Hydrochloric Acid Deficiency

Hydrochloric Acid Deficiency: Overview

Alternative names: HCI Acid Insufficiency

Hydrochloric acid (HCl) insufficiency can be complete (achlorhydria) or partial (hypochlorhydria) and intermittent.  HCl plays an important part in the first digestive step, which if not completed properly can result in digestive problems all the way through the digestive tract.

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In many cases problems associated with digestion are caused by an insufficient amount of HCl rather than a surplus.  Patients who experience heartburn, sour stomach, nausea and pain often assume it is because of an HCl surplus but the opposite is in fact true.

HCl does not digest food on its own, but creates an environment in which digestion begins.  HCl is responsible for converting pepsinogen to pepsin, which begins breaking down proteins in the stomach.  With limited HCl, pepsinogen is not converted to pepsin and protein digestion fails.

HCl also stimulates the pancreas and small intestines to produce digestive enzymes and bile that are needed to break down carbohydrates, fats and proteins.  Lastly, HCl plays an important role in killing pathogenic bacteria, parasites, and yeast that are normally present in food, thus preventing infection and disease since most organisms that are ingested are destroyed by an adequately acid environment.

Incidence; Causes and Development; Contributing Risk Factors

HCl deficiency is very common in America, affecting an estimated 50% to 98% of the population.  Deficiency increases with age and those aged 65 years or older are most affected.

The most common causes of hydrochloric acid deficiency are:

  • Chronic stress (may decrease HCl acid production)
  • Vital deficiencies of B-vitamins and zinc due to a lack of dietary intake can lead to low stomach acid
  • Long-term use of prescription medications used to treat acid reflux or ulcers
  • Age is a major factor because as the body grows older, less HCl acid is naturally produced
  • Any surgery of the stomach could reduce the production of stomach acid
  • Poor diet
  • Overeating
  • Lack of sleep
  • Birth control pills
  • Poor thyroid function
  • Excess alcohol consumption

Risk factors for hydrochloric acid deficiency include:

  • Infections caused by H. pylori
  • A history of stomach surgery
  • Prolonged use of stomach-acid-reducing medication
  • Being over the age of 65

Chronic health conditions often associated with hydrochloric acid deficiency include:

Signs and Symptoms

The most common signs and symptoms of HCl deficiency include:

Diagnosis and Tests

In order to detect hydrochloric acid deficiency, a doctor will first perform a physical exam while taking the patient's medical history into consideration.

If HCl acid deficiency is suspected, a pH test of the patient's stomach acid can be performed.  A stomach pH of less than 3 is considered normal; between 3 and 5 points to hypochlorhydria and a pH greater than 5 indicates achlorhydria (practically no stomach acid).

Treatment and Prevention

The first and most important step in treating hydrochloric acid deficiency is to confirm that the patient does indeed have a low stomach acid level.  Failing to do so could reduce a perfectly healthy acid level.

Once a low HCl acid level is confirmed, the first step is to adopt a healthier diet.  Fresh, unprocessed natural foods and organic foods are a great way to increase hydrochloric acid naturally.  Including fermented foods and beverages in the diet can also improve HCl acid deficiency by aiding digestion and restoring the balance of gut bacteria.

Digestion begins in the mouth, so it is important to thoroughly chew food.  This will reduce the amount of work that the stomach has to do.  Taking longer to chew food will also reduce the amount of food intake because the brain has more time to receive signals that indicate fullness.

Reducing stress can also ease the symptoms of HCl acid deficiency.  Stress causes the body divert energy away from digestion and reduces the production of stomach acid and important digestive enzymes.

Other treatments for hydrochloric acid deficiency include:

  • Taking digestive enzyme supplements
  • Drinking apple cider vinegar
  • Taking HCl supplements
  • Taking a multivitamin
  • Eating Manuka honey
  • Reducing sugar intake


A deficiency in hydrochloric acid can have serious consequences, and is commonly implicated with the following conditions:

Conditions that suggest Hydrochloric Acid Deficiency:


Heartburn / GERD / Acid Reflux

Based on the clinical experience of doctors such as Dr. Jonathon Wright, MD, supplementing with hydrochloric acid sometimes relieves the symptoms of heartburn and improves digestion in individuals who have hypochlorhydria.  Unexplained bloating, belching and heartburn are frequently diagnosed as symptoms of hyperacidity and sometimes wrongly treated with antacids, when in fact the underlying problem is insufficient acid production.



Rheumatoid Arthritis

Lack of stomach acid occurs frequently in rheumatoid arthritis patients.  This is associated with changes in gastric microbial patterns.


Vitamin B12 Requirement

Achlorhydria leads to improper absorption of nutrients such as B12.


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Risk factors for Hydrochloric Acid Deficiency:


Vitamin B6 Requirement

Vitamin B6 is necessary for the production of hydrochloric acid.

Hydrochloric Acid Deficiency can lead to:


Environment / Toxicity

Recommendations for Hydrochloric Acid Deficiency:

Botanical / Herbal

Cayenne Pepper

Capsaicin, the active ingredient in cayenne, is believed to assist digestion by stimulating the flow of both salvia and stomach secretions.  One or two capsules of cayenne pepper taken before meals stimulates hunger also.



Apple cider vinegar or lemon juice taken with meals mildly stimulates hydrochloric acid production.

Digestive Aids

Hydrochloric Acid (Trial)

Some people with low stomach acid have no symptoms that are obviously related, and are led to believe they are digesting properly, when they are not.  An HCl trial is a safe, worthwhile, and relatively accurate way to discover if an insufficiency exists.  Since the long-term administration of supplemental HCl may result in reduced stomach output of acid, administration is advised for diagnostic purposes and short-term use only.  Short-term use may result in a return of normal acid production.

Digestive Enzyme (Trial)

A trial using plant-based enzymes to enhance digestion demonstrated their additional benefit of improving hydrochloric acid production in those individuals who were hypochlorhydric.


Folic Acid

In cases of low stomach acid (hypochlorhydria) or no stomach acid (achlorhydria), supplemental use of hydrochloric acid normalizes folate absorption.

Vitamin B-Complex

Several B-vitamins are needed to support hydrochloric acid production.

Inositol Hexaniacinate

Inositol hexaniacinate might play a role in both the reduction of achlorhydria-related symptoms and in augmenting gastric acid secretion.  It may enhance the production of hydrochloric acid in a manner that cannot be explained by it simply being an acid.  Its benefits may be due, in part, to its stress-moderating properties upon the central nervous system.

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