Doctors typically treat symptoms of acid reflux, gas, bloating and heartburn with antacids, histamine type 2 receptor agonists (H2 blockers), Proton Pump Inhibitors (PPIs), or even surgery. They also do not use a lab test for stomach acid levels, even though testing exists.

Unfortunately, stomach acid meds worsen the problem for many people.

Antacids lower stomach acid for a temporary time. This causes the stomach to produce more acid to bring it back to its natural pH level. While this brings temporary relief, it does not fix the actual problem.

H2 blockers block a compound that activates the production of stomach acid. They work more slowly than antacids and last longer, however, they inhibit production of pepsin, a digestive enzyme that breaks down food proteins.

Proton pump inhibitors block an enzyme that tells your stomach to produce acid.

All of these methods not only cause serious side effects, but also perpetuate chronic low stomach acid and the larger health conditions that causes.

5 Ways to test for low or high stomach acid

Most people don’t know about low stomach acid, or hypochlorhydria, or that it plays a large role many chronic health conditions.

Fortunately, you can use a variety of methods to test your stomach acid levels. This will better help you remedying gut problems caused by low stomach acid.

1. Gastric acid secretion test.This test is very invasive and expensive. It’s often done for patients with stomach ulcers. It can be used to determine whether anti-ulcer medications are working and whether material from the intestines is washing back into the stomach.
2. The Heidelberg Stomach Acid Test. This test is considered the gold standard test for hypochlorhydria. It involves swallowing a small capsule with a radio transmitter that measures the stomach pH as you drink a baking soda solution, which lowers reduces acidity. If stomach acid does not return it to normal, this is a signof hypochlorhydria.

This test helps you determine if you have hypochlorhydria, hyperchlorhydria (high acid), or achlorhydria (complete lack of acid).

3. CBC and CMP.These are markers on a metabolic blood panel that, in combination with your symptoms, can indicate hypochlorhydria.
4. Betaine HCl challenge.You can do this test at home with betaine HCl capsules bought from the health food store. It’s best to repeat the test three times for the most accurate insight. If you have low stomach acid, taking betaine HCl can boost your own stomach acid production.
5. Buy Betaine HCl with pepsin.
6. Eat at least 6 ounces of meat (veggies are allowed with this).
7. Take one betaine HCl pill in the middle of the meal (not the beginning).
8. Observe what happens when you finish the meal.

Possible outcomes:

1. No symptoms. This likely means you haveml low stomach acid.

2. Indigestion. Burning, heat, or heaviness in your chest likely indicate your stomach acid levels are appropriate.

Repeat the betaine HCl challenge two to three times to confirm your results. Three positive tests is the best way to identify low stomach acids.

You can have a false positive for the following reasons:

• You didn’t eat enough protein, which doesn’t require much stomach acid to digest. As a result, the betaine HCl causes too much acid and symptoms.
• You took the capsule before the meal, which can cause indigestion. Make sure to take it in the middle of the meal.
• A hiatal hernia or poor esophageal sphincter tone can cause indigestion. Rule this out with a medical exam if you suspect it.

5. Baking soda stomach acid test.Though less accurate, this free, at-home test can provide insight into your stomach acid levels. Some people use it to track their stomach acid levels over time.

First thing in the morning, before eating or drinking anything:

1. Mix ¼ tsp baking soda in 4 to 6 ounces of cold water.
2. Drink the baking soda solution.
3. Time yourself for five minutes and track how long it takes for you to burp.

Not burping at all within five minutes may be a sign of low stomach acid. Burping after 3 minutes is also an indication of low stomach acid levels. Early, repeated burping may be from high stomach acid (do not to confuse this with burps from swallowing air). 

Associated tests

Because proper digestion is so important to gut and immune health, low stomach acid is associated with other health conditions:

B12 levels: Intrinsic factor in the stomach is necessary for B12 absorption and doesn’t function when stomach acid is too low. This results in vitamin B12 deficiency.

Homocysteine levels: You need sufficient stomach acid to absorb B12, which keeps inflammatory homocysteine at the right levels. When B12 is low, homocysteine becomes too high.

How to support healthy stomach acid

Eat protein at the beginning of your meal to stimulate digestive enzyme production.

Chew thoroughly. 

Limit liquid intake during meals to allow for proper stomach acid production and digestion.

Stay hydrated between meals to support gut motility so the contents of the intestines do not wash back up into the stomach.

Take betaine HCl with pepsin supplements to support healthy stomach acid levels and overall gut function.

Take your HCL either half-way through or right at the end of the meal — taking it before may create false heartburn and turn off stomach acid production. Caution: Do not take HCL if you are taking any NSAIDs such as ibuprofen, Tylenol, or aspirin.

When you feel warmth in your stomach, that means you are taking enough. Back it down a notch so you don’t have a burning sensation. You may need to lower the dose over time as your natural stomach acid production comes back online. The amount needed varies from person to person.

Pepsin. Typically used in conjunction with HCl, pepsin is a safe aid to digestion.

Digestive enzymes help to break down food proteins. Use a high-quality blend.

Apple cider vinegar. Take 1 tablespoon in a small amount of water prior to eating.

Taking the time to improve your stomach acid levels will make a huge difference in your symptoms and quality of life. Please contact my office for more help.