Hypochlorhydria (low stomach acid): Causes, symptoms, and treatment

An individual with hypochlorhydria is unable to produce enough hydrochloric acid (HCL) in the stomach.

Stomach acid, along with several enzymes, helps to break down food. Other functions of this acid include:

  • aiding the body in absorbing certain nutrients, such as protein and vitamin B-12
  • killing bacteria and other pathogens in the stomach to prevent infection

In this article, we describe the symptoms and causes of hypochlorhydria. We also explore the treatment options.


Common causes of hypochlorhydria include:


The stomach can produce less acid as a result of aging.

According to a 2013 review, hypochlorhydria is the main change in the stomach of older adults. People over the age of 65 have the highest risk.


While everyday stress may not have much effect on the production of stomach acid, chronic stress can contribute to hypochlorhydria.


Long-term use of antacids or other medications for acid reflux or heartburn may decrease the body’s production of stomach acid.

Doctors often prescribe medications called proton pump inhibitors to treat acid reflux, and these can cause hypochlorhydria.

Bacterial infection

Over 50 percent of people worldwide are infected with a bacteria called Helicobacter pylori (H. pylori). This infection can contribute to low levels of stomach acid and gastric ulcers.

Zinc deficiency

Zinc is necessary for the production of stomach acid. A lack of this mineral can contribute to hypochlorhydria.

Stomach surgery

Some surgical procedures, including gastric bypass surgery, can reduce the amount of acid the stomach produces.

Certain factors can increase the risk of developing hypochlorhydria, such as:

  • taking medications to reduce the production of stomach acid
  • being 65 or older
  • having high levels of stress on an ongoing basis
  • eating a diet that lacks zinc or having poor zinc absorption
  • having an H. pylori infection
  • having undergone stomach surgery

Reducing chronic stress can restore digestive function. The following lifestyle changes can help:

  • managing and reducing sources of stress
  • exercising regularly
  • learning deep breathing and progressive muscle relaxation techniques
  • practicing meditation and mindfulness
  • practicing yoga
  • attending therapy

Changing eating habits

Making some dietary changes can help to improve symptoms of hypochlorhydria.

Avoid foods that are difficult to digest, such as those that are fatty and fried. Also, chew each bite thoroughly to break the food down and allow it to mix with the digestive enzymes in the mouth. Smaller food particles are more easily digested in the stomach.

It is a good idea to avoid eating for at least 3 hours before bedtime. This allows the body to fully digest before sleeping, and it can reduce the risk of nighttime heartburn.

Do not lie down immediately after a meal, and do not eat while lying down.

Addressing nutrient deficiencies

For the stomach to produce HCL, the body needs to absorb zinc from the diet. Zinc-rich foods include:

  • pumpkin seeds
  • oysters and crabs
  • beef and pork
  • fortified breakfast cereals
  • baked beans
  • cashews

A low level of stomach acid can result in other deficiencies, such as a lack of iron, vitamin B-12, and calcium. A doctor or a dietician can help. They may recommend taking supplements or increasing dietary intake of these nutrients, especially once a person regains a regular level of stomach acid.


If left untreated, hypochlorhydria can negatively impact a person’s health and well-being. It is important for people to report associated symptoms and undergo testing.

Once a doctor determines why a person’s level of stomach acid is low, they can recommend ways to relieve or prevent symptoms. Prompt treatment also reduces the risk of complications.

Treatment options include making dietary and lifestyle changes, taking supplements, and altering the course of medications.

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