How weak stomach acid can cause iron deficiency anemia and remedies

Anemia can be related to low iron. HCL or stomach acid plays an important role in the absorption of iron. Some people may tell you that vitamins or minerals are absorbed in the small intestine, not in the stomach. Yes, the majority of nutrients are absorbed in the small intestine. But the fact is that if you miss the initial processing of nutrients to make it bio-available for absorption in intestine you are likely to miss some nutrients. They will just pass through your gastrointestinal tract without proper absorption.  How much nutrients you put in the mouth, you will likely miss the nutrients if your body fails to process the same. Here we will show you How weak stomach acid can cause iron deficiency anemia and remedies.

Iron is an essential mineral that has to obtain from external sources. It plays a critical role in the transportation of oxygen-rich blood around the body. Deficiency of which can lead to iron-deficiency anemia.

Not having enough stomach acid not only leads to iron deficiency anemia but also can lead to vitamin B12 deficiency anemia or pernicious anemia. 

How weak stomach acid can cause iron deficiency anemia and remedies

Usually human obtains iron from two food sources animal sources and plant sources. Organic heme-iron primarily comes from animal source and inorganic non-heme iron primarily from the plant source. However, the way of absorption inside the body of both sources of iron differs very much from each other. Plant source of iron is encased with fiber, so processing of iron from plant source is difficult than heme iron. The problem of absorption mainly occurs in the case of inorganic non-heme iron when the ph of stomach acid or gastric juice is high.

Low ph indicates a strongly acidic environment, in the other way high ph indicates weak gastric juice.

Processing of non-heme iron inside the stomach

The human body processes usually two forms of iron ferric iron and ferrous iron. Ferric iron reduces to ferrous iron and so the body can more easily process reduced form than ferric iron.

The absorption of inorganic iron in the small intestine largely depends on the bio-availability of inorganic iron-based upon its chemical and physical state when it reaches its point of entry.  In neutral or near-neutral acidic conditions, ferric irons normally undergo polymerization. And on the other hand ferrous irons tend to oxidize to ferric iron.  The presence of acid limits the polymerization of ions of ferric iron and prevents protein binding of irons. And thus increases the bio-availability of iron for absorption. Normal gastric juice contains substances that stabilize iron and prevent it from eventual participation with other substances at a low acid level. Normal gastric juice substances combine with iron, prevent eventual participation, and maintain a soluble form at the neutral acid level. This soluble state of iron improves the bio-availability of iron. And thus helps small intestine to absorb iron. (1)

Where are the researches?

In a study published in the American Journal of Clinical Nutrition, researchers found that patients with a weak stomach have severe malabsorption of non-heme iron. They found a weak stomach reduced the normal increase in heme-iron absorption from hemoglobin in response to iron deficiency. They further informed that weak stomach acid can be an independent cause of iron deficiency anemia. (2)

Study in vivo found that absorption of non-heme iron correlated well with the ability of gastric juice to solubilize the iron from the nonheme source. Based on result researchers concluded that pH is the only factor in gastric juice that is of importance in modifying the absorption of non-heme iron. (3)

In another study, 35 of 44 people with chronic iron deficiency found to have below normal acid secretion. (4)

Helicobacter pylori infection, ulcer relation

Helicobacter pylori bacteria infection leads to loss of parietal cells i.e. cells in your stomach lining and increases ph of gastric juice. The increase in ph indicates weak acidic value. (5) Helicobacter pylori and gastric acid have a close and reciprocal relationship. (6)

And a major percentage of people iron deficiency anemia has helicobacter pylori infection. Apart from other factors, iron deficiency is most often the result of gastrointestinal disease associated with abnormal blood loss or malabsorption. (7)

Helicobacter pylori commonly cause stomach infection, ulcer as well as closely relates to iron deficiency anemia. This infection reduces acid-secreting cells in the stomach.

Related Post:

H. Pylori and the relationship with gastritis, peptic ulcers & symptoms

Best natural treatments to eradicate H. pylori bacteria from your stomach

How weak stomach acid can lead to impair secretion of pancreatic enzyme. And further, it leads to malabsorption of nutrients including carbohydrate and protein fermentation as well as bacterial overgrowth.

