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Hey everyone, Miki here. You're listening to Mini Mikkipedia. And I wonder, have you ever felt bloated or heavy after eating a protein rich meal? Or maybe you've dealt with reflux, fatigue or undigested food in your stool. And have you been told that it's a consequence of too much stomach acid causing the problem? Well, what if it's actually not enough? Today we're diving into something most people and even many clinicians actually completely overlook.

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and that is low stomach acid or hypochloridia. And trust me, it is more common than you think. So in this episode, we're going to explore why stomach acid is absolutely essential for optimal digestion, immunity, and even mental clarity. You'll learn about the critical role it plays in breaking down protein, absorbing nutrients, and protecting your gut from harmful bacteria and pathogens. We will discuss the common symptoms that could indicate your acids are too low,

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the causes of it, and then of course the practical steps that you can take to support healthy stomach acid levels naturally. And also, you know, how you know you're on the right track. So if this resonates with you, or if you've been taking antacids or PPIs for years and still don't feel right, this episode could be a little catalyst to get you to explore it deeper. And I got to say that a PPI, a protein pump inhibitor, has never been designed to

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have this chronic use, but I do see it quite a bit in some of my clients that they're on a PPI and there's been no plan to sort of get them off of it, or it's been just something they take for years, and they struggle with some of these symptoms, which I'm gonna go work through. So first of all, when we think about digestion, most people focus on food choices, enzymes, or gut health. But rarely do we stop and think about what kicks off the entire process, and that is,

02:03
after the brain, course, stomach acid. So stomach acid activates enzymes that break protein down. So the hydrochloric acid lowers the pH of your stomach to around 1.5 to 2.5. And this is an acidic environment required to activate pepsin, which is a key enzyme that digests protein. Without enough acid, protein doesn't break down properly, which can lead to bloating, fermentation, and discomfort further down the digestive track.

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So think about HCl like the ignition in your digestive enzyme. Without it, everything would stall. It's essential for nutrient absorption like B12 requires the acid to separate it from the protein in food. Iron converts dietary iron into its absorbable form. Zinc, magnesium and calcium all need an acidic environment to be optimally absorbed. So lower stomach acid does have downstream effects such as

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vitamin and mineral deficiencies, which can influence fatigue, poor immunity, poor wound healing, brittle hair and nails. And your stomach acid is like a natural disinfection. It neutralizes bacteria, fungi and parasites in food. And without it, you're more vulnerable to infections, food poisoning and potentially small intestinal bacterial overgrowth, SIBO.

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And stomach acid signals the pancreas and gallbladder to release enzymes and bile into the small intestine. So if that signal is weak, you may struggle to digest fats and carbs properly too, not just protein. So when acid levels are low, it's like this domino effect. Everything else in digestion starts to break down. And some practitioners call stomach acid the acid switch of the digestive system, because when it's flipped on, everything flows.

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but when it's off, you're basically running on digestive low power mode. So if you're experiencing symptoms like reflux, don't assume it's too much acid, which a lot of people do. Let's dig into the full list of signs that might point to low stomach acid being the real issue. Bloating or feeling overly full after protein rich meals. This is a common symptom as insufficient acid hampers protein digestion leading to bloating.

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burping or gas shortly after meals. Reduced acid can cause improper digestion resulting in exactly that. While acid reflux and heartburn is often associated with excess acid, these symptoms can arise from low acids causing food to ferment and increase intra-abdominal pressure. And also when the food is fermenting in the gut, it will push up whatever acid there is into the esophagus. So that burning feeling you get is very real.

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But the reason for it is different. It's not too much acid. It's because there's too little. Undigested food in the stool, because inadequate acid impairs digestion. So it leads to these undigested food particles. Difficulty digesting protein due to low stomach acid can cause nausea post-meat consumption. Low stomach acid can hinder absorption of B12 and iron, as I mentioned, causing fatigue and subsequent

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Deficiency symptoms, deficiencies in nutrients like iron and zinc resulting from low acid can affect hair and nail health. Infrequent infections can also be a problem because hydrochloric acid is that defense mechanism I just talked about earlier. Bad breath, so due to undigested food fermenting in the stomach and bacterial overgrowth, you can have halitosis. Just that heavy feeling that food sits in your stomach. Bloating can be lowered down, so not just upper stomach.

