Do You Have Low Stomach Acid? Signs, Testing Reality Check, and Evidence-Based Remedies (2026 Update)

Written by Heidi Moretti, MS, RD, CLT — registered dietitian, Certified LEAP Therapist, and 25+ year clinical researcher. Founder of The Healthy RD. Updated July 2026 with current research.

Could low stomach acid be causing many of your health issues?

Absolutely — and it’s one of the most misunderstood topics in digestive health.

Stomach acid doesn’t get the attention it deserves, which means a lot of people are struggling with symptoms they’ve never connected back to their stomach. In fact, most people who assume they have “too much” stomach acid actually have the opposite problem.

In this post, you’ll learn what stomach acid actually does, how to recognize the signs of low stomach acid, what the research says (and doesn’t say) about at-home testing, and which remedies actually have evidence behind them.

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Functions of stomach acid

When food enters the stomach, it should be very acidic. A normal stomach produces several quarts of gastric fluid a day, most of which is hydrochloric acid.

The pH of the stomach is supposed to sit around 1–2, which is even more acidic than lemon juice.

Here are the roles stomach acid plays in the body:

• Kills unwanted germs and bacteria and helps prevent foodborne illness
• Stimulates the intestines and pancreas to release enzymes for digestion
• Breaks down proteins so amino acids can be absorbed
• Essential for vitamin B12 absorption
• Helps the body absorb calcium, iron, magnesium, and other minerals
• Signals the stomach to release its contents into the intestines at the right time, which helps keep food from flowing back into the esophagus

When you’re low in stomach acid — a condition called hypochlorhydria — this whole chain reaction breaks down. Current estimates suggest roughly 2–12% of people have hypochlorhydria, and it becomes far more common with age: only about 2% of younger adults are affected, compared to up to 12% of people in their 70s.

Because the stomach’s acid signal is also what triggers the valve into the small intestine to open properly, low acid can allow stomach contents (and the acid that is present) to move the wrong direction — back up into the esophagus. This is part of why some cases of “acid reflux” are actually rooted in too little acid, not too much.

In short: stomach acid is what unlocks the nutrients in your food. Without enough of it, your whole body can end up nutrient-starved, even if you’re eating well.

Related: Low Stomach Acid & Hair Loss: The Connection and Potential Remedies

What causes low stomach acid?

By getting to the root cause of your low stomach acid, you can address it more effectively than by just masking symptoms.

Common causes and contributing factors include:

• Chronic stress — the body deprioritizes digestion under sustained stress
• Aging — acid output naturally declines over the decades
• H. pylori infection — can damage the acid-producing cells of the stomach lining
• Acid-suppressing medications — PPIs (like omeprazole), H2 blockers, antacids
• Imbalanced or highly restrictive diets, including some vegan and vegetarian diets low in zinc and B vitamins
• Stomach surgery or gastric bypass surgery
• Autoimmune gastritis — an autoimmune condition that specifically attacks acid-producing stomach cells
• SIBO (small intestinal bacterial overgrowth) — low acid and SIBO often feed into each other, since acid is one of the body’s main defenses against bacterial overgrowth in the small intestine
• Diets low in B vitamins and zinc

Of everything on this list, one deserves special attention because it’s the one most people don’t realize applies to them: acid-suppressing medications are now the most common driver of clinically significant hypochlorhydria in adults, simply because so many people take them, often for far longer than intended. More on that below.

Zinc and B vitamins help the stomach produce hydrochloric acid in the first place, so restrictive diets that run low in these nutrients can become a bit of a feedback loop — low intake leads to lower acid, which then makes it harder to absorb what nutrients you do get.

Low stomach acid symptoms

Symptoms of low stomach acid range from digestive complaints to infections, allergies, and hair loss. Hypochlorhydria really can affect the whole body, not just your gut.

Often, people mistakenly assume their stomach acid is too high when it’s actually too low — the two conditions overlap in surprisingly confusing ways. The diagram below shows how much these symptom pictures can look alike from the outside.

Some commonly reported symptoms of too little acid include:

• Bloating and gas, especially after protein-heavy meals
• Diarrhea
• Trouble digesting meat, or undigested food visible in bowel movements
• Bad breath
• Increased risk of food sensitivities and allergies
• Acid reflux or heartburn
• Nausea after taking vitamins or supplements
• Nutrient deficiencies (iron, B12, calcium, magnesium)
• Hair loss, especially in women
• Brittle nails
• Acne and other skin issues
• Food sensitivities
• Recurrent yeast infections
• Mood swings

Think of it this way: stomach acid’s job is to break your food down and keep unwanted bacteria in check. When acid is low, food doesn’t digest well, the body becomes deprived of nutrients, and bacterial balance in the gut can shift out of balance too. That single upstream problem can show up as hair loss, low mood, breakouts, fatigue, and more — symptoms that look completely unrelated on the surface but often trace back to the same root cause.