This deficiency mainly associated with non-heme iron i.e. vegetarian source of iron, a plant source of iron, and some fortified foods. Iron in the vegetarian source is usually encased with fiber and inorganic state. And so to absorb iron, it must be separated from the fiber. And gastric juice contains ascorbic acid and plays an important role in reducing iron to the more bioavailable ferrous form. (8) For that reason, vitamin C helps in proper absorption of iron as ascorbic acid is the reduced form of vitamin C.

Bottom Line:

One advantage of non-heme iron is its slow absorption and release of iron in the bloodstream which prevents iron toxicity. However weak HCL or gastric juice secretion in stomach impairs the absorption process which can lead to iron deficiency anemia especially in people with a vegetarian or vegan source of foods. Restoring gastric juice can ease the problem if tested low. In our earlier article, we mentioned the importance as well as the restoration of gastric juice to a normal stage. Regular taking of antacid, proton pump inhibitor, or other acid suppressor weakens stomach acid as well as makes the situation worse. An individual should not use those drugs as over the counter medicine. Stomach acid also weakens with age. Some other lifestyle factors and mineral deficiencies may also play a role.

People may have infections or ulcers in the stomach. In such a case restoration of stomach acid should be done only after eradication of bacteria that causes stomach infection and healing infection. You can read our previous article healing of ulcer in the stomach along with some must-do prevention measures.

Hope this article will provide light on How weak stomach acid can cause iron deficiency anemia and remedies. We have linked other related article here so that reading them help to understand better.

Disclaimer: Information provided here are generalized information 
for informational and entertainment purpose only,  not intended 
to provide one to one health consultation or replace practice of 
a qualified practitioner.Different people may have different 
health condition and may have different reaction to the same 
food. Hence it has been advised to consult with health  
care provider before application of any of above information 
Source and references:

Source and references:

1.Role of gastric secretion in iron absorption,A. Jacobs and P.M. 
Miles,Gut,1969,10,226-229
2.Is achlorhydria a cause of iron deficiency anemia?,Betesh AL,Santa Ana 
CA, Cole JA, Fordtran JS.,Am J Clin Nutr. 2015 Jul;102(1):9-19
3.Bezwoda W, Charlton R, Bothwell T, Torrance J, Mayet F. The importance of 
gastric hydrochloric acid in the absorption of nonheme food iron. The 
Journal of Laboratory and Clinical Medicine, 1978, July 1978,
Volume 92, Issue 1, Pages 108–116
4.Gastric acid secretion in chronic iron-deficiency anaemia,A.JacobsM.D. 
Lond., M.C.Path.(SENIOR LECTURERIN HÆMATOLOGY)J.H.LawrieM.B. Glasg., 
F.R.C.S., F.R.C.S.E.(LECTURER IN SURGERY) C.C.EntwistleM.B. Brist.,M.C. 
Path.(LECTURER IN HÆMATOLOGY)H.CampbellM.A., M.B. Durh., F.S.S.
(SENIOR LECTURER IN MEDICAL STATISTICS),The Lancet, Volume 288, Issue 7456, 
23 July 1966, Pages 190-192
5.How does Helicobacter pylori cause mucosal damage? Its effect on acid and 
gastrin physiology, Calam,Gibbons A, Healey ZV, Bliss P, Arebi 
N.,Gastroenterology. 1997 Dec;113(6 Suppl):S43-9; discussion S50
6.Helicobacter pylori and gastric acid: an intimate and reciprocal 
relationship,Helge L. Waldum,Per M. Kleveland,and Øystein F. Sørdal,Therap 
Adv Gastroenterol. 2016 Nov; 9(6): 836–844
7.Iron deficiency, Helicobacter infection and gastritis,Hershko C1, Ronson
A.,Acta Haematol. 2009;122(2-3):97-102.
8.Regulation of intestinal non-haem iron absorption,M Lombard, E Chua, and 
P O'Toole,Gut. 1997 Apr; 40(4): 435–439

Author: Bikramjit Konwar