The Stomach Acid Connection

February 21, 2012 in Categories: , by

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If you are following a paleo diet and still having digestive issues, low stomach acid may be to blame.

When you eat, the cells that line your stomach produce gastric acid and some digestive enzymes.  The acid and enzymes start breaking down your food into the individual constituents that will cross the intestines into the blood stream or lymphatic system later.  Stomach acid is especially critical for breaking down proteins into the individual amino acids that our bodies need for just about everything.  When stomach acid is produced, signals are sent to your pancreas to release digestive enzymes into your small intestine (also neutralizes the stomach acid for the next phase of digestion in your small intestine).  Stomach acid also protects the stomach from bacterial and fungal overgrowth (bacteria and fungus cannot thrive in an acidic environment) and is critical for absorption of many vitamins and minerals.

Inadequate stomach acid and digestive enzymes results in “big” pieces of food in your small intestine, which cannot be properly digested.  One effect is malabsorption of nutrients (both macronutrients and micronutrients).  But perhaps more worrisome is that this undigested food provides an excellent food source for harmful bacteria, yeast and fungi in your small intestine and colon.  Peristalsis slows, increasing transit time.  The bad bacteria, yeast and fungi reproduce and Small Intestinal Bacterial Overgrowth (SIBO) results, causing irritation to the gut lining, inflammation, and production of toxins that must be filtered by the liver.

As strange as it sounds, the symptoms of low stomach acid are virtually the same as the symptoms of an overproduction of stomach acid.  Increased levels of bacteria in your small intestine cause increased gas production.  Coupled with a slower digestion, the increased volume in your small intestine puts pressure on your stomach and on the lower esophageal sphincter (whose job it is to let food down into your stomach but keep the stomach acid from going up).  Stomach acid and other stomach contents creep up your esophagus causing heartburn, indigestion, and acid reflux.  Other symptoms of too little stomach acid include: diarrhea, constipation, bloating, belching, gas, bad breath, nausea, vomiting, rectal itching and hemorrhoids.  Not to mention the host of illnesses related to the gut irritation and inflammation caused by SIBO.

How do you get low stomach acid?  Aging is one of the primary causes of low stomach acid.  However, adrenal fatigue, alcohol consumption, bacterial infection, chronic stress and certain medications are also common causes.  You may want to read my post on How Mood and Gut Health Are Linked to read more of the direct effect of stress, anxiety and depression on digestion.

What can you do about it?  Unfortunately, once low stomach acid gets this bad, it isn’t as simple as being more careful to thoroughly chew your food and taking a supplement to increase your stomach acid production (although that helps!).  See my post on Repairing the Gut for a comprehensive approach to gut health.


I have a habit of writing about whatever I’m reading about for my own health (or my family’s health), so it’s good to know that it’s interesting to other people too! 🙂

Why not just recommend the Low Fodmap diet for treating SIBO? It seems to me it is much more scientific and researched in it’s approach than GAPS or SCD. Those diets allow things that I know for me feed fermentation while unnecessarily restrict other low fermentable foods. Would like your opinion.

I think SIBO is more complicated than that and there is a great deal of individuality when it comes to response to either a low-starch approach or a low-FODMAP approach or a combined approach. You are correct that there is more scientific literature supporting a low FODMAP approach, but I don’t think that disqualifies the usefulness of a low-starch approach.

Low iodine supplies can also cause low stomach acid, adrenal fatigue, and alcohol cravings, as well as stomach sensitivities to soy, soy oil, and fluoride and chlorine in drinking water. I found this out the hard way. After the iodine treatment, my stomach acid drastically increased and they had to treat my adrenal fatigue as well.

How did you increase your iodine? We did the iodine test in college (College of Naturopathic Medicine) and I have low iodine and am showing all signs for low stomach acid and SIBO so increasing my iodine would be a start.

Hi Sarah,

I recently started supplementing with Betaine HCL, and I’m increasing my dose slowly to see when I feel burning so I can then reduce the dose by one. I’m up to 10 648 mg pills and I still haven’t had the burning. At this dosage I’ll go through the whole bottle in 4 days! I have an autoimmune disease, but is it really possible that I could need more than 10 pills for each meal?

Thanks a lot

I have been taking different levels of Betaine HCL for a few years now, and it helps immensely. Every time I run out or try to come off of it for a while, I see the effects within a couple of days – typically in the form of sluggishness and constipation, or just feeling kind of nauseated and wrong immediately after eating. I have realized I only really need it with a protein/fatty meal. So I’m not so sure that waiting for the burning sensation is the only option to find your most effective dose.

I’ve been on the AIP diet for 8 months. It has just become clear to me that my stomach acid levels have seriously declined 3 months into the diet. I’ve been well aware of low stomach acid dangers and thought I was addressing it through supplementation, however this serious decline in production caught me and my practitioner by surprise and has caused me a lot of harm. Can you help me understand why I’ve lost stomach acid production at a time when it should have been improving/healing? I’d like to understand the root cause of it too.

I have get really low stomach acid to where Im burping up my food without any burn in my throat.
When this happens I cant stop eating, Im always hungry and im never thirsty.
I found my problem.
Caffeine…. it some how effects the acid production in my stomach, maybe because it weakens the adrenal glands.
On the second to third day of quitting I get so much acid in my stomach and I get thirsty as hell, I drink tons of water because I crave it and I can almost digest anything. I stop eating all day long and sometimes just once a day.
Skin becomes clear, mind becomes clear and I just feel like a kid again.
The problem is I start to feel so good that I go off eating whatever and at the same time Im craving the coffee, so I go have some because I feel nothing will hurt me, then 7 days of coffee and Im back burping up food without acid in it.
This happens to me even with hot chocolate or green tea.
90% of people in the world drink or eat some form of caffeine.

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