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This relates to that fermentation further along the digestive tract. Undigested food proteins can trigger an immune response. Poor breakdown might contribute to developing food sensitivities. Fungal overgrowth because of that less acidic environment in the stomach. Poor absorption of micronutrients like B12, iron, magnesium, and zinc can affect cognitive and physical energy, leading to chronic fatigue or brain fog.

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Skin issues. There is some evidence that poor digestion can trigger systemic inflammation and affect the gut skin access. This is more clinical, but some people report that reflux resolves after using betaine HCl, which strongly indicates that reflux was caused by low and not high stomach acid. Betaine HCl is like a digestive, well, not medication, more supplement that you can take with meals.

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You also have this increased risk of that SIBO because the HCl that normally suppresses bacterial overgrowth from the lower GI tract is compromised. And let me also now go back to the idea that reflux is a sign of low stomach acid, because I know that this confuses people. Because I know that you may have been told you have too much stomach acid because you get reflux. And yes, that is absolutely true in some cases, but it's not always true.

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Burning in the chest, reflux or indigestion can cause you to go to your doctor or reach for over-the-counter meds like omeprazole, PPIs or antacids. And these medications often do relieve the symptoms because they lower the acidity of the stomach contents. So it burns less when it comes back up. But as I said, when the acid is too low, food sits in the stomach longer than it should. This causes fermentation and gas which increases pressure in the stomach.

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This pressure can force the lower esophageal sphincter to open, sending stomach contents upwards, acid included. So it's not that you have too much acid, you may have just enough, but in the wrong place. And how do you know the difference? And the reality is there are no at-home blood tests or anything that you can do, but there are some clues. So does your reflux happen after high protein meals? Do you feel bloated or gassy shortly after eating?

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Do you feel better with apple cider vinegar or lemon water before a meal? Because that can indicate low stomach acid. And did your reflux improve with a PPI? But now you've noticed other issues like fatigue, poor digestion, or food sensitivities. So that can point to a deeper problem that is being masked. So some practitioners even use that Betaine HCL challenge test to determine if low acid is an issue. And if you're

08:39
If the HCL does improve the symptoms, it is a pretty strong clue. What I will just say is this is best done under the guidance of a health professional, a naturopath, nutritionist, dietitian who really work in these areas, functional doctor. And I wouldn't necessarily suggest you just do this yourself, albeit if you try it at home, it's a pretty good indicator to tell you whether or not it is going to be helpful. So betaine HCL is, as I've mentioned, that supplemental form of hydrochloric acid.

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So it mimics the acid of your stomach, which your stomach is supposed to produce. And it's typically paired with pepsin, which is the enzyme that digests protein. Again, this isn't a diagnostic test and it should be done under supervision. Ideally, particularly if you have ulcers or on NSAIDs, you just wouldn't want to be doing this without the support of your doctor. Start with a high protein meal, something like chicken, steak or eggs, obviously. Take one capsule of Betaine HCl with the first few bites.

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Monitor for a warm sensation, a mild burning or discomfort in your stomach or chest area. If that happens, it likely means your stomach acid is adequate and the extra HCl is too much. If you feel nothing, it may suggest your acid is low. At your next protein heavy meal, increase to two capsules, then three and so on, up to a typical max of around five to seven caps until you feel that warmth. Again, ideally you would do this under guidance.

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Once you've reached that threshold dose, reduce by one cap, because that's often the amount your body needs for support. But let me reiterate these important cautions. Do not try this if you're on PPIs, have been diagnosed with ulcers or gastritis, or are prone to reflux unless under guidance. Always work with a practitioner. And this isn't meant to be a long-term fix. It's just a tool to give you insight. So the test.

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It can suggest low stomach acid if you need multiple caps before you feel anything, and it may confirm suspicions when other signs are present, like the bloating, the fatigue, the poor protein digestion. But what it can't tell you is why your stomach acid is low. It won't uncover underlying causes like H. pylori, nutrient deficiencies, or stress-related suppression of stomach acid. So let's actually discuss it in a little bit more detail. What actually causes low stomach acid to begin with?

