Low stomach acid

I was diagnosed with PA 20+ years ago and currently have low ferritin levels (was anemic once before, four years ago).  Several years ago I developed persistent heartburn which I had assumed was due to all the meds I take for several health issues.  The Dr. put me on prescription Prevacid which did the trick.  Now I keep reading about low stomach acid with PA and possibly not being advised to use medications like the one I am on.  Is this correct and should I be talking to the Dr. about this?  Thanks!

20 Replies

  • The symptoms of low stomach acid and excess stomach acid are very similar.

    However, if you have a diagnosis of PA and are being treated for PA with injections then using treatments such as PPI shouldn't affect your personal B12 position as the B12 you are getting isn't being absorbed in your gut anymore.  

    However, it could affect your ability to absorb other nutrients, including minerals and vitamins if the problem is that low stomach acid has been misdiagnosed and treated as high stomach acid.

  • Could it effect my ferritin levels?  I have had problems with low ferritin levels for over a year.

  • Short answer is yes - low/no stomach acid could could affect your ferritin levels.

    Slightly longer answer:

    Ferritin is a protein that the body produces to bind iron so it can use it - eg to create haemoglobin.  If your ferritin is low then one possible cause is that you are not getting enough iron from your food because you have an absorption problem. 


    Also came across this article which might be useful, given that you are in the US


    and this is some guidance on treating iron based anaemia provided by the CDC - so relevant to the US - know it mentions low stomach acid somewhere as it came up in a search on hypochlorhydria


  • Thanks!

  • Yes, it most definitely will affect iron absorption.

    Iron comes in two forms Fe(II) and Fe(III). These used to be (and, quite often, still are) called ferrous and ferric, respectively.

    At neutral pH any iron you swallow will rapidly convert to the Fe(III) form. This is fairly insoluble and difficult to absorb. At low pH (acidic) the solubility is increased, so absorption is improved.

    Some chemicals like citric acid (found in citrus fruit juices) and ascorbic acid (Vit C) can grab hold of the iron, increasing its solubility. That's why its best to take iron along with a glass of orange juice and a Vit C tablet.

    Some chemicals (found it wheat, tea and coffee) can grab hold of the iron and prevent its absorption, so these should be avoided shortly before and after taking your iron.


  • I have PA also, but I get B12 injections. I have also had tummy problems,and was told by my gastroenterologist that PA patients have either no or low stomach acid.The NHS does not treat low stomach acid.You have to treat yourself,. You need stomach acid to kill off bad bacteria,and also help absorb the nutrients in your food. Without acid,you are going  to miss out on lots of nutrients. Prevacid is the worst thing that you could be taking.  I used to take Betain Hydrochloric acid with pepsin capsules when I Ate protein. I have been able to discontinue those now. I do take a water-based probiotic and try to eat some organic raw sauerkraut every day. There is lots of information you can get about this on the Internet  Best wishes to you 

  • I also get B-12 injections, forgot to add that before!  I though I had read somewhere that you shouldn't take things for heartburn but I wasn't sure of it so thank you for confirming that for me!  I see a new Internal Medicine Dr. In 2 weeks so I will bring this up with him.  I hope he is familiar with PA!  BTW, I am in the US.  It sounds like most here are in the UK?

  • Yes most of us are because the founder of tha P.A. Society was from U.K. A marvellous man called Martyn Hooper who is doing so much to get P.A. Properly recognised . If your Internal Medicine Dr. Is of the conventional kind with blinkers on, he will not know much about P.A. A Dr. Kennedy from Santa Rosa has written a marvellous article on Hypochlorhydria(low stomach acid) Try to google it" medical- library.net/hypochlorhydria.html"  It is really informative.  All the best to you from the U,K.

  • I can vouch for the benefits of organic sauerkraut - more effective than any other probiotic I've ever tried.

    After years of gastritis, gall bladder symptoms, IBS, H/pylori, heartburn, etc. all digestive problems disappeared after avoiding gluten and daily spoonfuls of sauerkraut.

    Researchers believe 'leaky gut' is the ground zero of autoimmune disease so, hopefully, this is healing the micro villi in my gut and enabling better absorption of all nutrients.

  • Hi Polaris,  where do you buy your sauerkraut from?  I can only get one with wine in and I'm allergic to alcohol. Thanks, 'M'

  • I know that you asked Polaris(who is far more knowledgeable than I am,) but hope you don't mind me replying. You can buy ORGANIC RAW sauerkraut  it Must be organic and raw, from your local Healthfood shop in the cooler dept.  It's quite expensive at about £5 a jar, but it is very compressed and goes a long way . OR you can make your own. It is quite easy, and much cheaper . BUT IT MUST BE ORGANIC CABBAGE__that white one is the usual' Get instructions from the Internet.  All the best!

  • Grateful for the reply wedgewood.  Thank you 🌺

  • Forgot to say----you must not heat or cook it. You must eat it RAW!

  • I buy Biona organic sauerkraut  from the local health food shop, where they told me that it can also be added to stews and soups when they have cooled a bit - delicious!  

    Ingredients: White cabbage, sea salt, juniper berries - certified organic ingredients. 

    Large jar is just over £2.00 - 680g.

    Don't buy the supermarket version made with vinegar, etc. 

    Many people make their own, as I've been told that even some organic products are pasteurised but it works for me anyway. As Wedgewood has said, the unpasteurised version is probably even more effective but more expensive.

    All fermented foods are good but, having also tried Kefir, did not find it as effective personally.

  • I've just found that Ocado do it - ocado.com/webshop/product/O... - so that's on the next order. The only doubt is one reviewer who said it smells terrible.

    Still, I'm half-German. So my genes should like it.

  • Thanks for this FB - a good price too for unpasteurised. 

    I hadn't considered the genes - I'm half Austrian!

  • 😂👍

  • No nasty smell with Biona.  I wonder if this is why it's infused with juniper berries - I like the taste too.

  • 😋😃. I'll try and get some.

  • Thanks, that is consistent with what I remembered reading!

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