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The Rejuvenating Health Podcast
Join Women's Health Nurse Practitioner, Lindsey VanSchoyck for a weekly dose of Precision Medicine as she addresses the hot-button topics specific to Women's Health, Fitness and Nutrition, interviews expert guests and hosts round table discussions with the team of dedicated functional health care specialists.
The Rejuvenating Health Podcast
E153 | The Truth About Low Stomach Acid
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Heartburn that won’t quit, bloating after “healthy” meals, protein that feels like it just sits there, and labs that keep coming back low can all point to a surprising root cause: low stomach acid. We’re unpacking hypochlorhydria in plain language and explaining why it becomes more common as we age, especially through perimenopause and postmenopause, when digestion starts to feel less resilient and more reactive.
We connect the biology to real-life symptoms by walking through how stomach acid is made, why it’s an energy-intensive process, and how hormones shape it. Estrogen supports the stomach lining and parietal cells, while progesterone influences parasympathetic tone and vagus nerve signaling, which is essential for the “rest and digest” state. Add chronic stress and cortisol to the mix and it’s easy to see why appetite drops, meals feel heavy, and reflux shows up even when acid is actually low. We also tie in thyroid function and explain why hypothyroid patterns often come with constipation and slow gastric emptying.
Then we zoom out to the downstream domino effect: poor protein digestion, low ferritin and iron absorption, low B12 and higher homocysteine, mineral issues with magnesium, zinc, and calcium, plus a higher risk of dysbiosis, SIBO, and gut permeability. We break down the reflux mechanism, why PPIs can backfire long term, and which basic blood work markers can help you and your practitioner connect the dots. Finally, we share practical next steps, including digestive enzymes, betaine HCl, bitters, zinc support, and the underrated habit that changes everything: slowing down, breathing, and chewing like digestion matters.
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Medical Disclaimer
SPEAKER_02Any views, thoughts, and opinions expressed on the Rejuvenating Health podcast are solely those of the speakers and are intended as such. Please consult your trusted healthcare practitioner for medical advice. Let's go, girls.
SPEAKER_00Hey ladies, welcome back to the Rejuvenating Health Podcast. I am Coach Lakin and I'm joined by nurse practitioner Lindsay as always. And today we are going to talk about something that comes up a lot like under the radar, but a lot of people aren't very forthcoming about it because it is something that um I feel like a lot of clients deal with, but they don't necessarily feel comfortable talking about all the time. And we we want to talk about the symptoms that come up and the things that we know are plaguing you guys, but we tend to just put a band-aid on it.
SPEAKER_02Yeah, exactly. So today is one of those that you literally can't unsee if you see your symptoms that we're talking about, right? So we're gonna talk about low stomach acid or hypochloria. So essentially you have low stomach acid. That's just the complex word for it. But why it becomes so prevalent as we get older, especially when we hit perimenopause and postmenopause for sure.
How Stomach Acid Gets Made
SPEAKER_00So just another thing that we can add to the list of possibilities during perimenopause. But let's let's talk about what's actually happening in the body when we produce stomach acid. So let's get into some of the why.
SPEAKER_02Yeah. So first of all, the reason why we're talking about this is because I've been doing a lot of lab reviews lately. And I can see this in the lab markers because their protein's low, their sonophiles are elevated, or they're telling me, like, I can't eat that much protein, like it's just sitting in my stomach, or I'm looking at their nutrients and they're not absorbing vitamin D or B, or even though they're ingesting all of these things. So this is this is kind of how we need to understand it, right? So in order to understand low stomach acid, you have to understand parietal cells in the stomach. I know you don't know what those are, but those cells produce hydrochloric acid, okay, through a very energy-dependent process. And this process involves chemistry. Okay. So it involves the conversion of CO2 plus H2O to get carbonic acid. And then you have to split into hydrogen added and bicarb. So a lot of times I'll see women and they'll be a little bit acidotic, their bicarb's off. And then these hydrogen ions are pumped into the stomach via this HKAT paste pump. So lots of science don't expect you to understand it, but it has to do with like the acid-base balance in your digestion. And it has energy.
