Pernicious Anaemia Society
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Low Stomach Acid and Intrinsic Factor

Just thought I'd put this info up here before I write it up properly.

Some of you realise that B12 deficiency can be caused when stomach acid is low and the pH level of the acid falls so b12 cannot be cleaved from food.

Well another point to note is that I now have it confirmed by a specialist that when a person is suffering from no or low stomach acid (achlorhydria and hypochlorhydria) then neither is intrinsic factor released.

This means, that irrespective of tests for antibodies, someone with low stomach acid cannot cleave or transport the B12. The test for intrinsic factor, as many will know, used to be the Schilling test. This tested as to whether intrinsic factor was present or not. The test then shifted to that of being an autoimmune test. No one really knows the reason why apart from the fact it was cheaper and more convenient.

Anyway, the bottom line is that it appears many b12 deficient patients out there are lacking intrinsic factor and cannot transport b12 (although my argument has always been that you need to be able to cleave it before you can transport it).

4 Replies

And we all know how useful the IF autoimmune test isn't.

I thought the Schilling test was discontinued mainly because of the undesirability of and increasing scarcity of the cobalt-57 radioisotopes that it used.


I think there were several reasons why they stopped using it - but it still doesn't answer the question as to why they replaced a test which established lack of intrinsic factor with a test which attempts to establish if a patient has an auto immune condition causing the lack.

...and the auto immune thing - well, cause or effect? - and it's at least 50% wrong - and they are now warning that it throws an opposite result if a patient has had B12 within 2-14 days of test - and not everybody gets the test anyway.

If ever there was a worse than useless test, that has to be it.

The fact remains that it's the lack of b12 which causes the cellular damage...


Why did they change the test? Because they haven't a clue what they are doing.

1 like

That's it. You nailed it!


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