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and why does your body actually stop producing it? So the first one is chronic stress. This is a huge one actually. Stress directly impacts the parasympathetic nervous system, which is the rest and digest branch. If you're constantly in vital flight mode, your body isn't prioritizing digestion. So you get this decreased stomach acid production, poor enzyme output, and slower gastric emptying. So when you're rushing through meals, scrolling your phone, or eating on the go,

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your body literally doesn't get the memo to produce acid. Aging is another one, and unfortunately nothing you can do about. As we get older, especially beyond 60, your stomach acid production naturally declines. It's estimated that around 30 to 40 % of people over 60 may have hypochloridia. And yet, so many are still being prescribed antacids, which only make the problem worse. H. pylori is a common bacterial infection.

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which is another cause of low stomach acid and it can damage acid producing cells in the stomach lining. It is associated with gastritis, ulcers, and eventually low acid levels, and it's often asymptomatic. It's also surprisingly common, affecting up to 50 % of people globally. Medications also suppress stomach acid like proton pump inhibitors, PPIs, omeprazole.

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Linzoprazole, these are designed to reduce acid but long-term use can suppress it too much. And that's the issue for any medications that do that, it's the long-term use which is an issue. Antacids and H2 blockers like renitidine can also interfere with stomach acid production. And even non-steroidals like ibuprofen can damage the stomach lining and affect acid secretion indirectly.

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So these medications are useful short term, but when used long term without addressing the why, they can contribute to the problem. Nutrient deficiencies. You need zinc and B vitamins, especially B1 and B6 to produce hydrochloric acid. Deficiencies can arise from poor diet, restrictive eating, alcohol, or even low stomach acid itself. So of course that's a vicious cycle because stomach acid is required to help you absorb these nutrients.

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Zinc is involved in enzyme activity in the cells of your stomach lining which actually help produce stomach acids. So zinc is a particularly important micronutrient. We also have autoimmune conditions including pernicious anemia which can drive low stomach acid production. Autoimmune gastritis or conditions like Hashimoto's can damage acid producing cells and pernicious anemia involves antibodies that block intrinsic factor.

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This impairs both B12 absorption and acid output. Our eating habits and behaviors can also influence it. Eating too fast, not chewing food properly, drinking lots of water during meals, eating while distracted or stressed. All of these reduce the cephalic phase of digestion where your brain preps the stomach for incoming food. And there is some evidence to suggest that if you're not regularly stimulating your stomach acid with

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protein, acid production may down regulate over time. And this is why people on plant-based diets or low protein diets often struggle to increase their protein intake because there's just been this down regulation of stomach acid production. Excessive fiber plus low acid will also contribute to more fermentation and bloating. So it's really just one cause. For most people, it's a combination. Years of stress, aging, poor eating habits, maybe some new

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nutrient gaps or medications, this will slowly erode the foundational part of digestion. And the good news though, it's not a one-way street. So you can actually do things to support healthy stomach acid naturally and safely. So let's break these down into lifestyle, dietary and supplemental strategies. First, let's activate the rest and digest response. And for what it's worth, there are the likes of Dr. Chris Kresser,

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Dr. Michael Ruscio, and of course, Rob Wolf, who taught a lot about hyperchloridia over the years. And this is where I've gleaned a lot of information from. Chris Masterjohn would be another one as well. So you cannot digest well if you're in this fight or flight mode and always in sympathetic drive. Supporting the parasympathetic nervous system before and during meals is one of the most effective and free ways to improve your stomach acid production. Take five to 10 deep

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belly breaths before eating, avoid eating in the car, at your desk or while scrolling your phone. Also, you know, say a quick blessing or take a mindful pause. Do anything that signals to your body that food is coming and you're in a position to take it on board. Second of all, eat protein at the start of the meal. And Rob talks about this a lot in relation to the ancestral eating pattern. Starting a meal with

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protein helps stimulate gastrin, is a hormone that tells your stomach to make more acid. Plus, it does prevent the potential blood sugar spike that you get from starting your meal with carbohydrate, which is an added bonus. There are some natural acid supports that you've probably got in your cupboard at home. Apple cider vinegar diluted in water before meals, about one to two teaspoons in a small amount of water, will help stimulate your stomach acid. Similarly, lemon juice can help

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the stomach as well in the similar doses. Be mindful of course of rinsing your your mouth out with just water afterwards just to reduce the acidity on the teeth enamel. But if you have ulcers or active reflux I wouldn't advise to use these two tools. Digestive bitters is another one that can also help. Bitters like gentian, dandelion root or Swedish bitters stimulate saliva, bile and acid production.