SPEAKER_00Okay. So this is basically the vehicle that is responsible for aiding our digestion in our gut. And what you're saying is it's ATP dependent, which if you don't know what ATP is, essentially that's our conversion of energy in our muscles, essentially is how we usually look at it, right? But it is an energy supply that's being used to create the stomach acid that we need in order to digest whatever we put into our body. Is that correct?
SPEAKER_02Yeah. So it's a it's a that very heavy energy process, right? And what that means is that anything that reduces cellular energy or mitochondrial function, which we know it's decreasing as we get older, right? Is gonna impair that acid production.
SPEAKER_00Okay. So this is like when we talk about, we've talked about other things in the past that are like metabolically expensive to the body, right? Like it requires a lot from the body in order to maintain these things. And then on top of it, we have external stressors that are depleting it as well.
SPEAKER_02Yeah. Yep. And so in order for this to work, you have to have regulation of it, right? And stomach acid is really tightly regulated by gastrin, which is a hormone, by histamine, which we talked about what last week? No, yeah, a few weeks ago. Two weeks ago. Yeah, we talked about sleep last week, histamine, and acetylcholine, which has to do with your vagus nerve. Cortisol, stress. So all three of these must be functioning properly. Okay. So this is not just a stomach issue, as you can see, right? This is a nervous system issue, a hormone system issue, an immune signaling issue, a mitochondrial function issue. So it's not like necessarily just a gut health issue. A lot of stuff goes into it.
SPEAKER_00And this is part of the reason why a lot of people notice, and men and women, but a lot of people tend to notice that as we age, we can't handle the same types of foods that we could before, right? Like our digestive system is not as robust as it once was. It's not all things are not firing to be able to produce the correct amount of acid in place to be able to handle the things that we used to be able to handle in our body. Is that correct?
SPEAKER_02Yeah, and even if you are producing it, you're not regulating it because then you're popping tums and pepsid and ameprosine. Right.
Perimenopause Hormones And The Gut
SPEAKER_00Right, and trying to diminish the acid when we already have low acid. All right, so now let's layer in perimenopause. Like what's changing here on top of this system that we've already described?
SPEAKER_02So estrogen has a direct tropic effect on your gastric mucosa. Okay, whatever. What does that mean?
SPEAKER_00Your stomach lining.
SPEAKER_02Yeah, it supports the integrity of those parietal cells, which are essential for acid production, right?
SPEAKER_00Okay.
SPEAKER_02It also enhances gastric blood flow. It modulates your gastrin sensitivity. So when estrogen declines, what you're gonna have is a reduced stimulation of stomach acid secretion. You're gonna have increased vulnerability of stomach lining. So this is why we see a lot of gut health issues happening when the estrogen declines, because estrogen helps with inflammation. And so your stomach lining is more vulnerable, and then we're just decreasing that stimulation and secretion of stomach acid.
SPEAKER_00So then we have more opportunity for leaky gut or gut lining permeability, where either we're not absorbing nutrients properly, which is why we get we get questions all the time about supplementation, right? You're you're literally flushing your money down the toilet, literally, if you don't have a gut lining that can support this or an acid level that can support your gut to be able to digest or absorb nutrients properly. And so it's throwing the system off in addition to any of the negative things that we're putting in our body.
SPEAKER_02Yep. Yep. And it but it's not just estrogen, right? It's progesterone too. And progesterone starts declining in your late 30s. So this is why like you don't have to be in menopause to have this happening, right? Progesterone is really tied to your another nervous system, especially your parasympathetic tone. So low progesterone causes increased sympathetic dominance, so increased like blah, and then reduced vagal nerve signaling, which causes decreased acetylcholine release and impaired stimulation of parietal cells. So you're in this like fight or flight state, you're having reduced vagal nerve and you're not releasing as much stomach acid. Whenever we're fight or flight, everything shuts down. So this makes sense.
SPEAKER_00Yeah, like our body cannot prioritize digestion in that state, right? So if the vagus nerve is not firing properly, and that for everybody is wondering, the vagus nerve essentially is our biggest connector from our brain to our gut, right? And it's a very large nerve that runs kind of down through the throat and then down into the gut. That is not going to allow your digestion to take place, literally, if we're constantly upregulated all the time, we're not able to get into that parasympathetic response where digestion happens.
