Dr. Paul Deglmann
Meghan Feir Walker
If you regularly feel bloated or heavy after eating, suffer from acid reflux that doesn’t improve with PPIs or antacids, and have other digestive problems, you could be experiencing low stomach acid symptoms.
Low stomach acid production (hypochlorhydria) is a bigger cause of digestive distress than people realize. While many patients and doctors assume an overabundance of stomach acid causes digestive issues, the majority of the time, these problems are actually due to the opposite occurring. I commonly see digestive symptoms in my clinic caused by low—not high—stomach acid production.
Low stomach acid symptoms can greatly impact daily life and sleep quality, which is why it’s imperative to discover and address why your body isn’t producing enough stomach acid.
In this article, we’ll cover the role of stomach acid, signs and symptoms of low stomach acid, common causes, and practical ways to support digestion naturally.
Key takeaways:
| Low stomach acid can cause bloating, reflux, and fatigue that often mimic high acid production symptoms. |
| Low stomach acid is commonly linked to stress, aging, poor diet, or long-term acid-suppressing medication use. |
| Simple habits like eating slowly, chewing thoroughly, and adding protein or bitter foods can naturally boost acid production. |
What stomach acid does and why it matters
When you don’t produce enough stomach acid, you can develop far more problems than just acid reflux or heartburn.
Healthy levels of stomach acid are essential for digestion, nutrient absorption, microbial balance, and overall health. Low levels can lead to small intestinal bacterial overgrowth (SIBO), parasitic infections, and nutrient deficiencies, which can cause a wide range of additional symptoms and issues throughout the body, including fatigue, anemia, weak nails, thinning hair, neuropathy, etc.
Stomach acid naturally helps the body:
- Digest protein
- Activate digestive enzymes and signals to the gallbladder to release bile
- Absorb nutrients, especially B12, iron, zinc, calcium, and magnesium
- Protect against harmful microbes and control the bacterial load in the digestive tract
Symptoms of low stomach acid
When stomach acid levels are too low, food lingers in the stomach, causing these common digestive symptoms:
- Bloating or gas shortly after eating, often mistaken as having “too much acid”
- Frequent burping within minutes of meals
- Feeling full or heavy after a small meal
- Reflux or heartburn that doesn’t improve with antacids
- Undigested food that’s visible in your stools
- Constipation or irregular bowel movements
- And a higher chance of developing SIBO and parasitic infections due to not having enough stomach acid to control the bacteria and parasites
Low stomach acid levels also contribute to nutritional deficiencies. These deficiencies can lead to:
- Fatigue or low energy due to reduced absorption of B12 and iron
- Brittle nails, thinning hair, or dry skin
- Pale skin or dark under-eye circles
- Muscle cramps or weakness
- Frequent infections or lowered immune resilience
- Brain fog, poor concentration, or changes in mood
These symptoms often occur simultaneously, which is why people bounce from one remedy to another without results. They aren’t getting to the root of the issue.
If you are experiencing frequent bloating, belching, or reflux unresponsive to medication, early fullness and indigestion, fatigue, signs of nutrient deficiencies, and/or you're finding undigested food in stool, it’s time to consider low stomach acid production as a potential issue.
What causes low stomach acid
Low stomach acid can be caused by several things, including:
1. Chronic stress
Stress shuts down the parasympathetic, “rest and digest” system. When you're in a fight-or-flight mode, stomach acid production drops. Ongoing stress is one of the most common causes of low stomach acid production I see in my practice.
2. Aging
Acid production naturally declines with age, which is why people in their 40s, 50s, and beyond often start experiencing changes with their digestion.
3. Long-term PPI use
These medications reduce acid by design. But long-term, they can leave people with the exact symptoms they're trying to fix—bloating, indigestion, nutrient deficiencies, and even more reflux.
4. H. pylori infection
This is a gram-negative bacteria that can damage the cells in the stomach that produce stomach acid.
5. Low-protein diets & nutrient deficiencies
Not eating enough protein, or being low in zinc and B vitamins, reduces the body’s ability to make stomach acid. So load up on healthy, protein-rich meals with vegetables.
You may also have altered stomach acid production due to past stomach surgeries or structural digestive changes.
How to support healthy stomach acid function
The following mealtime and lifestyle habits can help you naturally produce more stomach acid.
Simple eating habits:
- Eat slowly
- Chew thoroughly
- Start meals with protein to stimulate the release of stomach acid
- Avoid large amounts of liquids during meals
- Add bitter foods or digestive bitters before eating
Lifestyle habits:
- Reduce stress before meals
- Avoid eating while rushed, multitasking, or in the car
- Allow time for meals and rest
Functional medicine strategies:
- Work with a practitioner to evaluate nutrient levels or microbiome imbalances
- Under the guidance of a functional medicine practitioner, see if digestive enzymes or betaine HCl support is appropriate for you. If you cannot swallow large tablets, you might be able to use apple cider vinegar or bitters before eating.
Ready to balance your gut? We can help
If you’re dealing with ongoing bloating, reflux that never improves, fatigue, or nutrient deficiency issues, low stomach acid might be the root cause. This is something we regularly help patients identify and correct.
By learning more about your gut health and the reasons why it’s been impacted, you can take proactive steps toward enhancing your whole-body health and overall quality of life.
Are you ready to improve your gut health? Read more on our blog about gut health, or schedule your free 15-minute consultation with Dr. Paul to explore a personalized, functional approach for a helpful and effective path to recovery.
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