If you’ve ever experienced heartburn or indigestion, there’s a good chance you were handed a prescription for a proton pump inhibitor (PPI). While these medications are designed to reduce stomach acid and offer temporary relief, they often mask a much deeper problem: low stomach acid. What’s even more concerning is that long-term use of PPIs can contribute to brain health issues and accelerate aging. In this post, we’ll dive into why low stomach acid is a huge problem, why PPIs make it worse, and what you can do to fix it using functional and holistic medicine approaches.
What is Low Stomach Acid?
Low stomach acid, or hypochlorhydria, occurs when the stomach doesn’t produce enough hydrochloric acid (HCl) to break down food properly. Contrary to popular belief, heartburn and indigestion are often caused by too little stomach acid rather than too much. Without adequate acid, food sits in the stomach longer, leading to fermentation, gas, and reflux—which mimics the symptoms of excess acid.
Signs You Have Low Stomach Acid
Low stomach acid can present with a variety of symptoms, many of which overlap with other digestive issues. Here are some key signs:
- Bloating and gas, especially after meals
- Heartburn or acid reflux
- Feeling full for a long time after eating
- Indigestion or upset stomach
- Nutrient deficiencies (especially B12, iron, calcium, and magnesium)
- Weak, brittle nails or hair loss
- Skin issues like rosacea
- Undigested food in stool
- Chronic infections like candida or SIBO (Small Intestinal Bacterial Overgrowth)
Common Causes of Low Stomach Acid
There are several potential causes of low stomach acid, and many are interconnected:
- Chronic Stress: When we’re stressed, the body’s “fight or flight” response reduces stomach acid production, as digestion is not prioritized during perceived danger.
- Aging: As we age, our natural production of stomach acid tends to decline, increasing the risk of hypochlorhydria.
- Nutrient Deficiencies: Deficiencies in zinc and B vitamins—both required for the production of stomach acid—can result in lower HCl levels.
- Poor Diet: Diets high in processed foods, refined carbs, and sugar can lead to poor digestion and decreased stomach acid production.
- Chronic Use of Antacids or PPIs: Ironically, the medications prescribed to treat acid reflux can further suppress stomach acid, creating a vicious cycle of dependency.
- Helicobacter pylori infection: This bacteria can suppress stomach acid and damage the stomach lining, leading to ulcers and chronic low acid levels.
Why PPIs Make Things Worse
Proton pump inhibitors (PPIs) like omeprazole and lansoprazole are commonly prescribed to reduce acid production in the stomach. While these drugs provide short-term relief, they don’t address the root cause of digestive problems and can have serious long-term consequences—especially for brain health and longevity.
1. PPIs and Nutrient Deficiencies
Stomach acid plays a critical role in absorbing important nutrients such as vitamin B12, magnesium, and iron. Long-term PPI use can lead to deficiencies in these essential nutrients, which are key for brain health, energy production, and overall longevity. For example, B12 deficiency has been linked to cognitive decline, memory loss, and an increased risk of Alzheimer’s disease.
2. Gut Health Disruption
PPIs can throw off the balance of your gut microbiome by reducing the acidity needed to prevent bacterial overgrowth. SIBO (Small Intestinal Bacterial Overgrowth) is a common result of low stomach acid, which can lead to bloating, malnutrition, and systemic inflammation—all of which are damaging to brain health.
3. Increased Risk of Dementia
Several studies have found a link between long-term PPI use and an increased risk of dementia. One study published in JAMA Neurology found that regular use of PPIs was associated with a 44% increased risk of dementia in older adults . This is likely due to a combination of nutrient malabsorption, gut health imbalances, and direct effects on the brain.
4. Bone Health and Longevity
PPIs also interfere with calcium absorption, putting long-term users at risk for osteoporosis and fractures, particularly in the elderly. Bone health is critical for maintaining mobility and independence as we age, both of which are important for longevity and quality of life.
Functional Medicine Approaches to Fixing Low Stomach Acid
Rather than masking the symptoms of low stomach acid, functional medicine seeks to address the root causes and restore balance to the digestive system. Here’s what you can do:
1. Test Your Stomach Acid Levels
One simple way to test for low stomach acid is the baking soda test. Mix 1/4 teaspoon of baking soda in water and drink it on an empty stomach. If you don’t burp within a few minutes, it may indicate low acid.
2. Support Stomach Acid Production Naturally
There are several ways to naturally boost stomach acid levels:
- Apple Cider Vinegar: Taking a tablespoon of raw, unfiltered apple cider vinegar in water before meals can help increase stomach acid.
- Lemon Water: Drinking lemon juice mixed in warm water can stimulate acid production before meals.
- Betaine HCl Supplements: Betaine hydrochloride (BHCL) is a short-acting acidifying agent, available over the counter in capsule form that mimics stomach acid and can aid digestion. Mealtime acid supplementation with BHCL has an historic basis and could ameliorate many autoimmune gastritis (AIG)-related gastrointestinal symptoms. Additionally, acidification through BHCL could theoretically reduce the potential for hypergastrinemia and the production of N-nitroso compounds, which have been linked to an increased risk of gastric cancers. By supporting stomach acid levels, BHCL helps restore the natural acidity required for optimal digestion. However, this should only be taken under the supervision of a healthcare provider.
3. Eat Mindfully
Mindful eating practices—such as chewing your food thoroughly, eating slowly, and avoiding distractions—can stimulate stomach acid production. Eating in a relaxed state (instead of when stressed or rushing) also enhances digestion.
4. Improve Nutrient Levels
Zinc and B vitamins are crucial for stomach acid production. Eating foods rich in zinc (pumpkin seeds, grass-fed beef, spinach) and B vitamins (organ meats, wild-caught fish, eggs) can help support HCl production. Supplementation may be necessary in certain cases.
Supplemental vitamin C may also play a crucial role in preventing gastric N-nitroso formation, which can occur regardless of gastric pH. Vitamin C helps neutralize harmful compounds and further supports the protective functions of stomach acid, contributing to a healthier digestive environment.
5. Heal the Gut
Since a damaged gut lining can contribute to digestive issues, healing your gut should be a priority. This may involve:
- Probiotics: To restore balance to your microbiome.
- L-glutamine: An amino acid that helps heal the gut lining.
- Collagen or bone broth: To repair and soothe the digestive tract.
6. Manage Stress
Chronic stress reduces stomach acid production, so incorporating stress management techniques like meditation, yoga, and deep breathing can be essential to restoring proper digestion.
What to Do Instead of Using PPIs
While there may be times when short-term use of PPIs is helpful, it’s essential to address the root causes of digestive issues for long-term relief. Instead of relying on medications that suppress stomach acid, consider these holistic approaches:
- Digestive Enzymes: These can help break down food when stomach acid is low.
- Bitters: Herbal bitters, taken before meals, stimulate stomach acid production and support digestion.
- Fermented Foods: Foods like sauerkraut, kimchi, and kefir help restore the balance of gut bacteria and can aid digestion.
Conclusion
Low stomach acid is a pervasive but overlooked issue, often misdiagnosed as high acid and improperly treated with PPIs. These medications, while providing temporary relief, can have serious long-term effects on brain health and longevity. By addressing the root causes of low stomach acid through functional and holistic approaches, you can restore digestive balance and improve overall health. If you suspect low stomach acid is contributing to your digestive problems, let’s look closer at what’s going on and create a plan. Schedule a free call to start the process here: https://resolvemedical.us/discovery-call/