SPEAKER_02Yeah. I mean, this is an energy-dependent process. When you're in fight or flight, you're not used, like your energy is not greatly used, right?
SPEAKER_00So it's there to fight or run.
SPEAKER_02Right, right.
SPEAKER_00Nothing else.
SPEAKER_02So when that vagus nerve isn't firing properly, digestion literally doesn't start, and you lose that cephalic phase of digestion. And that accounts for about 30% of stomach acid production. So you're literally losing 30% of your stomach acid just by like being upregulated.
SPEAKER_00Being chronic stress, having chronic stress all the time. Yeah. I mean And then this is a good like depiction of just to make sure that we're tying it back to what people can understand or correlate to, right? Is like that's why you see depicted all the time, or that you if you've experienced it personally, if you're under chronic stress and you're popping antacids, right? Or you feel like you have indigestion or you feel like you have heartburn all the time, right? It's because your system is being mismanaged.
SPEAKER_02Yeah. Yeah. I mean, there's a deeper layer to it too, right? Like you have that increased inflammation of gastric lining and the reduced gastric secretions, but you also have like reduced mitochondrial ATP production. And you have to remember that this acid production is ATP dependent. So you're slowing all that stuff down.
SPEAKER_00Okay. And then if let's say we do have like chronic cortisol, right? Our favorite word, and that's happening. What is gonna be what would be the first sign that it's affecting the gut? Would it be like feeling like you have heartburn all the time or feeling like you get bloated? Like, what's gonna be the first sign?
SPEAKER_02I don't like when you're chronically stressed, I'm not hungry.
unknownOkay.
SPEAKER_02And what like think about that? When you're not hungry, why are you not hungry? Because your food is just like sitting there in your stomach because you don't have any stomach acid because you can't break down that food. Or you're nauseous, right? Like, because it's just like it's sitting there and you're not digesting anything. I think it's different for everyone, but for me, for other people, like they get stress ulcers and and stuff like that. But for me, it's like that just gut-filling sitting there.
Stress And Vagus Nerve Shutdown
SPEAKER_00Okay. All right, so let's talk about how the thyroid ties in.
SPEAKER_02Yeah, so you've got estrogen, progesterone that can downregulate it, and then you've got cortisol, and then you've got the thyroid, right? So your thyroid is that master metabolism, it regulates your basal metabolic rate, your cellular energy production, your enzyme activity, and low thyroid, which 40% of perimenopausal women have some type of low thyroid, leads to reduced parietal cell activity. When you have low thyroid, you're constipated. Like it's that's one of the number one symptoms of low thyroid is constipation, right? Because you're slowing gastric emptying because you're reduced acid secretion, right? So it just everything slows down with hypothyroidism. So obviously your gastric secretions are going to slow down.
SPEAKER_00Yeah. So if you think about like, and this starts when even when you're preparing food, and your system starts to prepare for that food, right? Your body should be producing saliva, like your digestive system should be coming online. And when those things aren't happening, and then we're just throwing food that's also difficult for the body to break down or not absorb nutrients from on top of that, then it kind of bogs down the system.
The Nutrient Deficiency Domino Effect
SPEAKER_01Yeah.
SPEAKER_00Okay, so then let's talk about this domino effect that occurs, right? Because this is where like we have all these things that are stacking up against us.
SPEAKER_02Yeah, you kind of get like a multi-system breakdown when you start having low low digestion. Yeah. So one of the first things that I see is your like, I'm eating 120 grams of protein. Why does my protein marker say that it's 6.2 or my albumin is low and my globulin is low, right? So your protein literally has a digestion failure, right? So protein requires a low pH to convert it to pepsin, not protein, but the breakdown of protein requires pepsin, which requires a low pH, which is stomach acid. Pepsin breaks protein into peptides. So if your pH is too high, because you have low stomach acid, your protein remains partial partially digested. Okay. So what that like a good sign that you have low stomach acid is you're freaking gassy.
