Low Stomach Acid (Hypochlorhydria): Symptoms, Causes, and How to Fix It

Written by Sarah Bishop, MS Exercise Science, Functional Health Coach

Digestive issues can be a journey, and low stomach acid (hypochlorhydria) is a common challenge for people experiencing a range of health concerns.

Stomach acid is something we want our body to produce. It helps break down protein, absorb nutrients, signal other digestive processes, and act as a barrier by killing harmful microbes. When you aren’t producing enough, small issues can snowball into much bigger health problems over time.

Why Stomach Acid Is Essential for Digestive Health

Stomach acid isn’t just about digestion, it’s your first line of defense against infections and a key trigger for nutrient absorption. Without it, your body can’t fully use the food you’re eating. Over time, this can affect everything from your energy levels to your immune system and muscle recovery.

Common Signs and Symptoms of Low Stomach Acid

• Bloating

• Gas and burping

• Constipation or diarrhea 

• Trouble digesting protein

• Anal Itching 

• Patterns in bloodwork 

• Nutrient deficiencies

• Low elastase 

• Dysbiosis

• GI infections

How Stomach Acid Production Works

Stomach acid production starts with the anticipation of eating—just thinking about food can trigger your brain to send signals to your stomach to kick off this process. When you begin to eat, your stomach cells produce a hormone called gastrin. Gastrin then stimulates the release of hydrochloric acid (HCl) from parietal cells in the stomach lining.

 This acid release is also influenced by the vagus nerve, which connects your brain and digestive system, ensuring your stomach produces the right amount of acid when you need it. It's a beautifully coordinated system that helps your body efficiently process and absorb nutrients from your food. As a side note, this gut-brain connection is one reason why slowing down and eating in a fairly relaxed state is so important.

Causes of Low Stomach Acid (Hypochlorhydria)

 Several factors can contribute to poor stomach acid production, including:

• A history of undereating

• Hypothyroidism (the thyroid drives many metabolic processes)

• Aging (stomach acid naturally declines after age 40)

• Chronic stress

• Certain medications (such as proton pump inhibitors)

• Pernicious anemia

• H. pylori infections

 We alway want to consider the why so we can go about targeting root causes as we work to increase production and support the body globally. 

What Happens When Stomach Acid Is Too Low?

Nutrient Absorption and Protein Breakdown

Stomach acid serves as your first line of defense against pathogens and infections.

If stomach acid is low, it can lead you vulnerable to infections and overgrowth of bacteria that throw off the balance of your gut microbiome, causing digestive health issues.

Another key role of stomach acid is to help your breakdown and absorb protein. The release of stomach acid also kicks off the signals for your body to release digestive enzymes and bile, which help break down and absorb fats and carbohydrates.

If you are not breaking down and absorbing the nutrients in your food you can quickly develop nutrient deficiencies. All that protein, all those micronutrients- not doing a whole lot for you if you can’t absorb them!

Every cell and process in your body relies on vitamins, minerals, and amino acids to function properly. Without proper absorption, you may see a whole host of negative effects systematically. Experiencing things like hair loss, low energy, irregular menstrual cycles, or trouble putting on muscle mass can all be indicators of nutrient deficiencies.

Infections, Dysbiosis, and Gut Imbalances

Finally, low stomach acid can lead to low levels of beneficial bacteria in the gut, which is a form of dysbiosis. Those bacteria serve an important role in lowering inflammation, promoting a healthy intestinal barrier, and supporting immune health and metabolism.

If we see low commensal bacteria come back on a GI Map, it can be a telltale sign that someone needs either more diversity in their diet or they need help absorbing and assimilating the nutrients they are taking in. Because nutrient absorption impacts your entire system, low stomach acid can contribute to fatigue, thyroid dysfunction, hormonal imbalances, and weakened immunity.

How to Naturally Support Healthy Stomach Acid

At Fortify, we are big proponents of giving the body the tools to do its thing. In the case of low stomach acid, we consider lifestyle habits, nutrition and supplement interventions and adjustments as the big change makers.

Nutrition and Lifestyle Habits

• Chewing your food... you don't have to count chews, but food should be broken down to an applecause like consistency 

• Not eating when driving or stressed out

• Making sure you’re getting enough salt in your diet (sodium is a key nutrient for stomach acid) along with: 

• electrolytes along with zinc, iron and b vitamins support healthy production of stomach acid.

• Staying hydrated by sipping on drinks during the day- avoid drinking large amounts of water at meals

• Evenly space meals across the day

• Consider short term lowering of protein intake in the diet if having trouble with breakdown

Foods That Stimulate Stomach Acid

Including foods such as:

• lemon
• arugula
• dandelion
• radicchio
• kale
• apple cider vinegar 
• celery 

these foods act “bitters” that can be great to incorporate into your meal to stimulate stomach acid . This is a great example of how nutrition can be therapeutic.

 Supplements and Digestive Support Options

Another tool we love is digestive bitters! Bitters can be used to “prime” the digestive tract and naturally stimulate stomach acid. A few brands we like can be found HERE and HERE.Bitters and herbs can be powerful, but they’re not for everyone. If you’re pregnant, breastfeeding, or on medications (especially anything that changes stomach acid), make sure to check in with your healthcare provider before adding them in.

Stronger support such as implementing Betaine HCL supplements before meals could be warranted , however we always want to exercise caution before adding stronger supplements .

Betaine HCL is going to act to replace stomach acid (vs. priming the body's own production) . It can be too harsh for some or contra indicated in cases such as : someone with a hiatal hernia, H Pylori infections or a weak gastric membrane - more acid may make things worse. 

When to Seek Professional Support for Digestive Health

Understanding and addressing low stomach acid can be a game-changer for your digestive health and overall well-being.

If you’re experiencing any of these symptoms and want to take control of your health, we are here to help. Reach out today to schedule a consultation, and let’s work together to create a personalized plan to optimize your digestion and improve your quality of life.