Heartburn is a gastrointestinal problem commonly caused by excess stomach acid, for this reason often most people think that they are suffering from this condition and its symptoms are actually caused by having low acidity.

Hydrochloric acid deficiency in the stomach is known medically as hypochlorhydria , many of the patients are treated with antacids, the treatment being inadequate and temporarily hiding the true cause.

In this article I will explain what stomach acid is, the symptoms of having low heartburn and you will also discover what causes it.

What is stomach acid and why is it important?

Stomach acid contains hydrochloric acid (HCL), potassium chloride (KCL) and sodium chloride (NACL), it is a colorless and aqueous digestive liquid. Together with several enzymes and a mucus layer that protects the gastric mucosa, it is part of gastric solutions.

Hydrochloric acid is secreted by specialized cells in the stomach called parietal cells.

During the digestion process, food mixes in the stomach with digestive enzymes and HCL. The acid inactivates the enzymes in the food and breaks down the food in combination with another enzyme called pepsin , later this mixture of nutrients moves to the small intestine, where the HCL is neutralized.

Enzymes produced by the pancreas are attached to the intestine to help complete the process. Once digestion is complete, the nutrients pass through the intestinal wall into the blood to be used by our body.

HCL has a key role in the digestive processes of our body, some of its functions are:

  • Helps break down dietary proteins, digest and absorb nutrients.
  • Eliminates bacteria and viruses from the stomach, protecting the gastrointestinal system from infections.
  • It is essential for the absorption of minerals such as calcium, magnesium, potassium, zinc, and iron.
  • Facilitates the absorption of folate and vitamin B12.

Symptoms of hypochlorhydria or low heartburn

Low levels of HCL affect the ability of the digestive system to properly digest and absorb nutrients. If not treated properly, it can cause gastrointestinal tract damage, infections, and various health problems.

The first symptoms of low heartburn are related to the digestion and absorption of the minerals necessary for the body (bones, teeth), in a study published in the journal Integrative Medicine in 2016, it was evidenced that the lack of heartburn is It has been linked to increased osteoporosis and bone fractures.

This is because calcium increases its absorption in the presence of an acidic environment, in addition, minerals are useful to activate enzymes and hormones such as insulin, among other functions.

The stomach acid deficit also causes problems in the absorption of iron, which can cause the appearance of iron deficiency anemia .

Hypochlorhydria can cause deficiency of “intrinsic factor”, a protein essential for the absorption of the B12 complex. Its deficiency causes pernicious anemia.

Stomach acid is responsible for breaking down the proteins we eat, if there is little it can increase allergies associated with incomplete protein digestion .

Another consequence is the abnormal increase in bacteria in the small intestine , with little heartburn harmful bacteria appear, becoming a risk factor.

If there is not enough heartburn, the pepsin enzyme cannot be optimized, therefore, the digestion and absorption of nutrients is incomplete, causing the classic symptoms of:

  • Gases
  • Abdominal swelling
  • Indigestion.
  • Belching
  • Diarrhea or constipation
  • Heartburn.
  • Food remains in the stool.
  • Fatigue.
  • Vitamin and mineral deficiencies.
  • Protein deficiency
  • Skin diseases.
  • Brittle nails and hair.
  • Numbness of the hands

In addition to these symptoms, it can also cause autoimmune disorders, rheumatoid arthritis, and intestinal disorders such as Crohn’s disease.

Causes of low heartburn

The most common causes of low levels of heartburn can include:


Babies and about 30% of older adults have little hydrochloric acid secretion from the parietal cells of the stomach.

As you get older, less acid is produced, because of this people over 65 years of age have a higher risk of having low heartburn.


Chronic stress can contribute to disrupting the production of HCL and other digestive juices, as it causes poor digestive function.


Long-term use of antacids and proton pump inhibitors known as gastric protectors are among the top 10 most prescribed medications. These drugs can mask the clinical picture and decrease heartburn.

Overuse of antibiotics disrupts the normal flora of microorganisms in the digestive tract. They can cause intestinal inflammation and lead to increased stress hormones that reduce acid production.

NSAIDs , such as ibuprofen, diclofenac, and aspirin, wear down the mucus lining that protects the gastric mucosa and reduce the activity of cells to produce heartburn.

Bacterial infections

Infection with H. pylori is a common cause of gastric ulcers, when not treated promptly, can decrease heartburn.

There are several causes that can lead to a decrease in your heartburn, treating them is important, since HCL is necessary and must be kept in balance for good health.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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