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How Does Low Stomach Acid Relate To Osteoporosis Treatment?

Symptoms of low stomach acid are valuable clues to risky medications that cause osteoporosis. They can result from calcium supplements or antacid drugs.

Gas, bloating and constipation can all be symptoms of low stomach acid when taking calcium supplements. In the short term:

  • Take just 500 mg of calcium a day for one week, then slowly increase the dose.
  • Increase your intake of fluids.
  • Take your calcium with meals, especially if it is calcium carbonate.
  • Add more high-fiber foods to your diet.

Finally, try different supplements (after referring to the best calcium section) until you find one that suits you and meets the recommended dietary requirements for osteoporosis prevention. Calcium comes in chewable tablets and also in liquid form.

Food based supplements may also be easier on your stomach as may calcium citrate... although more tablets will be required to meet a daily requirement of 1,500 mg.

Stomach Acid Basics

It is also important to investigate acid balance within your stomach to see if there is a larger issue that may be affecting your ability to absorb calcium.

When someone is affected by bloating, heartburn, gas, and indigestion... these may be symptoms of low stomach acid rather than too much acid as most people believe.

Taking an antacid such as TUMS to prevent osteoporosis could further reduce the already depleted amount of stomach acid which is needed to absorb vitamins and minerals.

In a healthy digestive system, the proper concentration of stomach acid – also known as hydrochloric acid (HCl) – kills unhealthy bacteria and fungi that are normally ingested with food and assists the body to absorb nutrients.

If the HCl concentration is too low, a chronic condition called hypochlorhdyria develops.

Some research suggests that low stomach acid affects a significant portion of the North American population and especially the elderly... because stomach acid production naturally decreases with age.

A low output of HCl can lead to chronic nutrient deficiencies as the body's ability to absorb vitamins, amino acids, and minerals is compromised. Prolonged nutrient deficiency can set the stage for many chronic conditions including osteoporosis.

Causes Of Low Stomach Acid

There are a number of things that can cause an imbalance in your stomach acid:

  • HCl production decreases with age. The average 60-year-old produces only one-fourth as much HCl as a 20-year-old.
  • Chronic stress can impair the body's ability to produce the proper amount of HCl.
  • Vitamin and mineral deficiencies due to anorexia or a continued poor diet can cause HCI which in turn affects the body's ability to absorb vitamins and minerals needed to produce proper levels of HCI... a vicious cycle.
  • Excessive alcohol consumption can damage the cells that produce HCl in the stomach.
  • The presence in the stomach of a common bacteria, Helicobacter pylori (associated with stomach ulcers), can impair the body's ability to produce the proper amount of HCl.
  • Prolonged used of proton pump inhibitors (PPIs), commonly used to treat acid reflux and peptic ulcers.

Symptoms Of Low Stomach Acid

Symptoms of low stomach acid may include any of the following:

  • An unusual sense of fullness after eating
  • Bloating, belching, burning, and flatulence immediately after meals
  • Chronic Candida infections
  • Hair loss
  • Indigestion, diarrhea, and/or constipation
  • Itching around the rectum
  • Multiple food allergies and nausea
  • Undigested food in stools
  • Weak, peeled, and cracked fingernails

The symptoms of low stomach acid closely mimic those of excess stomach acid, so it is important to test stomach acidity before you begin treating the symptoms. Maintaining a healthy balance of stomach acid is essential for preventing osteoporosis.

Stomach Acid Tests

The following tests will help you discover whether you're suffering from a stomach acid imbalance:

  • Self-Assessment. To test your current stomach acid, look for a pH paper kit in your local health food store. The test is relatively straightforward and will help you determine your acid/alkaline balance.
  • Comprehensive Digestive Stool Analysis. This test reveals undigested protein fibers in the stool which is a symptom of low stomach acid.
  • Blood Tests. Blood tests can reveal pernicious anemia- a disorder in which the body does not absorb enough vitamin B12 from the digestive tract due, in part, to low stomach acid levels.

Diet To Combat Low Stomach Acid

Diets that help to balance stomach acid are also excellent for osteoporosis prevention.

