Blog: Gut Essentials

Does this sound like you?

• You get the dreaded belly bloat with cramps and pain, and you feel like food is sitting in your gut after eating.
• After eating a healthy, normal-sized meal, you feel exhausted, hungry, or anxious.
• You have peeling nails, low iron or B12 levels, acne, or chronic fatigue.
• Soon after eating you have heartburn or belch repeatedly.

If so, you may be experiencing hypochlorhydria (or low stomach acid). This very common condition is widely misunderstood. Hypochlorhydria, (Hypo = low; chlorydria = hydrochloric acid (or HCl)), refers to low stomach acid production. The stomach is highly acidic – with an optimal pH of 1.5-3 – which would burn you to touch it. This acid is essential to activate a little enzyme called pepsin that begins to break down food. Without an acidic environment it becomes difficult to begin the process of digesting protein, and this impacts the effective absorption of key nutrients from food.

Why Acid Is Important

Acid in the gut is the body’s first line of defense to kill any bacteria, viruses, or harmful substances that enter the body through the mouth! The secretion of HCL is an essential part of the digestive process and protects the body from many pathogens that we come in contact with on a daily basis.

Perhaps you are thinking, what about all the people (perhaps including you) who take antacids and proton-pump inhibitors (acid blockers)? It seems as if the general public all suffer from heartburn or reflux these days, and the media is overrun by advertisements suggesting we need these pills for relief of our symptoms.

It may be hard to believe, but it is all too common that those with heartburn-like symptoms are actually experiencing LOW stomach acid, not too much! I see this in my practice on a regular basis. Originally antacids and PPI’s (proton-pump inhibitors) were only prescribed for short term use if a patient was found to have a stomach ulcer or gastritis. Next to statins (cholesterol lowering drugs) antacids are now the most over-prescribed medication in our country. Many people on acid-lowering drugs not only do not need them, but they’re making their problem worse.

How To Test for Hypochlorhydria

Testing for low stomach acid is done through something called a Heidelberg test. This essential test for anyone with hypochlorhydria symptoms is rarely done, but it’s a great option to determine the balance of acid essential for your gut.

 Keep In Mind: If you have signs of low stomach acid or ANY kind of digestive dysfunction, it is important to rule out hypochlorhydria. And if you are taking PPI’s or antacids, consider talking with your MD about tapering down the dose and eventually eliminating them — unless you have gastritis or an ulcer. Taking PPIs while you have hypochlorhydria could hold you back from healing your gut and absorbing key nutrients, and could be one of the root causes behind many digestive issues such as chronic GERD/reflux, IBS, SIBO, parasites, food sensitivities, and more.

