We’re going to talk about gut health today and how it impacts your GYN health, hormone health, and your overall health. I want to talk about how stomach acid helps you digest your food and what happens when your stomach acid is low. We are going to learn what kind of symptoms you can experience, how to test for it, and most importantly, how to get it fixed and back into balance.

I see this all the time in my practice, women have symptoms of low stomach acid levels. That can look like bloating, belching, upper abdominal bloating and discomfort, or having excess gas right after you eat. You can also have changes in your bowel function like diarrhea, constipation, and indigestion. You can experience fatigue, develop food sensitivities, rectal itching, iron and B12 deficiency, and yeast overproduction. You can even have hair loss from low stomach acid. It can feel like heartburn. You may see weak, peeling, and cracked fingernails. You may also notice dry skin, dandruff, and acne all because of low stomach acid. 

So what the heck is stomach acid?

Our stomach has cells that produce hydrochloric acid. That is what helps break down our foods as well as our digestive enzymes like protease. Having stomach acid is super important to be able to digest your foods. It keeps bad bacteria from overgrowing and getting into your intestines where you don’t want it to be. Hydrochloric acid is important and a lot of us aren’t making enough of it. 

So what has happened over the past 15 – 20 years, is that Big Pharma has really made gazillions of dollars on this whole idea of heartburn because you’re making too much stomach acid. Here’s the problem, you’re not making too much stomach acid, you’re actually not making enough in most situations. And taking the medications like Protonix, Pepcid, Nexium, and Pricillasec, that is supposed to suppress acid production, is actually making your situation worse and making you dependent on those medications. 

What’s Really Happening? 

Normally, when you eat food, you want to do it in a slow and relaxed state. You want your brain to have time to realize that you’re actually putting food in your mouth, you’re digesting it, and putting it into your stomach. Your stomach needs time to create and release pancreatic enzymes, digestive enzymes, and acid from your stomach. The acid and enzymes start to work on the food that your mouth has already started to digest just by chewing. That type of process releases amylase and lipase as a digestive enzyme and then it goes down to the stomach and it keeps working. 

You need that acid to help that process, especially with protein. For example, a steak takes a lot to digest and you need to have adequate stomach acid levels to make that happen. So what happens often is that we’ll eat too quickly and our stomach doesn’t have time to know to make that acid by the time we chew it twice, swallow it when it’s halfway whole still, and it’s in our stomach already. It’s about slowing down while eating, but it’s also about what’s living in our gut.

When we don’t have enough acid, the food sits in our stomachs longer. I hear from patients all the time, “I just feel like food is stuck,” “I feel like it’s in my stomach too long,” “It doesn’t want to leave, I just get bloated,” “As soon as I eat I feel horrible,” and “I get really tired after I eat.” These are all symptoms of low stomach acid. 

When food sits in your stomach a lot longer than it should it’s because it hasn’t been digested enough for your intestines to accept it. So it just sits there. That causes reflux into your esophagus, the tube from your mouth to your stomach. Anything in your esophagus that shouldn’t be there, like undigested food or any stomach acid, feels like heartburn. So what’s really happening is that the food is sitting in your stomach, it’s not being digested because of low stomach acid, it’s eventually being pushed back up into your esophagus, and your esophagus is feeling irritated. So you have this complaint of heartburn. You then get put on this medication to suppress that symptom instead of addressing why that symptom is happening. Why am I feeling heartburn? It’s because you’re not digesting your food in an efficient manner and getting out of the stomach into the intestines to keep going. 

Watch the video version of this blog post here.

The key is to get you digesting and moving that food along. The other big component of that is that our stomach and intestines have to physically contract and move things through. So many things affect our stomach contractions. We have this entire nervous system in our gut called the enteric nervous system. It’s different from our central nervous system. It’s definitely partly controlled by that, but it’s also controlled by hormones, especially our stress hormone, cortisol, and adrenaline. That’s why when you’re really scared or excited, you feel butterflies in your stomach because it can affect that. Or if you have irritable bowel syndrome, what’s happening is that rush of cortisol and adrenaline are stimulating the enteric nervous system to contract and peristalsis. You can experience cramps in your gut and diarrhea. The enteric nervous system is really important to nurture to help function in a proper way so that things can move through your gut. I see women with hypothyroidism which affects their enteric nervous system. There are a lot of things that can affect it so we want to stimulate proper movement and digestion so that you stop having these low acid symptoms. 

Testing for low stomach acid

There’s a really easy way to check for low stomach acid that you can do at home. It’s like the poor man’s test. What you can do is, get a quarter teaspoon of baking soda and 4-6 ounces of cold water. First thing in the morning before you eat or drink anything else, you drink this baking soda and water and see how long it takes for you to have a really good burp or belch. Wait up to five minutes and if you haven’t burped in five minutes, that is a sign of insufficient stomach acid production. 

