As we visit the doctor with symptoms related to heartburn, gas or acid reflux, the diagnosis of high acid in stomach, is typically based on symptoms. There is no lab test done for stomach acid levels. As a result, prescription is usually for Proton Pump Inhibitors (PPIs), histamine type 2 receptor agonists or the (H2 blockers) and sometimes surgery.
However, for most people, these drugs are known to worsen the situation.
Antacids can help in reducing the stomach acid but temporarily. Later, more acid gets produced and the stomach gets back to the intended pH level. The temporary symptoms are treated in the process and the actual problem doesn’t get fixed.
H2 blockers work by blocking a specific substance in the body, which plays a role in acid production. These work slower than antacids and their effects are for a longer time. However, the downside is that they are known to stop producing pepsin. Pepsin aids in digestion, as it helps down in breaking the proteins.
Proton pump inhibitors work to block any enzyme which is involved in production of acid in stomach. All these processes are closely linked to different side effects. These can lead to situations of chronic low levels of stomach acid and often lead to different health concerns.
5 Ways to test stomach acid levels
Since hypochlorhydria is not known to most people, patients are usually not able to trace it back to their condition. Their suffering continues for a long time.
However, there are multiple options which help in testing stomach acid levels. A game plan can be created, as a remedial measure to overcome the situation.
Gastric Acid Secretion Test: This is an expensive and highly invasive process. The test is done when the patient has been diagnosed with stomach ulcer. It helps in tracking if the anti-ulcer medication is effectively working. It also helps to check of the materials from intestines are getting back to the stomach.
The Heidelberg Stomach Acid Test – This is the standard gold test for hypochlorhydria. A tiny capsule, which has a radio transmitter is ingested for measuring the pH of the stomach, as the patient drinks a solution mixed with baking soda (helps to reduce acidity). The baking soda helps in neutralizing HCL in stomach. In case the body does not get back to normal, it is a sign of hypochlorhydria.
The test offers a graph which displays the response of stomach to baking soda. It helps in determining if the patient has hypochlorhydria or hyperchlorhydria (high level of acid) or achlorhydria (total absence of acid). The test costs around $350 and is not covered by most of the insurance plans.
CBC and CMP – Usually covered by insurance, these are quite common on the metabolic blood panel. An experienced clinician can easily diagnose hypochlorhydria after considering the lab results along with a study of the symptoms.
Betaine HCI Challenge – This is a reliable at-home test. But false positives are possible as well. Experts recommended to repeat this test at least three times. Such betaine HCl costs approx. $20. In case of low levels of stomach acid, this can be taken to restore the HCl levels.
Purchase Betaine HCl with pepsin.
Consume a high-protein meal which should have at least 6 ounces of meat. You can have veggies along with this.
Just at the middle of your meal take a betaine HCl pill. You shouldn’t take the pill in the beginning.
Complete the meal and watch out for what happens.
Probable outcomes:
1. There are no symptoms. It means you have low levels of stomach acid.
2. Dyspepsia. Burning sensation, feeling of heat and heaviness in the chest which means satisfactory stomach acid levels.
It is suggested to carry out the betaine HCl challenge at least twice or thrice as a confirmation of results. If there are 3 positive tests it means low levels of stomach acid.
False positives are possible in the following situations:
- You have very little protein. The low protein meal does not need much acid. Betaine HCl often leads to increase in acid level.
- The capsule was taken before meal. This caused indigestion.
- You are suffering from esophageal sphincter dysfunction. There might be a poor esophageal sphincter tone or a hiatal hernia, which leads to increased indigestion symptoms. This can be ruled out through a medical exam if suspected.
Stomach Acid Test with Baking Soda: This is not a totally accurate test as the above, but this is a free at-home test, which gives a good indication of stomach acid level. The stomach acid level can differ from a person to person and is quite dependent on the interpretation of results. Many use this as a baseline measure and can track changes with time.
As you wake up in the morning before you eat and drink anything:
- Mix ¼ teaspoon of baking soda in just 4 to 6 ounces of cold water.
- You can drink it.
- Consider the time taken for the burp to occur. You can time it for 5 minutes
In case you do not burp in five minutes, this means there is inadequate stomach acid. If you notice early and several burps, it might be due to too much stomach acid. However, be careful not to confuse this with smaller burps which occur when air is swallowed as you drink the solution. If you burp after three minutes, it means low acid level.
Related tests:
People suffering from low stomach acids can suffer from different health issues which can have long-term consequences. In case you feel you are suffering from low stomach acid, get in touch with us for testing the following:
B12 levels: Intrinsic factor is a glycoprotein in stomach which is essential for vitamin B12 absorption. As the stomach acid gets low, the intrinsic factor is not able to do the job. It can result in deficiency of vitamin 12 and it’s a serious health problem.
Homocysteine levels – Acid in stomach is crucial for vitamin B12 absorption. It plays an important role in methylation, which helps in keeping the inflammatory homocysteine at the best level. If B12 is low, homocysteine elevates.
Healthy Stomach Acid – How to Support?
- Consume proteins before you start your meal. It will help in stimulating the digestive enzymes which are essential for digesting protein.
- Chew Your Food Thoroughly – This is an important aspect of digestion. It is crucial to break down the food proteins so that they are digested well.
- Limit your liquid intake as you have your meals. Wait till 30 minutes after you have consumed your meal which is necessary for the right stomach acid production, for the purpose of protein metabolism and pathogen sterilization.
- Drink plenty of water between the meals. This supports gut motility. It helps in pushing the contents out of the intestine and doesn’t push them back to the stomach. This is quite crucial for those suffering from SIBO.
Betaine hydrochloride supplements provide excellent support for healthy gut functioning. It also helps in safely restoring normal gastric acidity.
(Betaine HCl should not be confused with anhydrous betaine, which is a methyl-donor nutrient and is necessary for homocysteine levels.)
Ensure that the betaine HCL is taken either halfway through your meal or you take it after the completion of your meal. If you take it before a meal, you might have a false heartburn experience and the stomach acid production can be turned off.
Word of Advice: In case you are having NSAIDs like aspirin, Tylenol or Ibuprofen, you should not take HCL.
HCl with pepsin – This should be part of your diet when you have protein. If you feel warmth in the stomach, it means you are having enough. You can back it down and check the response. There are a few people who need a capsule while others might need something else. It is unique for everyone.
Pepsin. This is generally used with HCl. It is quite safe when it is used for digestion.
Digestive enzymes help in breaking down food proteins. It is important to use a high-quality blend of products.
Apple Cider Vinegar – You need to add one tablespoon of this in water before you have your meal. It helps in better digestion.
A few fermented foods liked water kefir, kimchi, sauerkraut, pickles and pickled ginger are rich in organic acids. These, along with probiotics and enzymes are quite effective in easy digestion. Such products are said to be anti-microbial and help in fighting H. pylori which is an enemy of the stomach acid production.
You need enough time to improve the acid levels of your stomach. It will make a big difference in the symptoms you experience and will also help in improving the quality of life. Get in touch with my office for additional help.