprouting nuts, seeds, grains, and legumes can reduce phytic acid levels and increase the absorption of nutrients.  

As you can see, there are many different dietary and lifestyle factors that can inhibit the production of stomach acid and impair the digestive process.  So let’s talk about the ways you can increase your stomach acid levels naturally!  Implementing a few of these lifestyle tips and/or supplements can ensure proper digestion and absorption of nutrients.

 Strategies for Improving Stomach Acid Levels

1. Be Present at Mealtime

This is one of the easiest but possibly hardest for people to implement in our hurried, on-the-go lifestyles.  When we stand, rush to eat, and multitask, the sympathetic nervous system is activated - aka fight or flight. The perceived stress does not prioritize proper digestion or secretion of gastric juices.  Instead, sit down to eat, take a deep breath (or 3) before diving, eliminate distractions and chew your food thoroughly,  Try putting your fork down between bites to allow proper time to chew your food.

2. Include Bitter Food or Digestive Bitters With Meals

Bitter foods can stimulate the production of gastric juices.  Examples include dandelion greens, arugula, kale, radicchio, citrus, fennel, cranberries, and apple cider vinegar. Digestive bitters or 1-2 tablespoons of ACV in 2-4 ounces of water can be taken before a meal to stimulate stomach acid production.

3. Increase Your Zinc Consumption

Zinc is a key mineral for over 100 enzyme reactions in the body, DNA creation, cell proliferation, immune function, tissue repair, and stomach acid production but a nutrient that many people are under-consuming.  Zinc can be found in food sources like beef, chicken, pumpkin seeds, mushrooms, oysters, asparagus, chickpeas, almonds, and cashews.  You can include a high-quality multi-vitamin as well.

4. Include a Betaine HCl Supplement at Mealtime 

Purchase a low dose (150mg) of betaine HCl with pepsin. With a meal containing animal protein, seafood, or poultry, take the capsule midway through the meal.  Finish your meal and observe your body for a reaction. If indigestion, warmth, burning, or heaviness in your chest/left upper quadrant of your abdomen occurs, you likely have sufficient HCl.  If no reaction occurs, you are likely low in stomach acid.  For low stomach acid, you can try increasing the number of capsules you take every 3 days.  Once you have an adverse reaction, return to the previous level that was tolerated.  Make note that some meals with lighter protein like eggs, seafood, and protein shakes may require less betaine HCl than beef, lamb, chicken, or pork.  For individuals who may already be experiencing discomfort in the stomach/esophagus or on a prescription proton pump inhibitor, upper gastric healing may need to occur first before addressing stomach acid levels.  Please consult a professional before trialing this on your own if that is the case.

5. Limit Fluid Intake at Mealtime

Diet culture has been promoting drinking a lot of water before and during meals to help you eat less at meals.  While there is so much wrong with that whole concept in general, consuming a large quantity of water before or during meals will dilute the stomach acid you do have available.  Small sips to take supplements and cleanse your palate is fine, but avoid guzzling water with your meals to support proper digestion. 

6. Identify and Eridaicate Bacteria Overgrowth

Testing for H.pylori can be done through an at-home stool test.  My favorite is the GI MAP which provides a comprehensive overview of the state of the microbiome by quantifying the amount in which a pathogen may be present through DNA evaluation.  The GI MAP also provides information about the virulence factors of h.pylori. VIrulence factors represent the capacity for an h.pylori strain to be pathogenic.

As you can see, there are many factors that can negatively impact the amount of stomach acid you have available to support the proper digestion and absorption of nutrients.  Becoming more in tune with your body and implementing some lifestyle and dietary changes can have a profound effect on your overall health and wellness. 

*The information available on this website is for general health information only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should not rely exclusively on information provided on the Website for your health needs. You can read more about our disclaimer here.*

References

1. https://journals.lww.com/ajg/Abstract/2006/09000/The_Burden_of_Gastrointestinal_and_Liver_Diseases,.28.aspx

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5076771/#bibr28-1756283X16663395

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093718/

4. https://pubmed.ncbi.nlm.nih.gov/33641749/