In addition to having lots of fruits and vegetable in your diet (rather than too much meat), you can add the following foods to your menu to help address symptoms of low stomach acid:

  • Yogurt. The best yogurts are the plain, organic ones with live, active cultures. Look for the yogurts that include probiotics, which literally means "life giving." Probiotics strengthen the good bacteria that help fight infection.
  • Kefir. Kefir is a fermented milk drink that originated in the Caucasus region and is now widely available due to its health benefits. Kefir aids in lactose digestion, making it more suitable than other dairy products for those who are lactose intolerant. It also tastes great and is wonderful with fresh fruit.
  • Ground Flax Seed. Golden flax seed is yummy because of its nutty flavour. (Golden flax seed is slightly more expensive than brown flax but a lot tastier.) Flax is also great for increasing your fiber intake. I like to grind some seeds in my coffee grinder and snack on them during the day.
  • Nuts and Seeds. Nuts and seeds supply the boron that is so great for healthy bones. People with Candida may find that raw or sprouted nuts and seeds are easier to digest.

For information on how one person used a vegan diet to deal with the symptoms of low stomach acid visit Night Time Acid Reflux.

Foods To Avoid

Fortunately the foods that should be avoided to reduce the symptoms of low stomach acid should also be limited to protect bone health.

  • Refined carbohydrates (white bread, pasta, cookies, cakes, crackers, etc.)
  • Alcohol – Many beverages stimulate acid secretion but the worst of all is beer. It could double your stomach acid within an hour.
  • Nightshade vegetables – A small percentage of people experience a bad reaction to nightshade vegetables such as tomatoes, eggplants, potatoes, and peppers (chili, green, red). These may cause gastrointestinal upset such as heartburn and indigestion, or increased inflammation for arthritis sufferers. Avoid these foods if you have a bad reaction to them.
  • Wheat and gluten (a wheat protein) if you have celiac disease.
  • Excessive coffee/caffeine intake.
  • Refined sugars and artificial sweeteners that can feed Candida.
  • Sodium nitrite found in processed foods such as hot dogs, lunch meats, and bacon.
  • Monosodium glutamate (MSG) found in many foods as a flavor enhancer.
  • Trans fats found in many processed and deep-fried foods, fast food, and junk food.
  • Carbonated soft drinks that alter blood pH levels.

Eliminating some or all of these foods is an excellent strategy for reducing the symptoms of low stomach acid.

Calcium Supplements

Calcium requires a lot of stomach acid to break down enough so that it can be released into the blood stream and eventually absorbed into the bones.

Calcium carbonate is perfectly adequate when taken with meals-unless a person has symptoms of low stomach acid.

Calcium citrate will provide additional acid to assist with the breakdown of this important mineral and in liquid form will be even easier to absorb.

The combination of magnesium with your calcium supplement will not only support bone density but will also help to build high quality bone tissue that is resistant to fractures.

More Great Tips

  • Eat small meals throughout the day, instead of three large, heavy meals. Small amounts of food exert less workload on the stomach and require less acid secretion for digestion.
  • Don't overeat. Eating too much of any foods will stimulate the stomach to secret more acids for digestion.
  • Maintain an upright position 45 minutes after eating, to allow for easier digestion.
  • Do not drink ice-cold water as it slows down HCl production.
  • Monitor research on the impact of proton pump inhibitors on osteoporosis and discuss their use with your doctor.


Walking is a perfect exercise for moving the bowels and maintaining a healthy digestive system. A daily 30-minute brisk walk, preferably outside in sunlight, is a good start of any exercise plan.

Meditation, Tai Chi, reflexology, massage, yoga and listening to calming music can also combat stress that may imbalance stomach acidity.

Vitamin D

If you are concerned that low stomach acid may be interfering with your calcium absorption, it is especially important to ensure that your vitamin D blood levels are healthy throughout the year. Osteoporosis Canada reports that vitamin D3 can increase calcium absorption by as much as 30 to 80 percent.

During the winter months in northern regions, 5,000 IUs of vitamin D are often necessary to maintain adequate blood levels. The cost for six-month supply is approximately $10.

For information on supplements that address the symptoms of low stomach acid, visit Osteoporosis Treatment Guidelines.

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