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These can be helpful for anyone with sluggish digestion, not just stomach acids. And you'd take about 10 to 15 drops in water about 10 to 15 minutes before meals. And you can pick these up at the likes of IE Produce, Natural Medicine, Herbal Shops, Common Sense Organics, Naturally Organics, Harvest Whole Foods, a bunch of places will actually have these products.

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As I discussed earlier, number five on my list is the B-Tain HCL to do under practitioner guidance. Number six, slow down, chew more. So can you chew your food 20 to 30 times per bite? To be honest, I don't know that I can, but you should give it a go if you've got issues with your stomach acid and digestion. Chewing activates enzymes and tells your stomach what's coming in. And it is super easy to overlook, but it is one of the most effective tools to support

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the cephalic phase of digestion. And you do really want to slow down your meals. You don't want to do what I have in years gone by. I've sort of shoveled my food in and had to swallow because I'm too fast at putting my fork up to my mouth. And so I haven't even finished chewing, but I see this incoming fork and I swallow and it's only then that my brain goes, hang on, you didn't even chew that. So if you're anything like me, actually putting your cutlery down in between bites can be really helpful. Tip seven is don't

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over hydrate with meals. So drinking lots of water, especially cold, some suggest it can dilute stomach acid and enzymes. And look, I've never seen research to support that, but it certainly does make it more likely that you sort of wash down your food and you haven't really chewed it properly. So aim to absolutely be hydrated through the day, but just keep fluids light around your meal time. Number eight is repleting nutrients that support acid production.

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So zinc is often depleted in those with long-term low acid or stress. B vitamins such as B1 and B6, especially for HCl production. You do want to be mindful though, you don't want too much B6. So sort of a maximum of 50 milligrams from any of your B vitamins you might be taking. Magnesium also supports enzyme function and gut motility. But of course, if we're thinking about food first, we're thinking about shellfish, meat, leafy greens, eggs, legumes, nuts and seeds.

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Number nine is addressing underlying issues like H. pylori. So don't just throw supplements at the problem. If H. pylori is present, it really should be treated, ideally confirmed via a stool antigen or breath testing. And then you work with a practitioner to eradicate the issue, like a really good naturopath or doctor. Also, let's think about supporting the gut holistically. And this is tip number 10.

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Low stomach acid often comes with SIBO, dysbiosis, or leaky gut. So you do want to focus on whole foods, removing those ultra processed junk and rebuilding from the ground up. And this is where that practitioner support can be really helpful because you sort of need to eliminate plus then heal the gut with some of the supplements I suggested, bone broth, collagen, maybe some MSN, maybe some curcumin to help dampen down inflammation.

20:14
Low stomach acid doesn't just impair digestion, it does actually alter the entire ecosystem of the gut. And so that is why over time it does lead to some of those dysbiosis, leaky gut, SIBO issues I was just mentioning. And further suppression of stomach acid can also occur because of the chronic inflammation or bacterial byproducts and there is an increase in gut permeability.

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So low acid isn't just a symptom, it can cause and sustain dysfunction throughout the entire gut. Now interestingly, there are some genetic influences on acid production as well. So some people may have polymorphisms in genes involved in acid secretion like ATP4A-B, which affects the parietal cell function of the gut. You will only know this if you've actually had a genetic test.

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It is not widely discussed in mainstream functional circles yet, but it is worth flagging for genetically curious or those doing those nutrigenomic testing. And let's not forget circadian disruption and acid secretion. So acid secretion is partially governed by body clock, melatonin and cortisol both influence digestive secretions. And this is why people who are night owls, shift workers or poor sleepers may have impaired stomach acid rhythms. So

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we really have to think about tying in overall sleep hygiene and light exposure, which are topics that we've already discussed in Micropedia, both in mini Micropedia episodes and of course, in my interviews with Greg Potter, I he was one of the very early ones, and Alex Bartle more recently. There is also the brain, gut axis and emotional suppression. Yes, we've talked about stress already, but there is this emotional aspect of digestion.