SPEAKER_00Yeah.
SPEAKER_02Because what does that do? It produces ammonia and phenols, right? And it leads to um petrifaction in the gut. So you know.
SPEAKER_00Yeah, because food is essentially not being broken down and nutrients delivered to the areas of the body that's needed. It's just kind of sitting and rotting.
SPEAKER_02Yeah. Yeah. Yeah. You also can get like brain fog and fatigue and neurotoxicity, right? One of the like really key things I see is iron absorption. Like low ferritin. So iron absorption requires an acidic environment. So you have to, again, a chemistry process, but you have to have acid to convert Fe3 to Fe2, which is the iron that you want to absorb, right? And so low stomach acid is gonna lead to poor iron absorption, low ferritin, hair loss, fatigue, low thyroid conversion, right? So in labs, you got low protein, you got low ferritin, you got low B12 because B12 absorption requires acid to release B12 from its protein, right? It also requires this thing called intrinsic factor. So if you have low stomach acid, you're probably gonna have low B12. You're probably gonna have elevated homocysteine, and you're probably gonna have those neurological symptoms like anxiety, depression, ADHG type symptoms that you have if you have poor methylation. Then then it affects mineral ionization. So it affects your calcium and magnesium and zinc. All of those require acidic pH. So you're gonna have low zinc levels, you're gonna have low magnesium levels, you're gonna have low calcium levels. Again, all these things that we can see in your labs, right?
SPEAKER_00And then supplementing them isn't doing any good because we don't have an environment that can actively break it down and use it the way the body needs to needs it to be used.
SPEAKER_01Yep.
SPEAKER_00So it's not a matter of like, and this is where I think it gets confusing because we'll do these labs, right? And it'll show, well, you're low in these things. And then if I try to supplement them, but I'm not optimizing the gut, then it could be all for naught. And again, some of the times we have to pull in these different variables to see, okay, if we're supplementing and we're still not getting absorption, then we need to take a look further and see what else is going on.
Dysbiosis SIBO And Leaky Gut
SPEAKER_02Yep, exactly. Exactly. So this is where like it can get a little bit interesting is that stomach acid is your primary antimicrobial barrier. So if you have low stomach acid, it allows for the survival of bacteria, parasites, and fungi.
unknownYeah.
SPEAKER_02So you're like literally like allowing microbiomes to just like well, it's because everything's in balance, right?
SPEAKER_00Like that's the goal, homeostasis. The body wants everything in balance. And so if we don't have an acidic environment that's required to fight off some of these bad things that are in our gut or that can gain entry into our gut, then they're gonna be prevalent.
SPEAKER_01Exactly.
SPEAKER_00And that's when we look at like dysbiosis in the gut, where we have an imbalance of good and bad bacteria.
SPEAKER_02Yeah, it leads to SIBO, H. pylori, candida, dysbiosis, all of those things that you know that you've heard, heard of, right? It also causes this just immune cascade, right? Like if you have undigested proteins, it's gonna cross your intestinal barrier, it's gonna trigger an immune response, it's gonna cause increased food sensitivities. It is a huge contributor to leaky gut and systemic inflammation.
SPEAKER_00That's another one that I want to bring up because the food sensitivity tests are really popular, and we tell people all the time, you know, that they're not extremely accurate. And what tends to happen is the foods that you eat most often are gonna come up as foods that the sensitivity test is telling you that you can't have, and this is part of the problem, right? Because if those foods are sitting and not being digested properly, then it's showing that there's an overabundance of like the histamines that are produced by them in your system, right? So it's another reason why it's like, okay, well, it may not necessarily be the type of food that you're eating if it comes to like, you know, eggs or bell peppers or tomatoes or whatever it is, right? It's not necessarily that food in particular, it's the way that your body is receiving it.
SPEAKER_02Food sensitivity tests are crap.
SPEAKER_00Yeah.
SPEAKER_02I'm just gonna throw that out there. I don't believe in them.
Reflux From Low Acid Plus PPI Trap
SPEAKER_00So let's talk about the reflux mechanism, like how this is showing up. Because I feel like a lot of people that have issues with this like tend to develop acid reflux.
