Doctors tend to diagnose a patient with high stomach acid if they experience symptoms like acid reflux, gas, bloating, and heartburn. This diagnosis typically is reached without actually performing a lab test to measure stomach acid levels and usually results in a prescription for antacids, histamine type 2 receptor agonists (H2 blockers), Proton Pump Inhibitors (PPIs), or even surgery.
Unfortunately, these drugs can actually make the problem worse for many people.
Antacids don’t resolve the problem. They only temporarily reduce stomach acid which then triggers the stomach to produce even more to bring it back to its ideal pH level.
H2 blockers stop the body from producing a substance that stimulates acid production in the stomach. While they work more slowly than antacids, they are intended to last for longer periods of time. The problem is they block production of pepsin, a digestive enzyme required for breaking down protein.
Proton pump inhibitors permanently block an enzyme that tells your stomach to produce acid.
Each of these methods can have serious side effects and can even contribute to the root causes of continued chronic low stomach acid, or hypochlorydria, and other serious health conditions.
5 ways to test stomach acid levels
Most patients are not aware of hypochlorhydria so they aren’t aware of how it could be contributing to their chronic health condition.
It would be best to get your stomach acid levels tested as this will help you determine how to treat the underlying cause of the condition, not just the symptoms.
The gastric acid secretion test is usually done for a patient who has been diagnosed with a stomach ulcer. It can be helpful to monitor the effectiveness of anti-ulcer medication and to see if material from the intestines is coming back into the stomach. It is also highly invasive and expensive.
The Heidelberg Stomach Acid Test involves swallowing a small capsule with a radio transmitter which measures the pH of the stomach as you drink a solution with baking soda. This will naturally neutralize the HCL (acidity) in the stomach. Hypochlorydria is indicated if the body does not return acid levels back to normal.
This is considered to be the gold standard for testing hypochlorydria. It graphs your stomach’s response to the baking soda challenge and can help determine if you have hypochlorydria, hyperchlorhydria (high acid), or achlorhydria (complete lack of acid). It costs about $350 and is usually not covered by insurance.
CBC and CMP are common metabolic blood panels that are usually covered by insurance. A skilled clinician will take into account your lab results as well as your symptoms in order to diagnose hypochlorhydria.
The Betaine HCl challenge can be done at home. While it’s considered to be quite reliable, it can result in false positives, so it’s recommended to repeat the test three times. The betaine HCI costs about $20. If you do have low stomach acid, you can then start taking it to help restore your HCI levels.
First, buy Betaine HCI with pepsin. Then, eat a high-protein meal containing at least 6 ounces of meat (veggies are allowed with this). In the middle of the meal (not the beginning), take one betaine HCI pill. Finish the meal and observe what happens.
If you don’t notice any symptoms, you most likely have low stomach acid. If you experience indigestion or burning, heat, or heaviness in your chest, this can indicate adequate stomach acid levels.
Again, the recommendation is to repeat the betaine HCl challenge two or three times to confirm your results. Three positive tests are a good indicator of low stomach acid.
You may get a false positive if:
- You don’t consume enough protein. A low protein meal doesn’t require much acid, so the betaine HCl can cause too much increase in acid.
- You took the capsule at the beginning of your meal, which can cause indigestion.
- You have esophageal sphincter dysfunction. A hiatal hernia or poor esophageal sphincter tone can cause increased indigestion symptoms. If you suspect that you have this condition, a medical exam will either confirm or rule it out.
The baking soda stomach acid test is not as accurate as the above tests, but it is free and easy to perform at home. Although the results can vary from person to person depending on how you interpret your results, it can provide an indication of your stomach acid levels that you can use as a baseline measurement. You can then track changes over time.
First thing in the morning, before eating or drinking anything, drink a solution of 1/4 tsp baking soda mixed with 4 to 6 ounces of cold water. Then time how long it takes for you to burp.
If you have not burped within five minutes, it may be a sign of insufficient stomach acid. Early and repeated burping may be due to too much stomach acid. However, don’t confuse this with small burps from swallowing air when drinking the solution. Any burping after 3 minutes is an indication of low stomach acid levels.
Low stomach acid can be linked to other health issues that have far-reaching consequences. If you think you might have low stomach acid, contact my office to learn more about testing for the following:
B12 levels: Intrinsic factor is a glycoprotein in the stomach necessary to absorb vitamin B12. When stomach acid is too low, intrinsic factor can’t do its job. This results in a vitamin B12 deficiency, which is a serious health concern.
Homocysteine levels: Stomach acid is important for proper absorption of vitamin B12, a key factor in methylation that keeps inflammatory homocysteine at the right levels. When B12 is low, homocysteine elevates.
Supporting healthy stomach acid
Eat your protein at the beginning of your meal to stimulate the digestive enzymes necessary for digesting protein.
Chew each bite thoroughly as food proteins need to be broken down to be properly digested.
Limit drinking liquid until at least 30 minutes after a meal to allow for proper stomach acid production, pathogen sterilization, and protein metabolism.
Stay well hydrated between meals to support proper gut motility. This flushes the contents of the intestines out of the body instead of back into the stomach and is especially important for those who are prone to SIBO.
Take betaine hydrochloride supplements which help support healthy gut function and safely restore normal gastric acidity. (Do not confuse betaine HCl with anhydrous betaine, a methyl-donor nutrient taken to control homocysteine levels.)
Always take the betaine HCL either half-way through the meal or right at the end of the meal. Taking it before a meal may trigger a false experience of heartburn and can turn off stomach acid production for this meal. Caution: Do not take HCL if you are taking any NSAIDs such as ibuprofen, Tylenol, or aspirin.
Add HCl with pepsin to your diet when you consume protein. You will know you are taking enough when you feel warmth in your stomach. Then back it down a notch and monitor your response. Some people need one capsule, others need more. Adjust your dose according to your unique needs.
Consuming pepsin, typically used in conjunction with HCl, is considered very safe when administered to assist digestion.
Use high quality digestive enzymes to to assist your body in breaking down food proteins.
Drink apple cider vinegar, about one tablespoon in a bit of water, right before a meal to help with digestion.
Include fermented foods in your diet such as sauerkraut, kimchi, pickles, pickled ginger, and water kefir. These contain organic acids, enzymes and probiotics to assist with proper digestion. They are also anti-microbial and fight H. pylori which sabotages stomach acid production.
Contact my office to find out how optimizing your stomach acid levels can reduce your symptoms and increase your quality of life.