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and a growing body of research of how suppressed emotion, trauma, or chronic tension can down-regulate the vagal tone and hydrochloric acid output. There are somatic practices such as vagal nerve stimulation like gargling, cold exposure, or singing, which may help. And I would definitely recommend if you think you fall into this camp to exploring this a little bit further. Menstrual cycle impacts. This is super interesting. So, it was not directly studied in HCL production.

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Many women report more bloating or reflux around their luteal phase. Possibly this is due to a slower gut transit, maybe due to fluctuating progesterone. So what I would suggest that you do is to track symptoms in relation to cycle timing. And it could be that you need to pull out certain foods or really hone in on some of these strategies that I've been talking about to help assist digestion during that luteal phase. Number six is sodium intake. And chloride is part of hydrochloric acid.

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and many low sodium diets can impair acid because salt is sodium chloride. So have a think about that, your salt intake in relation to acid production. And then lab markers may suggest you have low stomach acid as well. So there are no direct HCl blood tests, but clues in your labs might be a low serum B12, low ferritin, elevated homocysteine, high MCH or MCV, low chloride,

23:28
That's pretty rare, but it is possible. And these may be a helpful tool for you as a practitioner to help your clients sort of undercover some of these underlying issues. And then you know what, these are just, if I think about the way that we sort of eat these days, long-term plant-based eating without supplementation, excessive chewing gum, which increases saliva and dilutes acid, chronic antacid use starting in childhood. And I know there are

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probably many children, people who are a whole lot younger, where it's much more prolific to sort of give across sort of medications. And then bariatric or stomach surgery, which limits the absorption of certain nutrients. So the key takeaway here is that low stomach acid isn't just about fixing your digestion. It's about restoring a foundational part of your entire metabolic health with some simple habits, the right nutrients, and a bit of self-awareness.

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you can absolutely turn it around. The last thing I want to sort of leave you with is a little bit of a rapid fire myths around stomach acid because there is a bit of confusion out there. So here are things that I hear. Myth one is that heartburn is too much stomach acid. And I hope you know now from listening to this that that's not always the case. Myth two is that PPIs are long-term fix for reflux. Look, the PPIs reduce symptoms but certainly do not fix the root cause.

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and long-term use can worsen nutrient deficiencies, lead to lower stomach acid over time, can also impact negatively your metabolic health. Myth three is, if I don't feel acidic, I must have enough acid. Many people with low stomach acid don't feel anything unusual until they try to digest a steak and end up feeling bloated, fatigued, or foggy. Low acid can absolutely fly under the radar for years. Myth four, reflux is a disease, not a lifestyle issue.

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Hey, stress, eating habits, nutrient gaps, and infections like H. pylori all play a role in acid production and reflux. It's often a functional issue, but it's not a permanent defect. Myth five, more acid is always better. Well, I mean, you want your acid just right, enough to break down food and signal downstream digestion, but not so much that you're damaging the gut lining or triggering symptoms. Let's work on restoring balance. Myth six, it's dangerous to supplement with HCl.

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When done carefully with practitioner guidance, B-Tain HCL is one of the most effective tools for storing healthy stomach function. The real danger is ignoring the problem for years. stomach acid is absolutely essential for digestion, nutrient absorption, and immune defense. Symptoms like bloating, reflux, fatigue, and undigested food may not mean too much acid, but not enough. Common causes include stress, aging, medications,

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nutrient deficiencies and infections like H. pylori. You can absolutely support your digestion naturally by slowing down before meals, chewing well, eating protein first, using apple cider vinegar or digestive bitters, and if appropriate, trialing betaine HCl with professional guidance. And finally, more acid isn't always bad, and long-term suppression of acid often leads to even more problems down the line.

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So if you've been struggling with digestion, fatigue, or other sort of symptoms that I've mentioned and haven't really gotten to the root cause, have a look at your digestion and have a look at your stomach acid. All right, team. So hopefully that was insightful for you. Let me know. You'll find me on Facebook @mikkiwillidennutrition, on threads, Twitter, and Instagram @mikkiwilliden. Or head to my website mikkiwilliden.com. And I've got that vegetarian webinar coming up.

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Absolutely, if you're a vegetarian, want to tune into that because this is a topic which we will absolutely discuss. All right, team, have the best week. See ya.