Do I Have Too Much or Too Little Stomach Acid?

Steven Sandberg-Lewis, ND, DHANP

The parietal cells of the stomach produce hydrochloric acid (HCl) which should be strong enough to aid the digestion and absorption of protein and minerals. HCl is also needed for absorption of vitamin B12, folic acid, and for the stimulation of gut hormones that trigger the pancreas and gall bladder to release their secretions. The acid should also kill excessive bacteria, preventing bacterial overgrowth.
Adverse health effects can occur when the stomach either over or under produces acid.
Health conditions associated with decreased HCl include diabetes, childhood asthma, hyperthyroidism, Hashimoto’s thyroiditis and other forms of hypothyroidism, rheumatoid arthritis, lupus erythematosus, gallstones and cholecystitis, osteoporosis, depleted adrenal function, chronic hepatitis and atrophic gastritis. Skin conditions associated with decreased acid include recurrent hives, eczema, vitiligo and rosacea. Small intestine bacterial overgrowth is more likely when acid levels are decreased.
The Heidelberg pH test is a procedure available at our southeast Portland office which directly measures the acidity of the stomach. The test involves swallowing a small capsule about the size of a vitamin capsule, which is attached to a thin thread. Contained inside the capsule is a radio frequency transmitter. The capsule enters the esophagus and then the stomach, where it measures the pH level.
The device tracks the pH level in the stomach initially and over time, as the patient swallows small amounts of bicarbonate soda. The bicarbonate neutralizes the HCl. The pH level should return to normal (less than 3.0) as the parietal cells produce additional acid. The time it takes for reacidification will distinguish whether the patient has low acid levels (hypochlorhydria), normal acid, or excessive acid (hyperchlorhydria). The time required for this test varies, but it generally takes about 1-2 hours.
This test can be scheduled by calling 503-224-0443.

Steven Sandberg-Lewis, ND, has been in clinical practice for 44 years, with a focus on functional gastroenterology. He has been a professor since 1985, teaching a variety of courses but primarily focusing on gastroenterology and GI physical medicine. In 2019, Dr. Sandberg-Lewis co-founded Hive Mind Medicine, continuing his specialization in gastroenterology with a focus on reflux, SIBO, inflammatory bowel disease and functional GI disorders. He is currently working on his latest book, Let's Be Real About Reflux: Getting to the Heart of Heartburn, written to help non-medical and medical professionals alike develop a better understanding of diseases affecting the gastrointestinal tract.

Hive Mind Medicine blog posts are for educational purposes only and are not intended as medical advice. Please consult with your health care practitioner for personalized guidance. Click on the contact button below if you would like to schedule with one of our Hive Mind practitioners.

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