Do I Need to Test My Stomach Acid?

The answer might surprise you...

Welcome to the Gut Honest Truth blog where a Certified Functional Medicine Practitioner gives you digestible information to tackle your chronic health concerns.

That's me, Katie Morra; and in this blog I'm going to break down why stomach acid matters more than most people realize, the signs that yours may be low, and how to actually test it.

If you want to learn more about supporting your gut and acid reflux specifically, check out my How to Get Rid of Your Acid Reflux e-book.

And as always, working one-on-one for your specific needs is always our top recommendation, check out our appointment options to get started with one of our licensed health care professionals today.

What Does the Stomach Actually Do?

The stomach is a large, muscular, hollow organ made up of four main regions: the cardia, fundus, body, and pylorus. Its primary job is temporary food holding and the partial chemical and mechanical digestion of food.

The upper portions of the stomach relax as food enters to accommodate increasing volume. The lower portions contract rhythmically to break food down and mix it with stomach juices — preparing it (as chyme) for further digestion in the small intestine.

Everything downstream — enzyme production, bile release, nutrient absorption, pathogen defense — depends on this process happening correctly.

Signs Something May Be Off in the Stomach

These symptoms are commonly written off as unrelated or just "how you are" — but they often point directly to low stomach acid:

• Excessive burping or belching

• Bloating and excessive gas

• Indigestion or heartburn

• Undigested food in stool

• Food allergies or sensitivities

• Stomach pain or cramping

• Anal itching

• Avoidance of meat (can't tolerate it)

• Weak, brittle hair, nails, or bones

• Neurological symptoms

• Diarrhea

• Fatigue, especially after meals

• Bad breath

• Chronic dysbiosis, candida, or parasites

What Causes Low Stomach Acid?

• Medications and supplements (especially PPIs and acid blockers)

• Chronic stress

• Age

• Atrophic gastritis

• H. pylori infection

• Abdominal surgery history

• Poor diet

• Hiatal hernia

• Poor chewing habits

• Impaired motility

Why Stomach Acid Is So Important

Stomach acid is the conductor of all digestion — and your first line of defense against everything you put in your mouth every single day.

Without adequate stomach acid:

• Protein can't be properly broken down and absorbed

• Digestive enzyme and bile production are impaired downstream, affecting fat and carbohydrate digestion

• Large, undigested food particles reach the intestines and become fuel for pathogenic bacteria, yeast, and parasites

• Nutrient deficiencies develop — particularly iron, B12, zinc, and magnesium

• Pathogens that should be neutralized in the stomach make it through to the gut

This is also one of the most misunderstood aspects of acid reflux — most people assume reflux means too much acid. In practice, it's more often a sign of too little.

How to Test Your Stomach Acid

Baking Soda Test (At-Home)

Mix 1/4 teaspoon of fresh baking soda in 4 ounces of room temperature water and drink on an empty stomach. Time how long it takes to burp. Baking soda combined with stomach acid produces CO2, which causes burping. If it takes longer than 3-5 minutes — or no burping occurs — low stomach acid is likely.

Betaine HCl Challenge (At-Home, With Guidance)

This should ideally be done under practitioner supervision. Start by taking one 300-600mg capsule of Betaine HCl 5 minutes before a protein-containing meal for two consecutive meals. If no signs of reflux, discomfort, or increased belching occur, increase to 2 capsules before meals. Continue increasing one capsule at a time until you feel discomfort, or up to 5 capsules per meal (do not exceed 6). Once discomfort occurs, drop back to the previous dose. Continue at that dose until it eventually causes discomfort, then decrease by 1 again. Repeat until you no longer need the supplement — this gradual decrease reflects your stomach acid production recovering.

Heidelberg Test (Physician Order Only)

Involves swallowing a small capsule with a high-frequency transmitter that measures the pH levels of the GI tract in real time. One of the most accurate objective measures of stomach acid available.

SmartPill Test (Physician Order Only)

The SmartPill capsule measures pressure, pH, and temperature throughout the GI tract. Primarily used to assess gastric emptying time and transit time, but pH can also be evaluated.

Do You Need Betaine HCl Forever?

Rarely — and that's never the goal. Betaine HCl is supportive while you and your practitioner identify and address the root cause of why stomach acid is low in the first place. The supplement should be supplementing a deeper investigation, not replacing it.

There are two exceptions where longer-term support may be appropriate:

Atrophic gastritis — a condition where the stomach's acid-secreting cells are damaged, resulting in little to no acid production. One study found that over 30% of men and women over 60 have atrophic gastritis. Another found that 40% of women over 80 produce no stomach acid at all.

Age over 60 — stomach acid production naturally declines with age, and longer-term support may be clinically appropriate in this population.

Always work with your healthcare provider to determine when supplementation is appropriate and when it's time to taper.

Low stomach acid is one of the most commonly missed root causes behind bloating, IBS, reflux, hair loss, skin conditions, and nutrient deficiencies. If you're dealing with any of these and haven't looked at stomach acid yet, it's worth investigating.

Schedule a free discovery call with our team here.