I am so glad I found this site... I'm very new to dealing with B12...
have now got books and am well researched. In short what I need to
know is information about other form of acid reflux control other than
the ones now known to inhibit B12. (PPI)
My GP kind of poo pooed the suggestion that PPI's had been inhibiting
all my vegetarian diet B12 intake.... I hear you saying, "Well not much
there in the first place then"...ha ha.. I was confident enough to tell him it was quite true and asked him to Google it soon....I have all the symptoms of PA. I fill most
of the criteria including a grandmother who died of it and an elderly cousin
who has to injections.
I am being blood tested next week to see if my iron count has improved
as it was low. Only after reading out all the symptoms and family history
did my GP add B12 to my blood bag. It seems B12 is very far from GP's
diagnosis prowess despite him to be a very investigative
doctor...the best we have in the practice. I was surprised. However he
willingly and quickly added B12 to the list.
He did not think much of my suggestion that people could show they have fair
B12 levels but their body just cannot utilize it for some reason. He has obviously
never heard of that arena... That will be my fight if any.
Meantime... I am desperate to come off the PPI's I have been prescribed for
about 13 years now... I went without earlier this week and it was not a good
experience on two consecutive days. Hoping one of you has found something
as an alternative. Perhaps something to see one past occasional bad bouts without
hindering the B12 utilization..?
On the diet front I am a vegetable and fruit freak...in case you are thinking I am a butter, cream or fast food lover and aggravating my stomach via diet.. lol.
AFTER my blood test and whilst I am waiting for my results I'm going ahead and
going to test drive some B12 patches. I ordered them today.
Many thanks in advance of any hints and tips you can pass on.
Written by
Cybrook
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Hi Cybrook I've had P.A. for 44 years following gastric surgery and have been on PPIs since the mid 1980s when I suffered very badly with reflux. I was started on Cimetidine and am now on Lansoprazole.
Not being a medically qualified person I've often wondered how it can be possible for me to have a high acid level having had two thirds of my stomach removed in 1959 but the pills "seem" to have worked down through the last 30 odd years so I'm reluctant to stop taking them. The fact that they are known to inhibit B12 absorption through the stomach does not apply to me as I have monthly injections of cyanocobalamin.
Your saying that you are vegetarian indicates that you really do need to supplement your B12 level - I assume that your Folate level is good from your diet as this is essential as it works hand in hand with B12.
Oh right...... I do take a high strength pre-and pro-biotic... which made no difference to the reflux ..it was the same about 4 years ago when I started the probiotics and is the same with or without them... However, I do understand it is nothing to do with SIBO... I will now research SIBO ...Ive not heard of it ... Very interesting. Thank you.
Thank you Clivealive... Folate...I am a huge fan of green leafy vegetables and in love with Brussels sprouts..lol... I did ask if folate would be tested on Tuesday but that part may have been lost in the fast time span of my appointment... I have been taking a B complex for many years. I have also taken vitamin D for many years. Acid?-Or not..that is the question indeed...I have read of the DIY test and I will try this out when the time is right.. I am on a PPI as you are with Lansoprozole.
On reading your words, Has it been well established that if you are taking PPI via injection or patch then this will completely ring fence your body store of B12 and the PPI Lanzoprosole and other PPI's wont get to it in the blood stream and inhibit its utilization? i.e. The PPI can only destroy/weaken any B12 within the arena that is the stomach? The PPI effect never reaches the blood stream?
This is an area I have not researched on yet...so I have no idea...
Clivealive.. I think Ive put my reply to you as a main post...sorry if if I have... It does have your name in an addressing form...please look out for it as it should be very nearby..... Ive not used the forum before... forgive.. lol..
Are you sure the problem is high stomach acidity - the symptoms of low stomach acidity - which will cause problems absorbing B12 - are very similar to those of high stomach acidity and the two are frequently mistaken.
13 years of PPIs is definitely too long
If it is low stomach acidity then things like cider vinegar can help and there is a product called Betane (or is it Betaine?) that is frequently mentioned.
I find that having lime or lemon juice in water either with or just before a meal helps with digestion.
Not sure and Ive read there is only a DIY test to do to check out the low or high acidity dilemma. I am waiting till I can get of the PPI before I do the test.
The problem with treating reflux with acid suppressants is that its often caused by low acid in the first place, and not high. If the acid level in the stomach doesn't get high enough then the reflex which shuts the valve at the bottom of the oesophagus doesn't kick in, and the still fairly acid stomach contents can leak back.
You can test yourself whether your stomach acid is adequate by following this article
but you will, of course, need to be off your PPIs for a while. Just stock up on gaviscon and go for it! If your acid is low then cider vinegar or Betaine will help. If it is genuinely high then the PPIs probably are the only way forward.