SPEAKER_02Yeah. So your lower esophagical sphincter, it's like sits down here. Your LES is is dependent, is pH dependent, right? It requires adequate stomach acid. So stomach acid signals it to close tightly, essentially. When you have low stomach acid, so this is what causes the acid reflux. It's not like you would think, what? Why would I have acid reflux if I have low acid? Yeah. It doesn't make any sense. But here's the thing: the acid causes the lower esophageal system to close tightly. So if it's low, then you have this really weak LES tone. So you have to lay gastric emptying, increased intraabdominal pressure, and that's what causes the reflux.
SPEAKER_00Okay. So what I the way that I would imagine this is like we have to have a certain level of acid to create a pH that's high enough. In my mind, it like creates uh a reading or enough pressure for this top on this jar to close tightly, right? It's like I have to have this reading of like, okay, there's enough pressure here that I need to close tightly to prevent a problem. And then if that's not the case, then I need to stay open or ajar, right? Because the acid level hasn't reached where it needs to be yet. But that causes acid to be able to freely move through because the levels are low enough that the pH isn't causing the closure. But then the acid is coming through the sphincter where it's not supposed to.
SPEAKER_02Yeah.
SPEAKER_00Okay.
SPEAKER_02And taking a PPI makes it 10 times worse in the long term. And a PPI is like your stomach acid reducer type things, right?
SPEAKER_00Like and some people will get on like really uh really aggressive versions of that, like prescription grade.
SPEAKER_02Yeah, yeah, which is not good because what that does is it further reduces your acid production. Right. And you're just perpetuating the cycle, right? So you can clearly see this in blood work, right? You're gonna have low globulin, which is poor protein digestion. You're gonna have low B UN, which is impaired amino acid metabolism, you're gonna have low ferritin, even though you're like, I'm eating red meat, I'm not bleeding out the butt. You're gonna have an elevated MCV, which shows B12 deficiency or a low B12. You're gonna have low alkaline phosphate, which shows a zinc deficiency, right? Like there's clear markers in your blood work to see this. You can do advanced testing, like you can do organic acid testing, you can do stool testing and look at dysbiosis and fecal fat. Like you can do a lot of these things, but you literally can look at look at regular blood markers and see this.
Lab Clues That Point To Low Acid
Menopause Symptoms Tied To Low Acid
SPEAKER_00All right, so now we have a picture of like all the all the terrible things that can happen as a result of this. Let's look back at specifically to our audience, right? Specifically the effects and menopause. What are women actually feeling when it comes to this uh this disruption?
SPEAKER_02I mean, they're gonna have some weight loss resist resistance, right? Because they're eating all this protein, but they're not utilizing it. You're gonna have some reduced satiety signaling.
SPEAKER_00So not gonna feel full.
SPEAKER_02Yeah. Some blood sugar instability because you got inflammation in the gut. You're gonna have a hormone imbalance because you've got impaired detox pathways, estrogen dominance is gonna happen. You're gonna have some mood changes because you've got these amino acid deficiencies, so your neurotransmitters are out of whack, right? Like it definitely shows up, and this is where it's like when we do blood work and all this stuff with patients, it's like I feel this and this and this, and you're like, well, what's the cause? Because you got like a million things happening that could be causing these symptoms.
Fixes Enzymes HCl And Nervous System
SPEAKER_00So let's say we do identify that it is low acid in the gut, then what what can we do?
SPEAKER_02Yeah, so digestion enzymes are great, right? Like I love Thorne's advanced digestion enzymes because it has like bed and HCl in it, which directly lowers your gastric pH and it restores protein digestion. Pepsin is great, bitter herbs are great because those stimulate the vagal response. Um, you can look at zinc, right? Zinc is super important for it. And then, oh my gosh, regulating your nervous system.
SPEAKER_00Weird. Weird. Yeah, because you I think people, well, there's been more and more attention around the vagus nerve. But I think it's really important to understand how it's tied to digestion. So I want to go deeper on the nervous system stuff. Like, can we talk about what the vagus nerve controls when it comes to digestion?
