Low stomach acid (hypochlorhydria): Symptoms, test, and treatment

low stomach acidLow stomach acid (hypochlorhydria) can often be difficult to diagnose because it can present symptoms similar to high stomach acid, like heartburn. The condition itself is often underrated but involves a low production of stomach acid. Stomach acid is produced by the parietal cells found in the stomach. When there is a complete lack of stomach acid, the condition is known as achlorhydria.

Researchers suspect that nearly half of seniors over the age of 65 suffer from low stomach acid. It is quite common for production of stomach acid to diminish after the age of 40.


Stomach acid is an integral part of the digestion system as it helps to not only break down the food we eat but also allows for the release of nutrients from food. Therefore, living with low stomach acid can lead to digestive problems, chronic intestinal inflammation, and lower nutrient absorption.

What are the symptoms of low stomach acid?

Symptoms related to low stomach acid are actually abundant, but there are some key ones you will want to pay close attention to. As mentioned, symptoms of low stomach acid are actually quite similar to high stomach acid, which can make diagnosis a bit challenging at first without proper testing.

Some key symptoms of low stomach acid that you should pay attention to include:

  • Heartburn or GERD
  • Bloating and cramping
  • Constipation or diarrhea
  • Multiple food sensitivities
  • Acne or eczema
  • Dry hair or skin
  • Anemia or weakness
  • Hair loss in women
  • Indigestion, burping or belching common after meals
  • Has within one hour of consuming a mean
  • Chronic intestinal infections
  • Undigested foods in stools
  • Chronic fatigue
  • Weak or cracked nails
  • Protein and mineral deficiencies
  • Osteoporosis
  • Having an autoimmune disorder

What causes low stomach acid?

Stomach acid is produced in the stomach, but there are factors that can hinder or limit the production of it. Causes of low stomach acid include:

  • Overuse of antibiotics
  • H. pylori infection
  • Chronic stress
  • Eating a poor diet
  • Eating too quickly or eating while on the go
  • Overusing NSAIDs (such as Tylenol or aspirin)
  • Using proton pump inhibitors (used for heartburn and acid reflux)
  • Having small intestine bacterial overgrowth
  • Aging. As mentioned, less stomach acid is produced beginning as early as 40
  • Having food sensitivities

Low stomach acid complications

Even though low stomach acid isn’t discussed as often as high stomach acid, it should still be diagnosed and treated as it can lead to serious medical complications. Complications resulting from low stomach acid include:

  • An inability to properly digest protein, which can lead to malnourishment over time.
  • Causing an acid-base imbalance, which can make the blood become acidic and creates toxins in the intestines.
  • Overgrowth of pathogens and illnesses such as cancer.
  • Mineral deficiencies, as nutrients cannot be properly absorbed.
  • Leaky gut syndrome, which is a condition that causes the digestive tract to become permeable, allowing for food, bacteria, waste, and undigested food particles to pass through.

Low stomach acid test

In order to properly diagnose low stomach acid, there are three tests that your doctor can perform. They are:

The Heidelberg stomach acid test. This is the most costly test for low stomach acid but is considered the gold standard. The test is performed by using a small capsule with a radio transmitter that records a person’s pH. The patient then drinks a solution of sodium bicarbonate. PH levels are then recorded and graphed at regular intervals. This is the most detailed form of testing that can measure stomach acid and will give your doctor a clear look at what’s going on inside your stomach.

The baking soda stomach acid test. For this test, the patient drinks baking soda, creating a chemical reaction in the body. As a result, carbon dioxide is produced, which results in burping. Although this test is cost effective and easy, it can be difficult to control all the variables that can affect the results. This test can be done at home though by consuming baking soda mixed with water and timing how long it takes for you to burp. If you haven’t burped within five minutes, stop timing, as that is an indicator of low stomach acid—normally, you should burp within two to three minutes.
Betaine HCL challenge test for low stomach acid. This at-home test is more reliable than the baking soda test and the kit can easily be purchased online. You will need betaine HCL with pepsin, to eat a high protein meal (with at least six ounces of protein), take a pill of the betaine HCL mid-meal and finish your meal while being mindful of your body. This test can yield two outcomes: the first being that nothing occurs, which is a sign of low stomach acid, and the second being you feel stomach distress such as heaviness and heartburn, which signals normal stomach acid. It’s suggested that this test is repeated a few times to verify results as it is not 100 percent foolproof. Generally, two positive tests indicate that you have low stomach acid and you should speak to your doctor about treatment.

How do you fix low stomach acid?

The stomach is naturally an acidic environment with the causes of low stomach acid having an effect that may compromise the entire digestive tract as well as your health. Not being able to break down your food in an efficient manner will prevent the body from absorbing vital vitamins and minerals.


The following are some of the ways to help naturally balance the acidity level of your stomach.

  • Apple cider vinegar: Consuming this right before your meals will help start to balance the pH in your stomach. It is recommended to take one tablespoon with a very small amount of water.
  • Chew thoroughly: the action of chewing your food helps to stimulate digestive enzymes in the mouth and in the stomach. Breaking up your food into smaller pieces also allows you to digest your food easier.
  • Drink hot tea with meals: Drinking warm ginger tea or dandelion root tea is a great way to increase stomach acid production naturally. Drinking ice cold water is not recommended, as it inhibits the production of stomach acid and slows digestion.
  • Stop eating before bed time: Refraining from eating three to four hours before bedtime is recommended. Eating too late cause your body to divert energy resources to your digestive tract instead of using them to help restore the body while resting.
  • Sea salt: Getting your recommended dose of unrefined sea salt helps provide your stomach with chloride, an important component of stomach acid.
  • Manuka honey: Produced in New Zealand and Australia, this type of honey has naturally occurring peroxide content, making it a potent anti-bacterial. It can be used to heal the stomach lining and help address Pyloriovergrowth. Take one tsp twice a day.
  • Don’t over hydrate: While getting plenty of water is often recommended, drinking too much can be bad for you. Drinking large amounts of water before or during meals can water down stomach acid and inhibit digestion.

Speaking to your doctor and looking at your lifestyle habits can help you narrow in on the root cause of your low stomach acid, which can reduce the risk of future complications.

Related: What causes excessive stomach acid and how to get rid of it



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