Updated: Oct 9, 2018
Stomach acid plays a vital role in maintaining optimal health. The strength of our stomachs Hydrochloric Acid (HCL) is very important in killing germs and protecting against infection, preventing bacterial overgrowth, and dissolving our food into smaller particles. HCL levels decrease after age 30, and with many lifestyle factors or chronic health conditions, and lack of stomach acid is one of the first places things can go wrong in our gut.
HCL sterilizes the stomach contents and is important in digesting carbohydrates, proteins and fat. Our stomach acid stimulates the release of pancreatic enzymes into the small intestine, so if stomach acid is insufficient, pancreatic enzymes will not be secreted and the carbohydrates will not be broken down properly.
Having an acidic stomach is important for extracting nutrients from our food and maintaining a balanced ph level for the rest of the body. Inadequate stomach acid often results in nutrient deficiencies which can cause a wide range of symptoms like anxiety, depression, fatigue, skin conditions, brain fog or more. Key minerals, calcium, magnesium, iron, zinc and vitamins B9, B12 and C are dependent on HCL concentration.
Low HCl creates an alkaline stomach environment, which leaves us susceptible to nutrient deficiencies, which in turn can lead to detoxification issues, and bone density problems. Worst of all, a lack of stomach acid creates the optimal environment for pathogens to thrive, leading to conditions like dysbiosis, Small intestinal bacterial or fungal overgrowth (SIBO or SIFO), inflammation and autoimmunity.
Reflux - The High Stomach Acid Myth
Traditionally it was thought that Heartburn and Gastrointestinal Reflux DISORDER (GERD) is the result of high stomach acid levels when in fact it occurs when stomach acid levels are too low. The predominant theory is that GERD is caused by malfunction of the lower esophageal sphincter (LES) which allows acid to flow into the esophagus creating reflux.
Conventional wisdom recommends avoiding overeating, obesity, bending or lying down after eating, spicy or fatty foods and taking acid blockers from treatment. While these may play a role in reflux, they are not the root cause of why it occurs.
A more likely explanation comes from microbiologist Dr. Norm Robillard’s theory, that carbohydrate malabsorption/ fermentation leads to bacterial overgrowth, which in turn causes an increase in gas production, and intra-abdominal pressure. This increased gas and intra-abdominal pressure leads to a malfunction of the lower esophageal sphincter, creating reflux.
Acid blocking drugs and Proton Pump Inhibitors (PPI’s)
These drugs only make the long-term problem worse, and as a result are associated with an increased incidence of chronic disease. One of the biggest ironies in medicine is that these drugs help relieve symptoms of reflux, while making the problem worse! Given that stomach acid plays a vital role in health, it makes complete sense that blocking it's production is a very bad thing for our health.
PPI’s suppress stomach acid production, allowing bacteria to proliferate, further contributing to increased reflux. If you suffer from GERD, slowly easing off PPI’s and supporting stomach acid, bile, and enzyme production is one of the most important steps you can take in treating GERD.
HCL and Anti Inflammatory Drugs
Our stomach is lined with alkaline mucous to protect it from being destroyed by it’s own powerful acid. If one stomach cell dies, there is a hole in our defense and stomach acid can leak from the gut. Molecules in the stomach called Cytoprotective Prostaglandins help the stomach to rebuild and gap fill. In other parts of the body prostaglandins reduce pain perception. Ibuprofen and other NSAIDS (non steroidal anti inflammatory drugs) inhibit the biosynthesis of prostaglandins, which reduces pain levels, but stops the stomach from healing itself. For this reason (any many others!) it’s important to avoid chronic NSAID used to prevent gastric bleeds and ulcers. Consequently HCL is contraindicated for those with stomach ulcers or anyone who is currently taking NSAIDs.
HCL & Yeast Overgrowth
Candida is common yeast inhabiting the mucus membranes of the body. It is an opportunistic organism that can quickly grow in huge numbers and become problematic. Low HCl levels allow yeast to thrive. Antibiotics are another big cause of yeast infections because they kill off gut bacteria, taking away the natural competitors for yeast.
Yeast is a health problem because it creates mycotoxins that damage the intestinal cells, reducing absorption and protection, and interferes with metabolism by binding to thyroid receptors. When you make mycotoxins you create acetaldehyde which is a chemical by-product of sugar, alcohol and yeast metabolism. Acetaldehyde is toxic to cells and tissues, and if it can’t be broken down it’s often stored in the brain, spinal cord, muscles and liver.
Factors that can lead to low HCl:
Being over 30
Auto immune conditions
SIBO (small intestinal bacteria infection)
NSAID anti inflammatory drugs, PPI Acid blocking drugs
Drinking alkaline water
Birth Control Pill
nutrient deficiency: niacin, chloride, sodium, potassium, zinc, and iodine
Common symptoms of HCL deficiency:
Feeling full for hours after meals
Burping, gas, bloating,
Acid reflux, Heart burn
Undigested food in stool
Skin conditions: eczema, rosacea, dry skin, brittle nails, vertical ridging of nails
Hair conditions, particularly hair loss in females.
Chronic fatigue, poor memory, difficulty concentrating,
When looking to increase stomach acidity, it’s important to take an integrated approach. While supplementing is extremely important, it’s essential to look at the bigger picture as to why levels dropped low in the first place. Lifestyle and nutrition must be optimised at first, as well as addressing any underlying pathologies. Apple cider vinegar, bitters, lemon, ginger and sea salt are natural ways you can begin to restore stomach acid production if taken before a meal. In health challenged individuals with chronic illness, supplementation is often needed.
Charles Poliquin once said in a lecture, ‘HCl is the most important supplement.’ And from our experience we would tend to agree. We used to perform HCl test kits to determine stomach acid levels, and noticed virtually all clients had inadequate HCl levels.
We have been supplementing with it on and off for 3 years and notice a worsening in digestive health every time we run out or stop using it. The biggest thing we notice is that it makes digestion run more smoothly and quickly, and helps you avoid that heavy feeling post meal when undigested food just sits in your gut longer than it should.
Testing for Low HCL
Testing for low stomach acid is complicated and invasive with the Heidleberg Radiotelemetry test, which is not commonly used. Instead a more practical way to test your HCl levels is with the HCL challenge.
HCl is taken within the first few bites of a meal. If you wish to try supplementing we would advise to start slowly and build up to a maximum of 3 x 650mg tablets per meal. So for example you would start with 1 tablet at your first meal and wait to see if you had a slight burn in your stomach like the feeling of having a warm tea in your belly. If no ‘burn’ was present then you take 2 tablets at the next meal. If still no burn, you can take 3 tablets per meal maximum. Any time you do feel a mild burn in the gut, drink water to dilute your gastric juices.
This is the one we use. It is coupled with bitters, and is GMO and gluten free.
Hope this helps you to have a happier gut!