Its not just B12 that is not absorbed properly. We produce acid in our stomach for a reason, and reducing it impairs all digestion, and therefore absorption. So its bad news all round.
Have you been tested for thyroid deficiency? The symptoms are very similar, and PA and autoimmune thyroiditis often go hand in hand.
Yes Acid Reflux was the problem... I have read of the test and am going to try it when Ive been off the PPI for a longer period.. I will read you link too.
Betaine has been mentioned twice in the good replies here and I am making a note of it...will research it today. Cheers.
Just checked out Gaviston... its no way a PPI so Im going to try it...they say it should be used for Reflux conditions. The article Ive just read said it should be used for Reflux but GP's are prescribing PPI's instead when their original intended use was really for ulcerated stomach conditions.
Great tip ..thank you.
Thyroid... I did specifically ask for a test about 7 years ago at a different medical centre.. it came back as normal... However, if I lived in the States my reading would have warranted investigation as it was just slightly under their guidelines. Hey ho...
If your reflux symptoms are back you can probably do the low acid test within a few days of stopping the PPIs. No need to wait till you are suffering damage to your oesophagus.
Gaviscon is just an antacid. Its very short term, but it gives short term relief if the discomfort becomes too unbearable. I haven't found any of the own brand variations to be as effective. I rarely need it now, but just sucking on one of their tablets is usually enough. Not sure if its the recommended way but....
Thyroid guideline levels have changed in the UK, so you may now fall into the hypothyroid group. The reason I asked is that reflux is common in hypothyroidism. ThyroidUK have a group here on HU. Ask for the test and if you aren't diagnosed then post your results (with ranges) on that group for an opinion regarding what is truly likely to be going on.
Ruth, that is very useful info about thyroid guideline levels changing... I would never have found that out if I had not joined this group... Thank you very much for that.
Im going for Gaviston.. I can get some with my shopping delivery on monday...... and then having a bash in a few days time with Cider Vinegar to see what happens. I will not use them both together and Gaviston will be used only when Im uncomfortable. Cheers for all this valuable information.
Hi sa1234.... Im not sure if digestive enzymes are pro/prebiotics... if so I do take them and have done so for years... but Im going to look up systematic enzymes this afternoon..
digestive enzymes are different than probiotics. They help to break down carbohydrates,proteins,fats,sugars and all foods that you eat.Look for a high quality product which has all the enzymes that you may need.Same goes for the probiotics. Garden of life Raw probiotics are recommended by many naturopaths.Or you should try raw saurkraut or kambucha or any other fermented food along with the probiotics.
The more I find out about PPI's it all gets rather scary on how they have been used by doctors. After talking to my GP yesterday he is either pulling wool over my eyes by stating they do not inhibit vitB12 or his knowledge of them is sparse.
Thank you. Sadly GP's do not always know everything and are often sold a good story by the Pharmaceutical reps ! I remember doing absorption and assimilation at school in Human Biology and learned that we need acid to break down proteins to release such goodies as B12 for their onward journey into the duodenum. When acid is low - food remains in the stomach for too long - it can then ferment - and it is this upward bubbling/fermentation that can give the feeling of heartburn or reflux.
Dr Sarah Myhill - has an excellent website in her name - and I have read her latest book - Sustainable Medicine - where she mentions taking Vitc to bowel tolerance before sleep takes good care of SIBO or gut fermentation.
My Mum used to have some bi-carb in warm water after enjoying home made bread with cheese and pickles
PIL - is the Patient Information Leaflet - which should accompany your pills. Maybe it mentions for short-term use only - not all of them do.
If you type Acid Reflux into the Search Box at the top of this page - then Press Enter on the keyboard - lots of posts will appear for you to peruse - and to know you are not alone !
As Ruthi mentioned I would also get the thyroid checked again - we are both also on the Thyroid UK forum - where having just checked there are over 700 posts regarding acid reflux. Not just the TSH - but the FT4 - FT3 and Thyroid anti-bodies Anti-TPO and Anti-Tg.
Oh heavens...Im so grateful for all these information indicators and links.. Everyone is so helpful... Thank you so much, Marz
I touched on this question in another reply of mine in this thread.....
If B12 is injected or enters the bloodstream via dermal patch, thereby by-passing the stomach, how does a non-ideal condition in the stomach inhibit/destroy it?? Or is B12 safe and readily utilized with any delivery providing it bypasses the stomach?
If you inject - have patches or use sublingual - then you are by-passing the stomach....and all should be well. As one of the articles mentions - it isn't just B12 that is affected by low/blocked stomach acid.
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