Thought of the day

Hi all, just had my second 8 week maintenance dose and struggling a bit. I have been reading posts concerning low stomach acid and think my recent symptoms of burping after meals, feeling full halfway through the meal and going to bed feeling like a stone is in my stomach may be due to this. Never had this till a month ago and been reading the 2 go together. My question is this.........does low stomach acid cause b12 def....or the b12 injections cause the low stomach acid.....a bit like the chicken and egg !

10 Replies

  • Low stomach acid and B12 deficiency do not cause each other. They both have a common cause - gastric atrophy.

    Have you been diagnosed with Pernicious Anaemia (have you been tested, and found positive for anti-IF or anti-GPC antibodies)? If so, then you have autoimmune gastric atrophy. If not, and you're not a vegan, or had stomach/intestinal surgery, then you probably have gastric atrophy.

    One form of gastric atrophy kills off Gastric Parietal Cells (GPCs). These cells do several things, the two most important being the production of Intrinsic Factor (IF) and production of hydrochloric acid (HCl).

    Intrinsic Factor is responsible for carrying the B12 molecule across the gut wall in the ileum (part of the small intestine). If the GPCs don't produce enough IF then you don't absorb B12 and you have PA.

    HCl is important for digestion. The acid breaks down long biopolymers, especially proteins. The B12 that you eat is bound to proteins in the food. Without HCl the B12 remains bound and can't be absorbed (even with enough IF). HCl does other things - like killing off the bacteria that might make it into the stomach from the small intestine. 

    Lack of HCl (achlorhydria) can produce symptoms similar to high stomach acid. Doctors know about, and can prescribe pills to treat, the latter. Many have never heard of the former, so guess which one gets treated! Giving pills that stop production of acid (Proton Pump Inhibitors - PPIs) only makes achlorhydria worse.

    Because some of the food isn't broken down in the stomach it sits there making you d=feel full. After it can easily make it through the gut to places where bacteria that can break it down start feasting - with the resulting unpleasantness of gas, rumbling and diarrhoea.

    Have a search on here for achlorhydria to find advice on how people have home-treated it.

  • Wow thank you for the really interesting information. I am treated for b12 deficiency due to neuro symptoms but never actually tested for anything else and that was only due to research and me doing a bh private blood test. I have started supplementing with betaine HCI and pectin, on day 3 and already noticing a slight difference, hoping with the right dose for improvement.

  • Thanks very much for that fbirder, WHY DON'T DOCTORS KNOW ABOUT ACHLORHYDRIA ? Has it possibly to do with the fact that any treatment is with UNPATENTABLE products? Like hydrochloric acid ,probiotics,organic cider  , to name but a few ?  

  • That might be the case if it weren't for the facts that - 

    1. The medicines they prescribe are out of patent.

    2. The doctors don't get any money from prescribing patented medicine.

  • No  money but brownie points. Some surgeries have nurses that are paid for by pharmaceutical firms. I happened upon this when I saw a doctor's letter to the BMJ saying that she thought it was unethical. 

  • Hi,

    A link that might be interesting....

  • Very interesting. Shame about some of the 'facts'.

    Achlorhydria does lead to an increased risk of stomach cancer. But it's not due to "Having the wrong bacteria and yeast in the stomach". It's because achlorhydria leads to hypergastrinaemia which increases the growth of some stomach cells. -

  • There is a lot of uncertainty as to the causal loop between the two. You may have gastric atrophy, which results in achlorhydria (reduced stomach acid) by way of the damage done to acid-producing cells in the lining of the stomach. If you have not done so already, you should consider having an endoscopy performed. The procedure will include taking biopsy samples that can be tested for GA. The reason for your symptoms while eating and lying down may be that the GA has reduced the digestive power of your stomach. If so, you may need to begin eating smaller meals and eating them earlier to allow for digestion before bed-time. I am not a doctor. My comments derive from my experience with the condition(s).

  • Thanks for the advice

  • I have low B12 and vitD on injections and vitamins. Before I found out I had been experiencing reflux at night and feeling I had eat too much. Just last night I had a takeaway pizza and fizzy at 7 went to bed at midnight and woke on my stomach coughing with food and a sick taste in my throat? Then slept almost sitting up as it was scary. Doctor doesn't think I have PA but I want to know why I am low in B12. Going to a gastroenerologist in May what will they do?

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