So I'm a 29-year-old guy and my GP told me I have a B12 deficiency after some blood tests. After talking to him he concluded that the most likely reason is my diet and PPI intake. Is that true I wonder?
If anyone here can help me understand if this could be causing my low B12?
I've had a lot of stomach acid related problems all my life , with gastritis when i was a teen and a duodenal ulcer about 5 years ago , caused by acid oversecretion. I got an endoscopy and a biopsy and I was H. Pilory positive and i got treated for it and i seem to be negative for the time being ( did a follow up test a few weeks ago ).
I did a few blood tests then and my B12 levels were good.
Now after my ulcer incident I started taking PPIs constantly for fear my ulcer will come back if I don't.
I was also overweight and in an attempt to lose weight ( which I did ) around 3 years ago I started a very strict diet consisting of small quantities of food and very little in the way of meats ( almost exclusively chicken/turkey ) which i follow to this day in order to maintain my health.
Now I wonder is the combination of 5 years of PPIs and 3 years of almost no red meat/fish consumption and relatively low dairy consumption enough to trigger the b12 deficiency?
I am scared I might have the autoimmune one but my doctor doesn't believe me. I heard it's liked to low stomach acid which was definitely not the case for me but I just want to hear about other people that are in my shoes.
I got a B12 shot for now and I started taking supplements and i will be slowly be getting off PPI's in the following weeks/months , but who knows.
Thanks for reading,
Alex
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gogo11
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I believe that the PPIs have caused your vitamin B12 deficiency . They totally neutralise your stomach acid which is essential for B12 absorption . I believe the small amount of meat you were eating , plus butter milk and eggs would provide enough B12 for your needs , but you were not able to absorb the B12 . We do not need large amounts of B12 . In your place I would try to drop the PPIs gradually . Give your stomach a treat with probiotics ( organic raw sauerkraut is the best and cheapest way ) You can make it yourself ! Recipes on line . Or if that fills you with horror try Symprove ( (expensive !) or Bio kult capsules . This will help establish good stomach flora , essential for absorbtion of all vitamins and minerals . There are good books on the subject . Read Patrick Holdords. Glutamine capsules are good for the stomach lining . If you do not have PA , then a vitamin B complex tablet will be excellent for you . If you do , then B12 injections are the only solution . You need B9( folate / folic acid ) to work with B12 . Mainly found in green leafy vegetables peas . You will get some better advice from some marvellous people on this site . But I wanted you to know asap that there is lots of help here ! Very best wishes
Hi gogo11 to absorb the B12 we source naturally by eating animal products we need a high level of acid in the stomach and the PPIs as you rightly say reduces acid levels so yes, now that you have eliminated the h pylori if you can wean yourself off the PPIs your digestion should improve.
Did you have surgery when you had the ulcer?
Are you on any other medication that might affect B12 absorption such as antibiotics, antidepressants, antacids etc.?
As wedgewood says, get your folate level checked just in case you are deficient in that too as it and B12 helps your iron to function properly.
I'm not a medically trained person but have had P.A. (a form of B12 deficiency) for over 45 years having had surgery for a perforated peptic ulcer at the age of 17 way back in 1959.
They don't use surgery to treat ulcers these days unless they are perforated. Mine wasn't so they just gave me PPI+ Antibiotics to get rid of H Pilory and allow it to heal naturally.
Thanks for the feedback guys, makes me feel better. My folate levels are good , having tested them as well but I do eat a large amount of vegetables and fruits.
I will start taking probiotics as I ease off the PPIs and hopefully that should get me back on track.
You might also give up on the grains; wheat, barley, oats, rye, soy, rice, sorghum and their products.
Do you know what parts/sections of your stomach have been affected by the gastritis? The mechanism for absorbing B12 is quite specialised to the ileum so if that area was affected it will lead to absorption problems. PPIs and lowered stomach acidity as a result of them will definitely affect B12 absorption but if you are trying to recover from the h pylori infection taking PPIs will be essential to allow your gut to recover.
Is it actually clear that the problem in the past was high stomach acidity - thought that had gone out of fashion as a theory for what causes gastric ulcers? may be its come back into fashion. Partly querying because the symptoms of low stomach acidity are pretty much the same as the symptoms of high stomach acidity - so easy to misdiagnose if just going on symptoms.
Generally dietary deficiency can take years or decades to occur but if you have also been using PPIs then that could have accelerated depletion of your liver stores - as the mechanism for releasing the stores will have become much less efficient.
If I remember it was an Antral Gastritis but that was a long long time ago. Over a decade. When I had the ulcer she did an endoscopy and she said saw where my old gastritis was but that it looked healed.
I have read about atrophic gastritis but I figure the doctor should have mentioned something then right?
Anyway, the ulcer was duodenal which as far as I know it is caused by H pylori because of the increase in acid in the area. I know some stomach ulcers can be caused by acid under secretion but as far as I know, mine wasn't.
Plus during the time with my ulcer problems before figuring it out we did a lot of tests and all the bloodwork came back good, including B12 and folate so it wasn't an issue before.
If it was the autoimmune one shouldn't it have been an issue then as well?
Now I have been on constant PPIs for 5 years now, mostly as a precaution even though the ulcer is healed and I have been on the low meat/dairy diet for almost 3 years as well and even before I consumed almost zero red meat and fish ( since I don't like them ).
I have started taking supplements and getting off PPIs in the last few days though.
It sounds like you have a couple of causes for your deficiency (h. Pylori and PPI intake).
While it doesn't appear to be autoimmune, the treatment may still need to be the same. You may have experienced enough permanent damage from the h. Pylori and the ulcer to permanently impair absorption of B12, so you may need to be on injections for life.
You should discuss this with your doctor.
problems since your teens suggest an agent causing problems. One major causal agent is of course the grains followed by dairy. you could give up all grains including wheat barley oats rye maize sorghum rice soy etc for 3 months . also ban processed foods. long term damage leads to autoimmune disease..
Dairy is a source of B12. Consuming dairy does not cause pernicious anemia or B12 deficiency.
While it is necessary for some people to avoid certain foods due to reactions to those foods, it is better to figure out if there is truly a reaction by keeping a detailed food diary rather than rather than rashly eliminating entire categories of nutrients.
None of the original poster's question points to celiac or food allergies/sensitivities.
There is currently no evidence showing a cause and effect relationship between the type or quantity of food consumed and the onset of autoimmune disease.
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