Increasing the amount of acid in your stomach may not sound like a soothing remedy, but it can actually ease digestive woes including heartburn, indigestion, reflux and gas in those whose levels are low. 

According to a landmark study published in the Journal of the American Geriatric Society, more than 30 percent of men and women over age 60 suffer from little or no stomach acid secretion. And though that percentage is lower in the young, it is still quite common. Luckily, boosting your body’s hydrochloric acid is simple; all you need are a few capsules of betaine hydrochloride (HCl) at each meal.

Isolated from beets, betaine is a modified version of the amino acid glycine with three methyl groups attached. It’s the donation of these methyl groups (called methylation) that converts pepsinogen, an inactive precursor, into the active digestive enzyme pepsin, which is needed for the digestion of protein, as well as the absorption of certain nutrients such as vitamin B12. In addition to aiding with digestion, adequate levels of stomach acid protect the body from orally ingested pathogens and prevent bacterial and fungal overgrowth. 

Belief in betaine

Although the scientific literature on betaine HCl is scarce, many practitioners recommend it for conditions related to low stomach acid. According to the Beth Israel Deaconess Medical Center, betaine HCl is used to treat asthma, hay fever, food allergies, candida overgrowth, digestive conditions, lupus and rheumatoid arthritis. In addition, betaine HCl is used to heal ulcers and address heartburn in those with low stomach acid. 

“Since 1976, I’ve checked literally thousands of individuals complaining of ‘heartburn’ and indigestion for stomach acid production using a commercially available, extremely precise, research-verified procedure,” says Jonathan Wright, MD, author of Why Stomach Acid is Good For You. “Over-acidity is almost never found, especially in those over age 35. The usual findings are under-acidity—from ‘just a little under’ to no acid at all—or normal acidity, in which case the indigestion symptoms are caused by something else.”

So how do you determine if you are producing enough stomach acid? “With difficulty, unless you have means to actually measure acid deficit,” Wright says. The challenge lies in the fact that the symptoms of underproduction and overproduction of stomach acid are virtually identical: Bloating or belching after meals, feeling like food is just “sitting there,” constipation and acid reflux. “According to references, some individuals have no gastrointestinal symptoms at all,” says Wright.

Working with a physician is the best way to accurately gauge stomach acid production, and the safest means of determining whether or not betaine HCl is an appropriate treatment for you. Some practitioners use the Heidelberg capsule test, which measures acid production via electronic equipment contained in a plastic capsule that is swallowed. The “self test” below is a less qualitative measure, but is often used to help pinpoint the need for betaine. People with low stomach acid will have a specific supplementary betaine HCl requirement, so it’s imperative to take the time and find the right dose. 

Tummy test

Many resources suggest the following method for determining betaine need and the appropriate dose. To start, take one 550–650 mg capsule of betaine HCl (with pepsin) at the beginning of a meal. Observe feelings in your stomach, such as heaviness, hotness, burning or GI distress. If you experience any of these symptoms, take a small amount of bicarbonate of soda (mixed into water) and discontinue use of betaine HCl. 

If you experience nothing out of the ordinary after taking one capsule, try taking two capsules at the start of your next meal. Again, monitor for burning and/or heaviness both during and after eating. If discomfort occurs, stick with one capsule at the start of meals. If the two-capsule dose produces no discomfort, try three capsules at the start of your next meal, and so on. Keep increasing the number of pills taken with each meal until you notice some GI discomfort. When this happens, you’ll know your ideal betaine HCl dosage is one pill less than the amount you just took. 

Ideally, the use of betaine HCl will help "retrain" your stomach to produce higher concentrations of acid on its own. This process may take anywhere from several weeks to several months, depending on the individual. The most obvious indication that acid production is improving is that one’s normal betaine HCl dose begins to cause a bit of GI distress.

“Though there are no reports of serious injuries occurring from taking too much betaine HCl, it’s possible to give oneself a ‘burn’ if supplementation is not needed,” says Wright. In other words, finding out if you need betaine HCl supplementation might be tricky, but its benefits are very obvious if you do.