Causes and Symptoms of Low Stomach Acid -

Causes and Symptoms of Low Stomach Acid


Causes and Symptoms of Low Stomach Acid

As a clinician who specializes in helping people with chronic digestive complaints and auto-immune diseases, one of the most common underlying problems I see with these individuals is low stomach acid.  This syndrome is also called hypochlorhydria in the medical literature and it is immensely important to correct first in order to get someone well.

Unfortunately, the mainstream medical system is almost completely unaware of this issue and actually does things, such as prescribing anti-biotics, NSAIDs and acid blocking medications that only make it worse.  Most natural health practitioners are either not addressing this issue or they often think very lightly about it.


Why Is Stomach Acid So Important?

Stomach acid is also called hydrochloric acid due to its chemical structure of one hydrogen ion combined to one chlorine ion making HCL.  It is responsible for sterilizing any food wishing to make it into your gut and breaking down protein.

Low stomach acid creates a vicious cycle of poor digestion, chronic gut inflammation, microbial overgrowth, leaky gut, elevated stress hormones and lowered nutrient absorption (1).  The only things that will break this loop are to reduce stress in all its forms and support adequate stomach acid production.


Main Symptoms of Low Stomach Acid:

The symptoms of low stomach acid are too many to count, but here are some of the major ones that I commonly see.


Main Causes of Low Stomach Acid:

There are a number of things that can lead to chronically low stomach acid production.  Anything that is causing a chronic stress in our body from poor diet, bad relationships, bad posture and subluxation in our spine, constant worry and fear and overuse of medications.

1) OverUse of Anti-Biotics: Anti-biotics transform your microbiome and cause an increase in intestinal related inflammation in the body.  This inflammation causes a rise in stress hormones which reduce the bodies ability to produce HCL.

2) H Pylori Infection: H Pylori is a common part of our microbiome, however, with the overuse of anti-biotics, chronic stress, poor diet, etc. we can cause a shift in the microbiome, a lowering of stomach acid and the overgrowth of H Pylori.

As H Pylori overgrowth occurs, these little guys produce an enzyme called “urease” which breaks down the urea in the stomach into carbon dioxide and ammonia.  This causes belching and halitosis (bad breath) for the individual and it neutralizes the acidifying effects of hydrochloric acid allowing for further growth of H Pylori and more stress on the GI system (2).

3) Chronic Stress: Chronic stress impairs the digestive systems ability to produce HCL and other digestive juices.  Our autonomic nervous system is composed of 2 main branches.  The sympathetic and parasympathetic branches.

         Sympathetic System: Fight or flight

         Parasympathetic System: Rest, Digest, Repair and Reproduce

Proper digestion depends upon us being in a parasympathetic dominant state.  Chronic stress puts us in a sympathetic dominant state which restricts activity in the digestive tract and causes poor digestive function.

4)  Poor Diet: A diet rich in processed foods, sugars, grains, etc change our microbiome and cause chronic inflammation and elevated stress hormone production.  Blood sugar stabilization is very important for normalizing stress hormones.  Stay on a lower carbohydrate, higher fat, anti-oxidant rich diet and your stomach acid levels will improve.

5)  Eating Too Quickly or on the Go: This is one of the BIGGEST PROBLEMS we have in our society.  We eat a lot of food quickly and often throughout the day.  It is critically important to be sure to never eat when we are in sympathetic (fight or flight) mode and to take time to relax, breathe deeply and increase parasympathetic activity.  You should feel relaxed at least 15 minutes before eating and up until 1-2 hours after finishing your meal.

6)  Overuse of NSAIDs: In our society, we pop Tylenol, aspirin, aleve and ibuprofen like candy.  We think that because they are sold over the counter there are no major issues if we take a relatively small dosage each day.  Unfortunately, this isn’t true as NSAIDs wear down the stomach lining and reduce the ability of the stomach cells to produce HCL (3).

7)  Using Proton Pump Inhibitors: These acid blocking medications reduce acid levels in the stomach which does give relief to those with acid reflux.  Unfortunately, because acid reflux is typically caused from too little acid, taking these medications further reduces stomach acid, which leads to microbial overgrowth and further stress on the body (4).

8)  Small Intestinal Bacterial Overgrowth: It is hard to say what comes first, is it the low stomach acid that allows for an elevated level of bacteria to enter into the digestive system alive and proliferate on undigested food particles (due to low HCL)?  Or is that SIBO causes chronic stress in the body, which reduces the bodies ability to produce adequate HCL?  Either way, there is a HUGE connection between SIBO and low stomach acid levels.

9)  Aging: As we age in our society, all of systems slow down and especially the digestive physiology (5) This is even more the case  if we are stressing our body more than we can adapt too.  If you take care of your body at an early age and keep your digestion at an optimal level throughout life, you should be able to produce enough HCL in your later years.  However, if you are over 50 years of age, it is wise to consider supplemental HCL as it may make a huge difference for you.

