5 Signs You May Have Low Stomach Acid

5 Signs You May Have Low Stomach Acid

By Dr. Justin Marchegiani

Do you suffer from any of the following?

Suffering from Indigestion, heartburn, constipation, gas, nutrient insufficiency

  1. Indigestion: Food doesn’t sit well after you eat.
  2. Heartburn: You have GERD (gastro esophageal reflux disorder).
  3. Constipation: You don’t pass at least 12 inches of stool per day.
  4. Gas: This is primarily in the form of belching or flatulence.
  5. Nutrient Deficiency: You have a past history of anemia or are low in certain micronutrients.

What is stomach acid, and why is it important?

Your body produces hydrochloric acid (HCl) for these primary purposes:

  • It activates pepsin, a specific proteolytic enzyme found in the stomach.
  • Pepsin’s primary job is to break down protein.
  • It provides an acidic pH in the stomach. This helps to decrease the chance of outside infections from proliferating like parasites, bacteria, and fungus.
  • It produces acidic chyme (the mixture of food in the stomach). When chyme is released from the stomach into the small intestine, the acidity stimulates the gallbladder to release bile and the pancreas to produce enzymes (lipase and chymotrypsin, to name a few).
  • It ionizes minerals so they can be broken down and absorbed by the body.
  • It stimulates gastrin, which helps protect the stomach and improve digestion.

Digestion and HCl

HCl is really, really important to start the domino cascade of healthy digestion. If that first digestive domino isn’t knocked over, it’s safe to say you are at a higher risk of digestive symptoms.

As mentioned above, HCl activates enzymes in the stomach, small intestine, and pancreas to start breaking down carbohydrate, protein, and fat. If HCl secretion isn’t initiated in the stomach, you will start to see a putrification, or rotting, of the proteins; fermentation of carbohydrates; and a rancidification of fats (1).

Digestion And HCL

Indigestion Creates Gas and Burning!

When the enzymes that are needed to break down these foods aren’t present, we start to see malabsorptions occur. These malabsorptions cause an increased intra-abdominal pressure, which can cause a weakening of the esophageal sphincter. When the esophageal sphincter loosens, this allows the organic acids from the rotting foods to rise up (reflux or GERD) and burn the esophageal tissue (2). Remember, esophageal tissue doesn’t have the protection (mucus) from an acidic environment like the stomach does.

Essentially, low stomach acid provides the environment for bacterial overgrowth in the stomach/small intestine to occur, which then creates malabsorption. You are now set up for a vicious cycle of poor digestion that almost never improves on its own unless the underlying cause is addressed (3) .

When food isn’t broken down completely, gas in the form of belching or flatulence is common. A dependency on pharmaceutical medications, like acid blockers, is now created that doesn’t address the underlying problem and only creates even bigger problems down the road, like B12 or iron anemias to name only a few (6).  In my clinical experience, HCl helps reverse these conditions and improve digestion; therefore, decreasing stomach acid in the long run with drugs isn’t a good idea most of the time.

Stomach Acid Protects Your Stomach and Your Esophagus…Huh?

Yep, you heard it here first! Most people associate stomach acid as a problem. Yet stomach acid is needed for the stimulation of mucus from pyloric glands. This mucus acts as a shield against the stomach acid and protects the gastric mucosa.

The pyloric glands secrete mainly mucus for protection of the pyloric mucosa from the stomach acid. They also secrete the hormone gastrin.

~Guyton’s Text Book of Medical Physiology, 11th edition.

The more your digestive track loses the ability to break down protein, fats, and carbohydrates, the greater the chance for a bacterial overgrowth to occur. As the balance of bacteria becomes more dysbiotic (more bad bacteria in relation to good), this can weaken your esophageal sphincter as mentioned above and allow burning in the esophagus to occur.

Why Am I Constipated?

Why Am I Constipated

As the ratio of good bacteria and bad bacteria becomes flipped in favor of bad bacteria, all kinds of bad things occur. We start to see incomplete digestion, which has an effect on motility. The excess of bad microbes in the GI tract can produce chemicals that slow down peristalsis, or the wavelike contractions that move food through your intestines. If you have more bad bugs in your gut, your transit times get slower (4).

Most people I see with digestive symptoms have some sort of gut infection, either H. pylori or a myriad of other parasites that are notorious for causing these types of issues. Unless these infections are addressed, these digestive symptoms tend to linger. To learn more about how you can address these issues, click here! 

Chronic constipation can also be connected to hypothyroidism as well. I strongly recommend ruling out any potential thyroid imbalances as well.

Stomach Acid Helps You Absorb Nutrients

HCl is needed to ionize minerals so they can be absorbed, assimilated, and utilized. There have been studies showing nutrient deficiencies in calcium, iron, and B12 when low stomach acid is present. Low stomach acid can even increase your chance of osteoporosis as well (5,6).

One of the most underutilized supplements is HCl, especially if you are already spending a good deal of money on organic food; you want to make sure you are absorbing and assimilating it properly. The old adage “you are what you eat” isn’t true. “You are what you eat, digest, assimilate, absorb, and utilize!”


If you have serious gastrointestinal irritation or a history of ulcers, you should not add any HCl into your supplement regimen without the guidance and support of a skilled functional medicine doctor. Some patients need more enzymes and gut healing herbs and nutrients before any HCl is introduced. This is on a case-by-case basis.

If you are having problems with you digestion, click here to schedule a complimentary consult to figure out the best solutions for you. 

Physiology References:

Guyton’s Text Book of Medical Physiology, 11th edition.

The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.