That’s great if you’re dealing with excess acid… but what if your heartburn is actually a sign of not enough stomach acid?

Low stomach acid (hypochlorhydria) is more common than most people think and can cause symptoms similar to acid reflux, like heartburn and bloating [3]. Using antacids or PPIs without addressing the real cause may actually make things worse by further lowering stomach acid, leading to poor digestion and nutrient deficiencies. If you have ongoing symptoms, it’s important to find out whether you have too much or too little stomach acid.

The Problem with Long-Term Use

Here’s why relying on acid blockers might not be the miracle cure you think it is:

1. Nutrient Depletion

Stomach acid isn’t just there to cause discomfort; its role is to help digest food and absorb nutrients [4]. Suppressing it messes with the absorption of:

• Calcium (linked to increased fracture risk due to reduced bioavailability)
• Magnesium (hypomagnesemia can cause constipation, muscle cramps, arrhythmias, and seizures, especially after prolonged PPI use)
• Iron (low acid impairs iron absorption, raising anemia risk)
• Vitamin B12 (acid suppression reduces protein-bound B12 absorption, leading to deficiency and neurological issues)

Over time, this can contribute to serious deficiencies, especially in older adults or those already struggling with chronic conditions.

2. Microbiome Imbalance

Stomach acid acts as a barrier against pathogens. Reducing acid increases susceptibility to infections like Clostridioides difficile, pneumonia, and gut dysbiosis (e.g., SIBO, candida overgrowth). Long-term PPI use alters gut microbiota, weakening immune defenses and increasing infection risks [5].

3. Masking the Real Issue

Reflux symptoms (heartburn, bloating, burping) may stem from low stomach acid (hypochlorhydria), which impairs digestion and weakens the lower esophageal sphincter. Suppressing acid without addressing the root cause, such as H. pylori infection, aging, or nutrient deficiencies, perpetuate deficiencies, infections, and digestive dysfunction [4].

What to Do Instead (Your Gut Will Thank You)

Ready to ditch the quick fix and actually support your digestion? Here are some tried-and-true, herbalist-approved ways to love your gut back into balance:

• Prime Your Digestion with Bitters

Take herbal bitters (like gentian, dandelion, or artichoke leaf) 10–15 minutes before meals to naturally stimulate:

• Stomach acid production
• Bile flow
• Digestive enzyme release

Bitters prep your body for digestion like a warm-up before a workout. Bitters work by activating bitter taste receptors in your mouth and gut, which triggers a cascade of digestive processes: more saliva, increased stomach acid, and enhanced bile and enzyme secretion essential for breaking down and absorbing nutrients efficiently [6]. This not only helps prevent indigestion and bloating but also supports a healthy gut microbiome and regular bowel movements (plus enhances liver function!).

• Soothe After Eating

If you still get a little burny post-meal, swap the antacid for a cup of chamomile or catnip tea. They gently calm your digestive tract and ease gas or cramping without shutting down your gut’s fire.

• Mindful Eating = Magic

Slow down. Chew thoroughly. Avoid eating when stressed or distracted. These simple shifts bring your nervous system into parasympathetic mode (aka “rest and digest”), helping your gut do its job beautifully.

Want More Tips? I’ve Got You.

To explore more Holistic Solutions for Heartburn Relief (including how to survive rich meals without the burn), check out my blog on Thanksgiving Heartburn Relief. You’ll learn how to make friends with your belly, one bite at a time.

And if you’re ready to stop treating your symptoms like annoying guests and start honoring your body’s deeper messages, my Fullscript herbal dispensary is stocked with gut-loving goodies I recommend. 

TL;DR: Antacids Aren’t the Villain, But They’re Not the Hero Either

They might help in the short term, but long-term use can create nutrient deficiencies, mess with your microbiome, and hide the real digestive issue. Instead, support your body’s natural digestive fire with herbs, lifestyle changes, and good old-fashioned chewing.

Because healing isn’t about symptom suppression, it’s about addressing root causes and the agency to choose the best path forward. 

Grab my free Natural Medicine Cabinet Remake Guide for a practical starting point in building a plant-based, evidence-informed home apothecary: pages.marinabuksov.com/medicinecabinet

References:

1. Salisbury, Blake H., and Jamie M. Terrell. 2023. “Antacids.” StatPearls – NCBI Bookshelf. August 8, 2023. https://www.ncbi.nlm.nih.gov/books/NBK526049/.
2. “Antacids.” 2023. August 10, 2023. https://patient.info/digestive-health/indigestion-medication/antacids.
3. “What Is Hypochlorhydria?” n.d. WebMD. https://www.webmd.com/digestive-disorders/what-is-hypochlorhydria.
4. Maideen, Naina Mohamed Pakkir. 2023. “Adverse Effects Associated With Long-Term Use of Proton Pump Inhibitors.” Chonnam Medical Journal 59 (2): 115. https://doi.org/10.4068/cmj.2023.59.2.115.
5. Kiecka, Aneta, and Marian Szczepanik. 2023. “Proton Pump Inhibitor-induced Gut Dysbiosis and Immunomodulation: Current Knowledge and Potential Restoration by Probiotics.” Pharmacological Reports 75 (4): 791–804. https://doi.org/10.1007/s43440-023-00489-x.
6. Harada, Yumi, Junichi Koseki, Hitomi Sekine, Naoki Fujitsuka, and Hiroyuki Kobayashi. 2019. “Role of Bitter Taste Receptors in Regulating Gastric Accommodation in Guinea Pigs.” Journal of Pharmacology and Experimental Therapeutics 369 (3): 466–72. https://doi.org/10.1124/jpet.118.256008.