Gastrin test

[yogamom1]

Hi everyone,

I posted on here a few weeks ago talking about some of my lab results and what they could possibly entail. Some possibilities were atrophic gastritis and pernicious anemia. I definitely have been diagnosed with barrett's esophagus at the young age of 30. The reason why atrophic gastritis/pernicious anemia was a possibility is because my parietal cell antibody count is off the charts high at 113.4 and also because of my symptoms. Upper abdominal pain/pressure, heartburn, excessive bloating and gas, feeling full quickly, iundigested food in stool, and malabsorption of vitamins/minerals. Last week my doctor did a gastrin serum test, and result of this is also WAY off the charts. Normal is 0-115. My result is 1847, was tested twice to be sure it wasn't contaminated or anything. I have discussed atrophic gastritis/pernicious anemia with my GI doctor as well as my hemotologist. Hemotologist says it's definitely pernicious anemia, but GI doctor says since my gastrin levels are so high that I may have a rare genetic condition called multiple endocrine neoplasia syndrome. I didn't know such a condition existed until yesterday. Has anyone had the gastrin test and had such a high result? I'm not sure if I'm posting under the right topic anymore, so if anyone knows another forum topic I could post this under please let me know. Doctor wants to do an MRI of abdomen/pelvis to check for tumors and draw more labs that are particular to this genetic condition. One thing as well, is he also tested SED rate (the result was 4) and c reactive protein (result was <0.3) so he says I don't have a lot of inflammation or anything. Is there anything else I should ask about or be aware of? Has anyone gone through something similar? Hearing all these possibilities at once has been pretty overwhelming the past couple of weeks.

[fbirder]

Do you know why the doc dismissed the idea of your hypergastrinaemia being caused by your anti-GPC antibodies. They kill off your GPCs, so your stomach no longer makes hydrochloric acid - and it's that acid that switches off gastrin production in the normal stomach.

That's much more likely than the idea that you have Zollinger-Ellison Syndrome causing a Type 2 Neuroendocrine tumour to boost gastrin levels. This is caused by a defect in the MEN genes.

Here's a review article that explains Type 2 NETs (and Type 1 - which is what I have) and how they effect, or are effected by, gastrin.

onlinelibrary.wiley.com/doi...

[ndodge in reply to fbirder]

Brilliant, fbirder!

[yogamom1 in reply to fbirder]

Thank you for your reply. I'm not 100% sure why he dismissed the idea but my guess is that he assumes I have way too much stomach acid because I have Barrett's esophagus. He's prescribed me a number of different acid reducers. I have been very reluctant to start them because I have entertained the possibility of low stomach acid but he's like "nope! It's definitely high since you have Barrett's esophagus!". So I still haven't started taking them for fear I may make stomach acid non existent. I am almost certain that a lot of these symptoms stem from atrophic gastritis/pernicious anemia and have assumed so for the last year or two. What you say makes sense. Other than the tests he's already doing in not sure how to prove to him that this is more likely the possibility. Maybe he will consider it again if the labs don't show any rare genetic conditions. Anyway, thank you for the excellent link I will print it out and highlight important areas.

[fbirder in reply to yogamom1]

Just about all of your symptoms match those of low stomach acid - except for the Barrett's Oesophagus. I've not found anything that suggests hypochlorhydria can cause it - although it is caused by GERD, which can be caused by hypochlorhydria.

There's a quick and dirty test you can try at home -

First thing in the morning add a teaspoon of baking powder (sodium carbonate) to a glass of water and drink it. Within a couple of minutes it should start reacting with any acid in your stomach to produce carbon dioxide (a lot of carbon dioxide). This will make you burp.

A couple of small burps (due to swallowed air) aren't an indicator of a reaction. If you have acid in your stomach you should be burping a lot.

From what I've read (just now) Barrett's Oesophagus is quite distinctive. Have you seen a picture showing the boundary between the two cell type in the wall of the oesophagus?

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ulcer free by georges m Halpern sheds some light on gastric health.