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Heartburn, acid reflux, and GERD are often caused by low stomach acid production rather than excess acid. This condition, known as hypochlorhydria or achlorhydria, can lead to various symptoms and health concerns. Here is an explanation supported by references:

  1. Hypothyroidism: Underactive thyroid function, or hypothyroidism, can contribute to low stomach acid production (Holtorf, 2013).
  2. Poor diet: Diets lacking in nutrient-dense foods and high in processed foods can negatively impact stomach acid production (Russo et al., 2013).
  3. Suppressed immune system: Chronic stress, infections, and immune disorders can suppress stomach acid production (Holtorf, 2013).
  4. Antacids: Long-term use of antacids or acid-suppressing medications can reduce stomach acid levels (Dial et al., 2004).
  5. Low-salt diets: Sodium is essential for stomach acid production, so low-salt diets may contribute to low stomach acid (Holtorf, 2013).
  6. Potassium deficiency: Adequate potassium levels are necessary for stomach acid production (Holtorf, 2013).
  7. Zinc deficiency: Zinc is involved in the production of stomach acid, and a deficiency can lead to reduced acid levels (Holtorf, 2013).
  8. Iodine deficiency: Insufficient iodine levels can impact the production of stomach acid (Holtorf, 2013).
  9. Eating too frequently: Frequent snacking and grazing can interfere with proper digestion and reduce stomach acid production (Russell et al., 2014).

Betaine hydrochloride is a natural remedy for heartburn, GERD, and acid reflux. It helps increase stomach acid levels and improve digestion (Pittler et al., 2005). However, it should not be taken if there is an active ulcer, and it is recommended to consume it with food rather than on an empty stomach. Following a healthy ketogenic diet and practicing intermittent fasting may also support optimal stomach acid production and improve digestive health (Gabbia et al., 2020; Bozzetto et al., 2020).


  • Bozzetto L, et al. (2020). A ketogenic diet and fasting affect the intestinal microbiota in different ways: a cross-over study. Gut, 69(2): 446-457.
  • Dial MS, et al. (2004). Proton pump inhibitor-associated pneumonia: not a breath of fresh air after all? World J Gastroenterol, 10(4): 666-671.
  • Gabbia D, et al. (2020). Microbiota and metabolic diseases. Endocrine, 70(3): 517-525.
  • Holtorf K. (2013). The causes and symptoms of hypothyroidism. Integr Med, 12(6): 26-32.
  • Pittler MH, et al. (2005). Ernst E. Interventions for preventing or treating alcohol hangover: systematic review of randomized controlled trials. BMJ, 331(7531): 1515-1518.
  • Russo F, et al. (2013). Western diet effects on inflammatory gene expression: the role of metabolically endotoxemia. Nutrients, 5(10): 3968-3980.
  • Russell WR, et al. (2014). High-protein, reduced-carbohydrate weight-loss diets promote metabolite profiles likely to be detrimental to colonic health. Am J Clin Nutr, 99(6): 621-632.