Baking soda is bicarbonate. Sodium bicarb is very basic on the pH scale. And stomach acid is hydrochloric acid, it’s very acidic, and they’re supposed to balance each other out. So if you don’t burp or belch, you haven’t created that chemical reaction necessary. I would do this at least two or three times to see if you are really burping within 3-5 minutes. Don’t confuse that with the little burps or feelings that you would get just from drinking it. When you first drink it, you might feel little burps of swallowed air, but you’re looking for like a real burp within 3-5 minutes. 

With my patients, I often see low stomach acid look like gut dysbiosis on stool tests. So H. pylori overgrowth, Staph, strep, yeast, Candida and Bacillus, all these species that are supposed to be at lower levels, they get out of control because there’s no acid to kill them off. So that’s another thing to look for is if you’re having recurrent yeast infections, then it could very well be low stomach acid. 

Why does it matter if your stomach acid is low?

It matters because you’re not going to digest your foods appropriately and that can lead to food sensitivities and major vitamin and mineral deficiencies. If you’re working with a functional practitioner, they’ll often look at your blood work like a CBC and a CMP. Those are normal blood tests that a lot of doctors will run. But most conventional doctors don’t look at the levels thinking about stomach acid, they’re looking for outright disease. 

You can see on your blood work certain things like low chloride levels. A chloride level under 100 is often a sign of low stomach acid because HCL is hydrochloric acid and it needs chloride to make that. You can also look at serum protein and globulin levels. If your serum protein is low, less than 6.9 or over 7.4, that could be a sign that you’re not digesting and absorbing your proteins properly. Low phosphorus and vitamin D levels can be a sign of high BUN levels. BUN stands for blood urea nitrogen. Those are waste products that our cells give off that you’re trying to get rid of. So a lack of stomach acid might result in high BUN levels because you have excess waste from poor protein digestion. So if your BUN is over 20, that could be a sign of it as well. 

Also, abnormal red blood cell sizes. So methylation with B 12 is a critical part of your red blood cells maturing in your bone marrow when they’re being made. Inadequate B 12 levels can result in immature red blood cells that end up being larger than they’re supposed to be because that makes them less effective at carrying oxygen. So you don’t want really big red blood cells, you don’t want this abnormal MCV level.

Something else to look for is HCL or stomach acid which is necessary for iron absorption. B12 is one of the key components of methylation. When you’re talking about B12 absorption that stomach acid is critical for your B12 absorptions.That’s an important process that your body does and it keeps your homocysteine levels optimal. You want those to be five-eight. When your B12 levels are low, your homocysteine becomes elevated. Elevated homocysteine is associated with a high risk of cardiovascular events.This all is connected. Gut health determines your overall health.

Intrinsic factor is a protein in your stomach that’s necessary for B12 absorption. I will see a lot of women who have had gastric bypass or stomach surgeries and they don’t make intrinsic factors the way that they’re supposed to. They don’t absorb their B12 efficiently and it’s like a cascade. One thing affects the other and it becomes a domino effect. 

It’s important to know that there are ways to figure out if you have low stomach acid. This can cause you to almost immediately have bloating, gas production, discomfort, and feeling like food sitting in your stomach too long. 

What can we do about it?

First of all, slow down and enjoy your food. Don’t eat in a rush or while you’re walking or driving.  I used to eat running to labor and delivery to catch a baby and I would shovel the food in 2 minutes. I was a master of eating so fast and that really destroyed my health. Eat when you’re relaxed.

Use lemon, apple cider vinegar, or pectin in your water first thing in the morning. You can do a teaspoon of apple cider vinegar and some water and that will set you up for the day. It will tell your stomach, “Hey, we need some acid in here.” Also, stay hydrated throughout the day. Your body needs water to make these chemicals and for these processes to happen. I like to say drink 8-10 glasses of water a day, but not with your meals. Keep your fluids away from your meals as much as possible. If you are going to drink with your meals, try drinking fermented drinks and keep them toward the beginning of the meal because once you have food in your stomach, especially protein, you don’t want to dilute your digestive enzymes and your hydrochloric acid. 

You can also use ginger. Ginger stimulates that enteric nervous system and helps move that food out of your stomach. You can take it as a supplement. That is why, honestly, sushi comes with a side of ginger. It’s very stimulating to your digestive system. The Asians knew what they were doing when they put their food together because they have fermented foods. They have foods to stimulate digestion and peristalsis and to feed the good bacteria.They have food to heal the gut lining. All of that food is all very healing and beneficial to the gut. So like I mentioned, fermented veggies are super good for stomach acid production. 

To Wrap It Up 

I hope this was helpful because if you have low stomach acid and you’re having these gut symptoms, it’s not going to end there. It’s going to lead to food sensitivities, leaky gut, and gut dysbiosis. This can then turn on autoimmune processes and to systemic inflammation which drives things like cardiovascular disease, diabetes, and hormone imbalance. So everything is connected and it almost always starts in the gut. 

If this is an issue for you, do the poor man’s baking soda test and try to get it figured out. If you want to do real testing with me, I would love that as well. Or you can find a practitioner to work with you. But figure this out because this could be a game-changer for you.