10 Signs of Low Stomach Acid, or  Hypochlorhydria:

1. You feel like you are unable to digest meat and/or have lost your taste for it. Most often I find that clients who are hypochlorhydric don’t enjoy meat or protein sources since they can’t digest them well! With a little HCL support, they regain the ability to digest protein
2. Your fingernails chip, peel, or break easily. If your fingernails chip, peel, or break easily, it’s typically a clear sign of deficiencies in protein, minerals, and often also essential fatty acids. By now you’re well aware that deficiencies in protein and minerals are often due, in part, to low stomach acid production.
3. You have anemia that doesn’t respond to iron supplementation. Iron deficient anemia is so often a gut issue, since it is typically an absorption issue. This is a very specific example of a mineral deficiency that is exacerbated by low stomach acid. Sufficient HCL is needed for iron absorption and iron regulation. This may help you understand why it is so critical to have optimal digestion in order to absorb nutrients from food and supplements.
4. You eat (or ate) a vegan or vegetarian diet. Vegetarians eat very little animal protein; vegans eat none. Therefore, the body slows down production of HCL accordingly and this decrease in stomach acid is one of the core reasons that a vegetarian diet can be taxing for digestion. Vegans are often challenged to absorb minerals from their food, properly triggering the production of pancreatic enzymes. In addition, the secretion of HCL triggers the release of intrinsic factor, essential to the absorption of vitamin B12. If you’re a vegetarian or vegan with acid reflux, low B12 or any of the other issues in this list, take note. 
5. You experience belching or gas about an hour after a meal. One of stomach acid’s important roles is to trigger the opening of the pyloric valve, the little valve that connects the stomach to the duodenum (the first part of the small intestine). That little valve is very smart, and it knows not to open until the contents of the stomach are at the proper state of digestion. This includes a sufficiently acidic stomach environment. If the pyloric valve is waiting for a level of stomach acidity that isn’t achievable due to low acid production, the contents of the stomach start to ferment. Fermentation creates gas. Whether it goes up or down depends on your constitution, but it will be released one way or the other.
6. You get heartburn. Contrary to popular opinion, acid reflux isn’t always caused by too much stomach acid…the acid may be just in the wrong place. Your esophagus has a pH of about 7, which is very neutral. Your stomach has a pH of 1.5-3, very acidic. The stomach secretes mucus to protect its lining, but the esophagus has no such protective coating. If you’re not secreting enough acid, the pyloric valve doesn’t open, and the contents of your stomach start to ferment. The gas it creates can build up and cause belching, which may open the esophageal valve – the valve that connects the esophagus to the stomach – to allow the gas to travel up. Sometimes, along with the gas, a little bit of stomach juices may also come up into the esophagus. The delicate lining of the esophagus is not equipped to handle such acidity and you experience “heartburn.”
7. You have really bad breath even though you brush your teeth. Ruling out poor dental hygiene, it makes perfect sense that bad breath would be the result of digestive dysfunction. If you’re not digesting the food in your stomach properly, it’s going to create toxic byproducts, which can quickly overload your body’s detoxification abilities. Let’s face it, we live in a very toxic world and our detoxification functions are significantly overworked. Our liver has enough to do without dealing with the by-products of a poor digestive system. 
8. You’re not hungry for breakfast. I see this scenario often! Do you find yourself eating a really large dinner, late in the evening, and then you don’t feel hungry for breakfast? You may not be hungry because your dinner is still processing and digesting upon waking in the morning due to low stomach acid.
9. You get sleepy after meals. Becoming sleepy after meals can mean a number of things: blood sugar dysregulation, poor sleep, improper macronutrient balance, or inadequate digestion. It takes a lot of energy to digest, so if digestion is not optimal it will put more responsibility on other body systems. Feeling energized after eating is normal if good digestion is occurring.
10.  You have undigested food in your stools. HCL triggers the release of pancreatic enzymes that help to finish the breakdown of food once it gets into the small intestine. If not enough enzymes are secreted, you won’t finish breaking down your food and will see undigested food in your stool.

What is the optimal low stomach acid treatment?

If you suspect you have hypochlorhydria, minor tweaks are often all that’s needed to boost HCL levels naturally. For others, more targeted support is required. I don’t advise that people take significant hypochlorhydria treatment into their own hands. You should only supplement HCL under the supervision of a health practitioner, and you should never do so if you have an ulcer, gastritis, or take prescription antacids.

Action Steps You Can Take At Home:

There is no one hypochlorhydria diet that I recommend for everyone. Instead, for those with mild hypochlorhydria symptoms I often suggest beginning with the following simple and enjoyable digestive supports.

• Drink a small glass of room temperature water with ½- 1 Tbsp raw organic apple cider vinegar before meals. This stimulates the digestive process and encourages your stomach to secrete stomach acid. (Note: if doing this produces a burning sensation in your gut, stop: this is not for you.)
• Try taking Swedish Bitters before meals, just like your great grandma did. Bitters work along the same lines as the apple cider vinegar – the bitter taste stimulates the digestive process.
• Eat sitting down, slowly, in a relaxed state. Digestion involves the connection between your parasympathetic nervous system and your gut, meaning that it only happens when you’re in a relaxed state. If you’re under stress, your digestion is compromised. Digestion actually begins in your brain!
• Give yourself some time to digest and take a light walk; don’t rush right into the next activity. It’s no coincidence that many cultures (with the exception of the US) enjoy relaxation after a meal. You don’t need a whole afternoon siesta, but a nice 10-15-minute stroll after lunch would be a nice gift to your gut.
• Eat your last meal of the day at least 2-3 hours before you go to bed. This gives your body time to digest before lying down.

It is important to remember that each of us is unique. It is all too easy to pin our symptoms on just one thing, like low stomach acid or a food sensitivity. Often it may be more complex, and that is why I am here to help you address hypochlorhydria in a way that is best for you …or partner with you to get to the ‘root cause’ of your struggle so you can thrive in life 🙂 .