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I’m a pretty mild-tempered gal. If you ask the folks who know me best, they would agree that it takes a lot to get me riled up. But sit me down in front of a commercial for an acid-blocking drug, and you’ll witness my Aries fire flare forth in an uncharacteristic way, complete with sarcastic back-talking to the TV and some mean-spirited fist-shaking. It freaks my husband out.

Even though none of us at Healthful Elements is anti-medication, the acid blocker industry is especially irritating because, more often than not, it’s simply not helpful – and potentially harmful – to a mind-boggling number of people. 

Acid blockers are the third most commonly prescribed class of medications in the country, according to Dr. Mark Hyman, and while we believe these prescriptions should be written with great care, the hard truth is that these drugs are often prescribed without hesitation and certainly without sufficient patient education regarding potential repercussions.

In our health coaching practice, we’ve seen countless cases where our clients, who are well-educated and well-meaning, tried a Proton Pump Inhibitor (PPI) and subsequently added to their laundry list of health concerns.

Most people get their hands on an acid-blocker or PPI because they’re seeking relief from acid reflux, heartburn, or GERD and have been led to believe that excess stomach acid is causing their symptoms. So they’re offered a solution in the form of a pill like Nexium, Prevacid, or Prilosec that prevents the cells in the stomach lining from producing acid.

Poof. Problem solved, right? Not so fast.

Stomach acid is important. Really important. Our digestive system isn’t meant to be a watery pool, it’s meant to be highly acidic so that we can thoroughly break down food, especially protein-rich foods. It’s also necessary for the adequate absorption of important vitamins and minerals, such as calcium, magnesium, zinc, iron, and Vitamin B₁₂ which, among other things, supports good bone health. A B₁₂ deficiency can also contribute to depression, neuropathy, memory problems, digestive issues, and more.

Dr. Gerard Mullin, author of The Inside Tract, has done his homework. He reports, “Since 2010, the Food and Drug Administration (FDA) has issued several warnings associated with long-term or high-dose use of PPIs, including: an increased risk of bone fractures, risk of low magnesium levels, and risk of Clostridium difficile-associated diarrhea – a potentially life threatening condition that is of particular concern to the elderly and immunocompromised.

“Since acid provides natural antibacterial properties, the lower stomach acid levels in adults over 60 already makes this group particularly vulnerable to infections. The combination of low stomach acid levels and daily PPI intake increases the risk of infections such as pneumonia, which can be very dangerous in older adults and other immune-suppressed individuals.

“The naturally acidic environment in the stomach also provides a protective barrier against pathogens. Lowering acid production through the use of PPIs, however, can erode this barrier and increase the risk of gastrointestinal infections from food-borne bacteria.”

Inadequate stomach acid (achlorhydria) is also critical to address in those with Hashimoto’s. Firstly, the thyroid is very protein-dependent. Secondly, nutrient depletions are common for those with any manifestation of autoimmunity and if digestive acids are lacking, it can be difficult to nourish the thyroid, as this gland is dependent on many of the vitamins and minerals listed above.

Finally, without adequate stomach acid, the bacterial imbalance in our gut gets all wacky, leading to conditions like Candida (yeast) overgrowth and SIBO (small intestinal bacterial overgrowth). Candida has been shown to up the ante on Hashimoto’s and with SIBO, as the name implies, too much and/or the wrong kinds of bacteria work their way into the small intestine where they don’t belong, causing a whole array of unpleasant symptoms, including the production of immune antibodies. A true domino effect. I could go on, but I think you get the point.

Here’s a mind-bender for you: chances are, if you have any of the following gut symptoms, you may actually have low stomach acid, especially if you’re over the age of fifty (stomach acid naturally and consistently declines with age):

• Undigested food in your stool
• Excessive burping
• Bloating
• Constipation
• Gas
• Heartburn

The idea that these symptoms could be caused by low stomach acid is contrary to what most of us have been told our whole lives and the reason I become a raging lunatic when I see one of those commercials. (Of course, there are cases where some really do have an excess of stomach acid; however, those cases are few and far between.)

If any of the above symptoms describe you, it’s time to get sleuthing. As usual, the solution is typically multi-pronged and takes some committed detective work to uncover, but the rewards are big.

Here are some of our best tips for assessing your stomach acid level, addressing the symptoms above, and generally restoring balance to your digestive system:

1. Take the HCl (hydrochloric acid) challenge: The HCl challenge is an easy and reliable way to test whether you have adequate stomach acid. You can either take HCl capsules or drink raw apple cider vinegar in some water with a meal. The idea is to start with a low dose (1 capsule or 1 tablespoon of apple cider vinegar in as little water as possible to get it down), then monitor yourself for sensations of warmth in your belly – the signal that there’s enough stomach acid. If there’s no warmth with a low dose, increase slowly by one capsule or tablespoon of apple cider vinegar, per meal, until you achieve the sensation of warmth. Then work your way back down again. (Note: do not exceed 6 capsules or 6 tablespoons.)
2. Uncover food sensitivities through an elimination diet: Food sensitivities are notorious for causing digestive upset, heartburn, and reflux. Over time they can disrupt one’s stomach acid balance and cause wear and tear on the lining of the digestive tract. The most common culprits are gluten, dairy, eggs, soy, corn, sugar, and nightshade vegetables, although citrus, nuts, shellfish, spicy foods, and fried foods are also common culprits. Experiment with removing these foods from your diet and observe your body’s response carefully.
3. Work toward a healthy body weight: We know, it’s easier said than done, but without the pressure of extra weight around one’s middle, reflux often subsides naturally.
4. Experiment with some helpful targeted supplements: High-quality probiotics, DGL (deglycerized) licorice, and glutamine all help heal the digestive system and restore balance.
5. Stay away from alcohol, caffeine, NSAIDs, and nicotine for a few weeks: These are common triggers and can cause some significant wear and tear on the lining of the digestive system. Give yourself a significant break from these irritants (we don’t suggest you go back to smoking or chewing tobacco!) and see how your body responds.
6. Manage stress: What do you need to relax (besides three glasses of wine)? Experiment with breath work, journaling, exercise, or more sleep until you find the combination of tools that helps you find your own calm center.

This list is by no means exhaustive, but it’s a good place to start. Please remember that sustainable solutions usually take a little time, but the end goal is to ultimately discover the root of your symptoms and correct that, not simply cover up your symptoms.

As health coaches, we never take people off of medications, nor do we suggest people quit their medications. If you’re on an acid-blocking drug, and you’re rethinking your choice because of what you’ve learned, please schedule a conversation with your doctor to enlist his or her help.

If you made it to the end of this blog post, we appreciate you going on this acid trip with us. Who knew that stomach acid could be such a game-changer?