SPEAKER_02Yeah, I mean, it controls your gastric acid secretion, your enzyme release, your motility. So if you've got low vagal tone, you've got low stomach acid, you've got slow digestion, and you probably have some bacterial overgrowth.
SPEAKER_00Yeah. So how do we like if we were to fix it, right? We're gonna be looking at slowing down our eating.
SPEAKER_01Slow your roll.
SPEAKER_00More than likely breathing, which I know is is wild. It sounds crazy, ladies, but yes, actually, like being intentional with your breath, just like thinking about downregulating, especially around meal times, right? Like getting your nervous system in a better position to prime it for digestion, uh, mindfulness practices, and all of this is really. Chewing thoroughly, right? Like taking your time with your food. And really, all of this, all of these practices, all they're doing is being intentional about slowing your ass down, right? Because we're on the go constantly and we're looking to the next thing, to the next thing, to the next thing. And how many of our clients talk about the inconvenience of eating meals or like how it is an interruption to the things that they have to do or their to-do list throughout the day? And we have got to fix that frame of mind. We have to eat food every day for the rest of our lives. And so being, yeah, having a more ritualistic approach of being, you know, um intentional with our meals has a huge benefit, especially in the long run, in preventing some of these things from happening in the gut and also just prioritizing how you approach your food and your relationship with your food. So slowing down is the key, and whatever practices allow you to take a more slow intentional approach with your meals will be highly, highly beneficial.
SPEAKER_02Yeah. Yeah. Like this is not just a digestion issue. It's it's really not a digestion issue at all. Like if you think about it, right? It's a hormonal issue.
SPEAKER_00The digestion issue is the symptom of it.
SPEAKER_02It's the symptom of it, right? But like the root is it's a hormonal issue. It's a nervous system issue, it's a metabolic issue, it's a root cause of gut dysfunction, right?
SPEAKER_00Yeah. And if you don't fix it, then it's gonna cause a bunch of stuff to pop up downstream. We're talking like here's the thing, right? Imagine like you don't take care of this. What is the the compound effect that this can have over time? Like we're talking, what, colitis or uh yeah, I mean chronic gut and leaky gut, yeah.
SPEAKER_01You're gonna feel yeah, it's gonna be bad. You're not gonna feel good, right? And you're not gonna lose weight.
SPEAKER_00Right. Right. And so it continues that pattern of, oh, I'm trying everything and it's not working, right? But sometimes it's the things that it feels boring or it seems like it's not a big deal, or it's like, can we can we start to have an approach of the inside out approach of like, okay, what do I need to do that a lot of this stuff is free?
SPEAKER_01Oh my gosh, I know.
unknownRight?
SPEAKER_00It's like slow down, being tension with your meals. It's like, yeah, and if you are already experiencing symptoms, because a lot of this stuff can be preventative, but if you are already experiencing symptoms, that's where getting blood work done with a practitioner that's going to be able to interpret it correctly and get all of the lab factors and test out and see what is actually going on and be able to paint this picture of putting these dots together to say, okay, well, this is probably what it is. And instead of doing this 50 supplement routine or, you know, trying to cure yourself with antacids, then let's take this approach and we can fix the foundation so that way the systems are working the way that they should.
SPEAKER_01Yeah, exactly. Exactly.
SPEAKER_02So if this episode made you rethink about your digestion or you're like, oh, I have some of these symptoms, right? Yeah, share it with someone who needs to hear it, right? Always, and if you have topics you want to learn about, let us know.
SPEAKER_00Yes. Yeah. Throw away the thumbs, get some mindfulness around your meals, and if you're having extreme symptoms, get the blood work done and see if there's something that you can do and get um get a better idea, a better picture of how to manage your gut because we talk about this all the time, but and we'll continue to talk about it because it is becoming more and more relevant as well. And I think more people are um being more open to it and understanding the tie and how much the gut powers everything else in the body and how important it is to everything else.
SPEAKER_01Yeah, so like and share, give us a five-star review. We appreciate it, and we will see you guys next time.
SPEAKER_00See you next time.
SPEAKER_01Bye.