How to tell if you have low stomach acid

The most accurate way to measure stomach acid is a professional test, such as the Heidelberg pH capsule test, which continuously measures gastric pH as a small wireless capsule passes through the stomach. It’s more invasive and less commonly available, which is why so many people reach for an at-home option first.

Baking soda test

The most well-known at-home option is the baking soda test:

1. First thing in the morning, before food, drinking, or brushing your teeth
2. Mix ¼ tsp of baking soda into 4 oz of cold water. Drink it and immediately time how long it takes you to burp
3. The idea is that a healthy stomach should belch fairly quickly afterward
4. If it takes more than 3–5 minutes, the theory is that you’re not producing enough stomach acid

The logic makes sense on paper: baking soda is alkaline, and when it reacts with hydrochloric acid in the stomach, it produces carbon dioxide gas, which should make you burp. In a stomach with normal acid, this reaction happens quickly.

Here’s the honest update: the baking soda test has never been validated against a gold-standard measurement like the Heidelberg capsule test, and there’s no published clinical research confirming it actually predicts real acid levels. Burping is also affected by how much air you swallow while drinking, how full your stomach already is, and normal day-to-day variation in gastric pH. That means the test can easily produce a false positive or false negative.

This doesn’t make it useless as a starting point — but it’s best treated as a curiosity, not a diagnosis. If you want to build a slightly more complete picture, some practitioners suggest repeating it over 3–5 consecutive mornings and looking for a consistent pattern rather than relying on a single test. But if your symptoms are significant, the more useful step is a conversation with your doctor about proper testing, rather than basing treatment decisions on a home test alone.

While it doesn’t provide a diagnosis, going through the exercise can be a helpful way to open a conversation with your doctor about the appropriate tests and treatments for you.

Note: baking soda is also used to neutralize stomach acid, so this test can make your stomach feel a bit off or nauseated afterward for some people. It does for me.

Remedies for low stomach acid

If your low stomach acid is being caused by a medication you’re taking, please check with your doctor before making any changes — some of these medications should never be stopped abruptly.

Otherwise, natural approaches for supporting healthy stomach acid include:

• Probiotics
• Diet changes
• Stress relief
• Sauerkraut
• Apple cider vinegar
• Betaine HCl
• Digestive enzymes
• Bitters
• Marshmallow root
• Bovine colostrum
• Vitamins and minerals
• Ginger

Gut health isn’t a one-way street. When you make positive changes to heal the gut as a whole, it tends to have ripple effects everywhere, including in the stomach. For example, we now know that probiotics for acid reflux can be beneficial, even though they were traditionally thought of as a lower-GI intervention.

Related: The Best Digestive Enzymes for Bloating and IBS

Diet changes

Eating a well-balanced diet may help support stomach acid production naturally over time. Whole, unprocessed foods are your best bet — try to minimize packaged foods, fried foods, and high-sugar foods and beverages.

Because autoimmune conditions are often at the root of low stomach acid, following an autoimmune protocol diet may also be worth exploring.

Stress relief

By building calming time into your day, you support every aspect of a healthy digestive tract, including a stomach with adequate acid for its job. Try yoga, meditation, slow breathing techniques, and simply getting outside for fresh air.

Sauerkraut

By far, one of the best digestive aids is sauerkraut. Time and time again, my clients tell me it’s one of the most impactful things they’ve added to their diet.

While raw sauerkraut is mostly thought of as a natural probiotic, it also provides a natural source of acidity and digestive enzymes, which makes sense as a support for low stomach acid too.

Apple Cider Vinegar

Apple cider vinegar (ACV) may help acidify the stomach, and it’s also a source of beneficial probiotics if you use the variety “with the mother.”

To be transparent, there isn’t direct clinical research confirming that ACV meaningfully raises stomach acid levels — the reasoning is largely logical rather than proven. That said, it has a long history of use for digestive complaints, from Hippocrates to traditional Chinese medicine, and anecdotal reports are plentiful.