10)  Food Sensitivities: Some of the most common food sensitivities cause major stress in the body, which puts us into chronic fight or flight.  Be sure to stay off of the most common offenders such as gluten, corn, soy, peanuts and pasteurized dairy.  If you notice other foods not agreeing with you, than look to avoid those as well.

If you have a wide number of food sensitivities than it is a good bet you have low HCL.



As you can see, there are many things that most people in Westernized countries are doing everyday that lead to the development of low stomach acid.  Addressing low stomach acid should be one of the first places we look in order to improve digestive health, heal leaky gut and reduce overall stress on the body.

Sources For This Article Include:

1. Champagne ET. Low gastric hydrochloric acid secretion and mineral bioavailability. Adv Exp Med Biol. 1989;249:173-84. PMID: 2543192
2. Cater RE 2nd. Helicobacter (aka Campylobacter) pylori as the major causal factor in chronic hypochlorhydria. Med Hypotheses. 1992 Dec;39(4):367-74. PMID: 1494326
3. Fromm D. How do non-steroidal anti-inflammatory drugs affect gastric mucosal defenses? Clin Invest Med. 1987 May;10(3):251-8. PMID: 3304754
4. Metz DC. Long-term Use of Proton-Pump Inhibitor Therapy. Gastroenterology & Hepatology. 2008;4(5):322-325. Link Here
5. D’Souza AL. Ageing and the gut. Postgraduate Medical Journal. 2007;83(975):44-53. Link Here

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12 Responses to Causes and Symptoms of Low Stomach Acid

  1. Richard April 27, 2016 at 9:31 am #

    Hello, so what’s the solution to low stomach acid? I noticed you didn’t provide any solution. Thanks

  2. Gala September 3, 2016 at 9:04 pm #

    Dr Jockers, thank you for sharing all this great information with us! I was looking for any information on LPR (laryngopharyngeal reflux), incl how to treat it, and can’t find any. Do you have experience dealing with it?

    • Dr. Jockers September 4, 2016 at 9:04 am #

      Yes, I would follow the principles in this article:

      • Gala September 4, 2016 at 9:25 am #

        Dr Jockers, this is very interesting because supplementing with HCL definitely helps with digestion, but on the other hand it causes more acid to back up into the esophagus, which causes the feeling of post-nasal drip and clearing the throat all the time. I thought clearing SIBO would help it, but it did not. I just have less bloating now. Checked for H-Pylori, came back negative. Do you think it maybe esophageal motility problem and prokinetic could help? Treating LPR is SO frustrating, even naturopath that I am seeing does not know what to do. Thank you for your help!

  3. Tanya Wyatt July 7, 2017 at 9:09 am #

    Hi Dr Jockers – many thanks for some very indepth and informative articles. I am presenting with a range of symptoms that all fall into the no, or low, HCL category and am currently working with a functional medical practitioner in my town. Having started taking HCL (with pepsin) and digestive enzymes, I began by increasing HCL gradually, hoping for some sort of response. Now, at 26g per every large meal, I still have no heartburn and have experienced a total cessation of migraines (plagued for nearly 30 years with these). NO other symptoms have changed but I’m concerned about continuing at this level for fear of creating an ulcer (or similar). It’s also bloody expensive! Have you had experience with someone taking massive doses? Would you caution against this amount? Should I drop down the dose and just continue for longer?

    • Dr. Jockers July 7, 2017 at 11:25 am #

      I would definitely not recommend that high of a dose. You may want to try a different brand and bring the dose way down. Here’s one I get good results with:
      I would say start with 1 cap with your large meals and move your way up to 4 and monitor your reaction, once you reach mild heartburn take one less capsule it took to cause it (if it took 4 to give you heartburn, take 3 as your standard dose)

  4. TINA August 15, 2017 at 11:32 am #

    I thought Tylenol was okay to take while you have gastritis. It’s not a NSAIDs. It’s a Acetaminophen.

    • Dr. Jockers August 16, 2017 at 6:30 pm #

      I would not recommend Tylenol Tina. It is not an NSAID, but is still a chemical that puts unnecessary stress on the body without promoting health. It blocks pain but does not inhibit inflammation which is a concern. At the same time it puts an excess toxic load on the liver.

      I hope that helps!

  5. Laurie November 26, 2017 at 9:12 pm #

    To the person who is taking 26g with every large meal. I was headed in that direction and it isn’t good. An endoscopy showed I had developed bleeding stomach ulcers so knew I had to do something. A friend recommended just making chicken or turkey soup and eating the broth and vegetables, and some chicken. I almost used it like a cleanse. I mostly ate the soup, then tried a bigger meal here and there and I turned out to need hardly any HCL. It healed me for at least for now.

    Typically, I eat very healthily, but nuts and many things are hard ad maybe were too hard to digest especially if my stomach was in this poor condition. It must have damaged my stomach. This feels very healing. And less acid is hitting those open ulcers..

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