Hypochlorhydria (low stomach acid) has been associated with many common health problems. Stomach acid is used to begin the process of protein digestion. A normal stomach acid level is a pH of 1.5 to 2.5. As we age, the parietal cells in the stomach lining produce less hydrochloric acid.

In fact, half of people over the age of sixty have hypochlorhydria, and by age eighty-five, 80 percent of the healthy people tested had low stomach acid. Use of acid-blocking medications increases stomach pH to 3.5 or higher. This inhibits pepsin, which can irritate the stomach, but it’s also essential for digestion of protein.

Stomach acid is also necessary for absorption of many minerals, so mineral depletion may occur with use of these medicines. Minerals that can become depleted include iron, calcium, magnesium, zinc, and copper. Stomach acid also provides our first defense against food poisoning, H. pylori, parasites, and other infections.

Without adequate acid, we leave ourselves open to decreased immune resistance. Overgrowth of bacteria in the intestinal tract occurs in 20 percent of people age sixty to eighty and in 40 percent of people over age eighty. Adequate HCl is necessary for the absorption of vitamin B12 from food.

B12 deficiency causes weakness, fatigue, and nervous system problems. Most B-complex vitamins require normal levels of stomach acid. Vitamin C levels are also low in people with poor stomach acid. Acid is critical for the breakdown of protein bonds in the stomach. Poor acid content in the stomach causes indigestion.

The symptoms of hypoacidity often mimic those of hyperacidity. Hypochlorhydria may be caused by the following: pernicious anemia, chronic H. pylori infection, long-term treatment with proton pump inhibitors (like Prilosec), autoimmune gastritis, and mucolipidosis type IV; it is also common in autoimmune diseases.

Healing Options

• Try betaine HCl. Begin with 1 10-milligram capsule of betaine HCl with meals. If you do not respond, build slowly to a maximum of 5 capsules with each meal. If you experience burning, immediately neutralize the acid with one teaspoon baking soda in water or milk. That indicates that you now have too much HCl and are irritating your stomach lining. Cut back your dosage to a comfortable level.

• Try umeboshi plum. You can suck on, eat, or make into a tea. These salty, fermented plums are highly alkalizing and aid in indigestion.

• Increase acidity with vinegar. Dilute 1 teaspoon of vinegar in water and drink with each meal. Gradually increase the amount of vinegar, up to 10 teaspoons. If you experience burning, immediately neutralize the acid by drinking a glass of milk or taking a teaspoon of baking soda in water.

• Test for vitamin B12 insufficiency. Have your physician test your B12 by testing homocysteine or methylmalonic acid. Serum B12 levels decrease only when tissue levels are very depleted. A more expedient and less expensive route is to ask your physician to give you 1,000 micrograms of vitamin B12 by injection weekly for four weeks.

Then you and your doctor can evaluate the benefits. Or you can use sublingual (under the tongue) hydroxocobalamin at 2,000 micrograms daily for four weeks. People who are deficient in vitamin B12 feel much more energetic and can accomplish more when levels are normalized.

• Take a multivitamin with minerals. Adequate HCl is necessary for absorption of vitamins and minerals. Because you are depleted in many nutrients, arm yourself with an excellent multivitamin with minerals. Because minerals are bulky, you’ll probably find yourself taking anywhere from four to nine pills daily.

Look for a supplement that contains the following: 1,000 milligrams of calcium, 500 milligrams of magnesium, at least 400 IU vitamin D, 100–200 micrograms of chromium, 100–200 micrograms of selenium, 5–10 milligrams of manganese, at least 15 milligrams of zinc, and at least 25 milligrams of each B vitamin.

• Try digestive enzymes. I recommend plant-derived enzymes because they work in both the low pH of the stomach and in the neutral environment of the intestines. They provide protease and lipase for the stomach and serve your enzyme needs throughout the digestive tract. Take 1 to 2 with meals for a trial period of four weeks.

• Use Swedish bitters. Bitters are a long-standing remedy for poor digestion in Europe. They stimulate production of HCl. Take bitters either in tablet or liquid form as needed.

• Change your eating habits. Chew food thoroughly and eat small meals frequently. Small meals are easier to digest. Avoid drinking liquids with meals. Fluids dilute stomach acid.