If you try it, dilute it: a common approach is 2 tablespoons of ACV in 16 oz of water, once daily. Some people add honey, which brings its own natural prebiotic content.

Betaine HCl

Betaine HCl is the most direct way to supplement stomach acid, and it’s also the remedy on this list with the strongest clinical backing. Controlled research has shown that a dose of betaine HCl can rapidly and significantly lower gastric pH in people with medication-induced hypochlorhydria — in one well-known trial, pH dropped from roughly 5.2 to 0.6 within 30 minutes, with the acidifying effect lasting for over an hour.

A more recent 2025 study found that even vitamin C can meaningfully lower gastric pH in a similar model, which adds a gentler option to the toolbox alongside betaine HCl for people concerned about drug or nutrient absorption tied to low stomach acid.

That said, a 2024 narrative review in The Journal of Nutrition was more cautious, noting that much of betaine’s broader marketing outpaces the underlying evidence, and that most positive reports are still based on small studies or case reports rather than large trials.

In practice, betaine HCl helps many people with reflux-type symptoms and even reported gallbladder-related complaints, though this is based largely on clinical experience and reviews rather than large trials. Take it right before eating, start low, and always discuss adding betaine HCl with your doctor first — especially if you have a history of ulcers or are on other medications.

Digestive Enzymes

Betaine HCl is often paired with enzymes because when stomach acid is low, you also can’t activate enough pepsin, the enzyme responsible for breaking down dietary protein.

A well-reviewed combination product is Pure Encapsulations’ betaine HCl with pepsin.

Bitters

Bitter vegetables and herbs — kale, broccoli, mint, sage, sorrel, yarrow, chamomile, ginger, and dandelion — are naturally stimulating to the digestive tract, which supports healthy acid production.

A well-regarded bitters supplement is by Urban Moonshine.

Marshmallow root

Marshmallow root helps form a protective mucus lining that supports both the stomach and intestines. It’s been used for digestive health for thousands of years, and research suggests it may help support gastric ulcer healing.

Bovine colostrum

Bovine colostrum doesn’t directly raise stomach acid, but it can support efforts to heal leaky gut, which helps protect the stomach lining and keep the whole digestive tract functioning better.

Look for a reputable, third-party-tested bovine colostrum brand if you decide to try this route.

*Avoid bovine colostrum if you have a dairy allergy.

Vitamins and Minerals

Low levels of B vitamins and zinc can directly impair your stomach’s ability to make hydrochloric acid. Filling these gaps with quality natural vitamins and minerals can help support healthy acid levels over time.

Ginger

Last, but definitely not least: ginger. This spice is a genuine rockstar for gut health across the board.

Ginger may help reduce the risk of stomach ulcers, ease inflammation related to low stomach acid, support nutrient absorption, calm nausea, and help the stomach empty properly. For all of these reasons, it’s one of the best all-around remedies for anyone dealing with low stomach acid.

Related: 12 Benefits of Ginger for Digestion

A note on acid-suppressing medications

This is worth its own section because it’s changed the most since this post was first written. Proton pump inhibitors (PPIs) — medications like omeprazole, esomeprazole, and lansoprazole — are among the most prescribed drugs in the country, and long-term use has climbed steadily over the past two decades.

Newer research reviews have connected long-term PPI use with increased risk of bone fractures, kidney disease, certain infections, and nutrient deficiencies (particularly B12, magnesium, and calcium) — all consequences that overlap directly with the symptoms of hypochlorhydria described above, because that’s essentially what long-term PPI use creates.

This isn’t a reason to panic or to stop a prescribed medication on your own. Some people genuinely need acid suppression for a diagnosed condition. But if you’ve been on a PPI for months or years without a clear ongoing reason, it’s a reasonable thing to bring up with your prescriber. A newer clinical approach called “PPI deprescribing” — gradually tapering the dose under medical guidance — has shown promising success rates in recent pharmacist-led programs, with the large majority of patients successfully reducing or stopping their PPI when it was reassessed.

If reflux symptoms are the reason you started a PPI in the first place, it’s also worth revisiting whether low stomach acid, rather than high acid, might have been part of the picture all along.

Frequently asked questions

The information on this website has not been evaluated by the Food & Drug Administration or any other medical body and is shared for educational purposes only. While The Healthy RD’s posts are backed by research, you are unique, so you must seek care from your own dietitian or healthcare provider. This post is not meant to diagnose or treat any conditions. Consult your doctor or healthcare provider before making changes to your supplement regimen or lifestyle.