If you struggle with heartburn or GERD (Gastroesophageal Reflux Disease), you are not alone. Sadly it is estimated that over 60 million Americans struggle with heartburn at least once a month and over 15 million struggle with it daily. But did you realize that this is a sign that you are not digesting properly and can negatively impact your performance and recovery?

The most common treatment of heartburn and GERD are PPIs (proton pump inhibitors) which include brands like Prilosec, Nexium, and Prevacid. This class of medications inhibit the production and secretion of stomach acid from the lining of the stomach. While they can be very effective at managing symptoms, they are really like sticking a Band-Aid on a gaping wound! You temporarily cover up the problem but you are NOT addressing the root cause. In fact, long term use will make it much, much worse! PPIs are meant to only be used for a short duration (<14 days); however, all too often patients are left on them for months or years – wreaking havoc on their digestive process and their health!

Stomach Acid 101

Stomach acid consists of hydrochloric acid (HCl). When food is eaten, gastric juices (HCl) are released from the stomach lining. The HCl brings the stomach acidity down, which triggers the release of a protein digesting enzyme (pepsinogen).

We can think of the stomach as a disinfecting antechamber where the acidic HCl ‘washes’ the food we eat and is the first line of defense for prevention of pathogens. It also breaks down protein into its digestible amino acids. If this process is not working properly, you will not absorb the amino acids and micronutrients from the protein you eat!

Only once the pH of the stomach reaches 1.5 – 3 (this is VERY acidic) does the pyloric sphincter into the first section of the small intestine open so digestion can proceed. If this is delayed due to low stomach acid (hypochlorhydria), your food will churn in your stomach causing belching, discomfort, heartburn, and possibly acid reflux.

Causes of Low Stomach Acid

Age – The older we get, the less HCl our bodies produce. Unfortunately, the older we get, the more our protein needs increase¹. This disparity can be a recipe for disaster if we are already producing less due to some of the other issues below.

Chronic Stress – Stress puts our nervous system in a sympathetic state (fight or flight) which basically shuts down the non-critical functions in our bodies. This includes the production of our digestive enzymes and stomach acid.

Helicobacter pylori (h. pylori) infection – This gram negative bacterium can infect the lining of the stomach and gone unchecked can lead to gastritis, peptic ulcers or even cancer. In fact, it is now classified as a carcinogen². Most people dealing with GERD or acid reflux typically have an h. pylori infection which will need to be addressed for the benefit of your long term health. H. pylori damages the stomach lining cells which are responsible for secreting HCl, so it will negatively impact production of HCl. This then creates an environment that allows for h. pylori (and other pathogens) to proliferate. As discussed above, the low acid environment is our first line of defense and is needed to protect us from all pathogens!

If you need to eradicate h. pylori, I recommend working with Holistic Nutrition Professional (like myself) or Functional Doctor as they will work with herbals first. It can take over a year to recover your microbiome from just one round of antibiotics, so I always recommend to start with herbals first and only recommend resorting to antibiotics if absolutely necessary.

A (chronically) Low Protein Diet – If you regularly do not consume enough protein, your body starts to shutdown the release of HCl. The body is smart and only releases enough to breakdown the amount of protein we eat. So, if you are always eating very low protein, the body will not expend the energy needed to bring down the pH of the stomach. Over time, this leads to low stomach acid which puts us at risk for more pathogens and lack of nutrients.

Nutrient Deficiencies – A number of nutrients are essential for maintaining proper acidity of the stomach. If you are not eating a diverse diet, or if you are struggling with a gut imbalance, you may not be absorbing enough of these nutrients to support a optimal HCl level in the stomach.

Some nutrients include: chloride, sodium, potassium, zinc, B vitamins (especially B6 and B12), choline, magnesium, and iron. Notice that many of these are electrolytes. This is why maintaining proper mineral levels and hydration are key to digestion! Also, if you are low in zinc and B vitamins due to low protein consumption (see above), this creates a negative feedback loop in the body. You need to support digestion to correct this!

Dilution – If you drink a large amount of water right before or during your meals, you are diluting your stomach acid and hindering its ability to do the work! Sip water at meals and drink the vast majority of your water away from meals.

Tips To Support Optimal Stomach Acid

Often times, you need some supplemental HCl and upper GI support to correct heartburn and GERD. This should be done along side a holistic practitioner.

However, here are some places to start on your own:

• Eat adequate protein at each meal (minimum of 20 grams, but target 30+ grams/meal). If you eat little protein now, slowly build up to this.
• Sip water around and during meal time. Drink the majority of your water away from meals to avoid diluting your stomach acid.
• Encourage stomach acid production with an apple cider vinegar or lemon juice “shooter” prior to meals (1-2 Tbsp + 2 Tbsp water taken in one gulp).
• Support digestion with digestive bitters and/or digestive enzymes.
• Eat in a non-stressed (parasympathetic) state for optimal release of digestive enzymes. Start each meal with 3 deep breaths and/or prayer or gratefulness practice.

Ways a Nutritional Therapy Practitioner Can Help:

• Work with you to identify and address any gut imbalances (dysbiosis) like an h. pylori infection. A simple at-home stool test like the GI-MAP is a tool I use regularly with clients to identify imbalances.
• Guide you through a HCl Challenge to find your ideal level of supplemental HCl support until your body optimizes production again.
• Give you supplement recommendations that can support upper GI healing from chronic acid reflux and/or GERD.
• Work with you to address nutrient deficiencies.
• Give you tools for addressing stress.

If you still don’t know where to begin, reach out! We can figure this out together!
Click HERE to book a free Discovery Call Today!

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1. https://cdnsciencepub.com/doi/10.1139/apnm-2015-0550
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2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678392/#:~:text=Helicobacter%20pylori%20(H.,and%20advanced%20gastric%20cancer%20consequently.
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