Should I Supplement With Hydrochloric Acid?
15 Dec 2025 · 6 min
Dr. Michael Ruscio explains that 20-30% of people with hypothyroidism have low stomach acid, rising to 50% if you're over 65 or have a family history of autoimmune disease. Take HCl mid-meal at 500-2000 mg per dose, and stop if you feel burning or continue if bloating improves.
Questions this episode answers
About 20–30% (with certain risk factors this can rise to ~50%).
Age over 65, history of anemia, and a family history of autoimmune disease (combined risk up to ~50%).
About mid-meal; avoid taking at the end of the meal.
Approximately 2–4 capsules per meal of about 500 mg per capsule.
Chapters
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Should I supplement with Hydrochloric Acid? This is JJ Virgin four time New York Times bestselling author, celebrity nutrition expert, and Fitness hall of Famer. I've been on a lifelong quest for answers to the toughest health questions, and now I'm sharing what I found with you. Welcome to Ask the Health Expert. Jay from the bay 77 from Instagram asks you recommend considering hydrochloric acid to supplement to your meals. If you have hypothyroidism or Hashimoto's what timing do you suggest or what protocol? Hey, it's J.J. and I've got Dr. Michael Ruscio with me to answer this question. Now. You may know him from his Dr. Ruscio Radio podcast or Moore is the author of the best selling book Healthy Gut, Healthy you. I know. He's also an adventure junkie who's a musician in his spare time with a secret dream to paraglide. We'll be right back to answer the question.
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This is a great question and it's definitely relevant. Why this is relevant is because there's about a 20 to 30% chance that if one is hypothyroid that they also do not adequately secrete stomach acid. And in these cases that tells us there is a root causative issue we can address. Which is really helpful to know because if you're not secreting adequate hydrochloric acid, there are an array of downstream effects that that can ensue behind that, one of which can be malabsorption of things like iron. Another can be malabsorption of B12. Also remember that as food goes from your stomach down the intestinal line into the small intestine and on, you need to have adequately acidified food or chyme so that you don't allow bacteria and fungus to overgrow. And so this may be why we see increased prevalence of things like SIBO in those with hypothyroid. So yes, hydrochloric acid for those who are hypothyroid is a consideration. It is not to say careful that everyone who is hypothyroid must take hydrochloric acid, because that would be wrong. We want to personalize this to the individual. And I'm working my way up to the question about meal timing here, but this context is really important because first we have to answer should you use this or should you not? So age is a factor that also helps us predict if someone needs hydrochloric acid. The older you are, the more likely you will need it. Being above 65 increases your potential need for hydrochloric acid. A history of anemia also increases your potential need for hydrochloric acid. And if you have a family history of an autoimmune condition, that also increases your need for and the need goes up to about 50%. Especially if you're older, you have a history of anemia and or an autoimmune condition up to about 50%. So that's not 100%. It's 1 and 2. It's something, but it's not everyone. Now, regarding timing, I don't think it really makes that much of a difference. The one thing that you probably should avoid is not taking hydrochloric acid supplements at the end of your meal. What happens in some of these cases is people feel a bit acidity and they feel refluxy and warm. And I think why that happens is because the acid is just sitting on top of your food rather than kind of being mixed in. So I would say take the supplement about mid meal. Again, it probably doesn't make a huge difference. What matters is is that you try to isolate this variable. Go onto a hydrochloric acid supplement if you notice a negative reaction that lasts more than a few times, like burning or reflux, that tells you yay. You have adequate production, you don't need it. I would not recommend doing the keep taking more and more and more pills until you feel a burning sensation and then take a little bit less because there's no evidence behind that and that's just a theory. And you don't need these whoppingly high doses. Just anywhere from two to four capsules per meal of about a 500 milligram capsule will be enough for most people. Alternatively, if you start using the supplement and you notice I feel less bloated, I feel less full, I have less reflux, these are all the positive benefits that you're looking for. Telling you that you need the hydrochloric acid supplement. So listen to your body on this one. It's about a 5050 if you will or you won't need it. We laid out some of the factors that may help predict if you do, and then go into an objective self experiment to qualify if you do or don't need this.
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