Pernicious Anaemia Society
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PA but now have some stomach issues

Any help comments appreciated.

I was diagnosed with PA in 2013. I also have asthma. I'm on 3 monthly injections.

Tail end of April I had stomach issues. A strange flutter feeling at top of stomach then extreme burping and wind. Went to see GP and he prescribed me omeprazole 20mg for a few weeks and thought gastritis. Symptoms went. Now they are back. Just can't stop burping after food. No flutter feeling thou.

Could they be connected to spatone iron? Could that irritate my stomach? I've stopped taking spatone just now but reckon my ferritin is low. Last tested in march and was 14 which I don't feel is that high.

Gona go back see GP or a private consultant if anyone can recommend one near Glasgow?

I've bought b12 sprays but not started them as worried they upset tummy more.

Im aware PA means I have absorption issues. Could stomach, PA and low ferritin be related? Anyone experienced similar?

I had low ferritin last year and was on iron tablets for 3 months and felt great but not allowed to be kept on them. Now feeling drained with tummy issues 😢

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Have you actually been diagnosed with PA, or with an unspecified B12 deficiency?

If you have PA then you almost certainly have Autoimmune Metaplastic Gastric Atrophy (AMGA). This means that your immune system attacks some cells in your stomach called Gatric Patietal Cells (GPCs).

GPCs have two main roles - they produce Intrinsic Factor (IF, a protein that is needed for B12 to get from the gut to the blood) and they secrete hydrochloric acid (HCl).

If you have AMGA then your stomach doesn't produce enough acid (achlorhydria). Strangely enough, the symptoms of achlorhydria are similar to too much acid. The Omeprazole is a PPI - it switches off acid production.

Obviously this is a 'good thing' if you have high stomach acid, but not very useful if you have achlorhydria.

If I don't fix my achlorhydria by drinking about 40 ml of lime juice with each meal then I can get some nasty symptoms - bloating, wind, diarrhoea, etc. The HCl produced by your stomach helps break down some food, especially protein. Without the acid undigested protein can enter the large intestine. The bacteria that live there have a huge party on this unexpected bonus.

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What's the difference between Lemon and Lime juice ?

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I prefer the taste.

I've just checked the pH of the lemon juice and the lime juice I use for cooking and the lime juice I add to my drinks. All three were around pH 1 to 2. As were malt vinegar and white rice wine vinegar.

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I was diagnosed with PA. My mum has it too. I've read so much about it that I don't know what to do next? Any tips? Go speak to GP again? I really like my GP but find it really frustrating that I need to point out that PA and stomach issues might be related. What do u recommend in the meantime? Dx

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My thought was that my stomach acid could be low. Could that be the case then?

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Would this cause low ferritin?

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Yes, low HCl can cause problems with iron absorption, especially if you supplement with iron sulfate. You can help absorption by taking iron in a 'chelated' form (fumarate, bisglycinate are common) or you can take it with citric acid and ascorbic acid (Vit C) which will both chelate the iron atoms.

My tip is to buy Martyn Hoopers book on B12. Indeed, but two copies and give one to your GP. That's what I did. He read it and passed it round the rest of the practice.

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Also does apple cider vinegar do the same job as lime juice?

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Yes , it does a similar job.As a PA patient I have had the problems associated with low stomach acid. I now regularly take probiotics either natural( all fermented foods organic raw sauerkraut, kimchi ) or capsules or Symprove .-Probiotics definitely stopped the bloating and pain .

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Maybe you should get tested for celiac disease. I have had celiac for the last 7 years and routinely have low ferritin. When it drops below 50 I have to go in for an iron infusion as I do not absorb the iron anymore. You must feel very fatigued with such a low ferritin. I hope they can help u get your levels up quickly.

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If you have pa then I think you would have low stomach acid and not high stomach acid so omeprazole doesn't sound like a good idea. Apparently symptoms of low and high stomach acid have similar symptoms. Have started reading 'why stomach acid is good for you' and found it very interesting but haven't finished it yet. Have digestive issues, ibs, and found a low FODMAP diet helpful but not sure about your specific issue I'm afraid.

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Thanks for all your comments. I have a GP appointment next week. What tests should I be hoping to have done? Is it easy to check low stomach acid?

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