Ibuprofen and b12

[Gillsie54]

Hi

Can anyone tell me why ibuprofen is so bad wit PA. I heard this at the conference.Is it the damage to the stomach if you have atrophic gastritis which I have or is it because it interferes with metabolism of B12? I have had a bad flare of spinal arthritis with very sore joints from neck to below shoulders, to the point that at night when lying in bed my arms are going dead. When upright it is sore but tolerable but I feel nauseous on eating. Having found the rub on gels less effective I have resorted to ibuprofen but now have had a digestive flair up a bit like pancreatitis with pain on left and biliousness. Seeing GP Thursday. NOt sure what to take. Thanks .

[KimberinUS]

I hurt so bad all over but mostly knees prior to injections that i was taking 3-4 200 mg ibuprofen 2-4X daily.

It was later discovered i had h pylori which causes inflamation. Im sure the ibuprofen was damaging my stomach in addition to the h pylori damage.

My only h pylori symptoms were a b12 deficiency, nausea and reduced appetite. Therefore i only ate once a day.

You might consider getting tested if yiu havent already.

[Foggyme Administrator in reply to KimberinUS]

KimberinUS, you could be right about the ibuprofen causing damage to gastric lining and, like heliobactor pylori, it can also cause gastric ulcers - so a double whammy, perhaps 😖.

I've posted some information about ibuprofen for Gillsie54 (below)...you might want to take a look 😉

[Gambit62 Administrator]

Ibuprofen is a NSAID (non-steroid anti-inflammitory drug).

this is a class of drug that can interfere with up-take of B12 in the gut - as it can cause damage to the gut

I am not aware that it will interfere with B12 in any other way meaning that it can contribute to developing a B12 deficiency but it isn't going to interfere with treatment if you are on injections.

[Gillsie54 in reply to Gambit62]

I will definitely not take ibuprofen again. I am glad the drug does not affect the metabolism of the injections though. My digestive upset has been horrible and the back pain I assumed was arthritis I think may be refered pain. I'll post more after the GP visit. I will follow advice and ask about helico pylori as well. Thanks

[Foggyme Administrator]

Hi Gillsie54.

B12 absorption issues aside, Ibuprofen should not be taken by those with any kind of gastric issues, including pernicious anaemia (autoimmune metaplastic atrophic gastritis) active gastritis, gastric ulcers etc): it's a known gastric irritant and can cause both sudden gastric bleeding and, in large doses, stomach and intestinal damage.

Interestingly, it should not be taken by those with any form of connective tissue disease, including Sjogren's and lupus (I mention this because some with PA also develop other autoimmune conditions).

Because Ibuprofen is a common over the counter pain relief medication, it's also often overlooked that there are a number of contraindications with other medical conditions (for instance, severe heart / kidney disease) and there are numerous potential side effects associated with it's use (parasthesia - something we hear of often in the forum - being one).

Note: Ibuprofen and aspirin should never be taken at the same time.

Here's some links to more information about ibuprofen. For anyone who takes ibuprofen regularly, it's certainly worth looking at the very long list of potential side effects - and also the contraindications:

drugs.com/ibuprofen.html

nhs.uk/conditions/ibuprofen/

So, you're right about not taking ibuprofen...not only can it exacerbate existing gastric conditions (PA and others), it can also cause sudden (and potentially dangerous) gastric / intestinal bleeding.

The digestive 'flare' you describe is something that can be associated with ibuprofen use, especially where there are pre-existing gastric issues, so suggest that you don't take any more ibuprofen (or aspirin) and discuss alternative pain relief with your GP on Thursday.

In the meantime, it might be worth having a discussion with a pharmacist to see if there's anything they can recommend for pain relief, prior to seeing your doctor.

Hope you manage to find something that works for you and that you manage to get some relief from your pain very soon.

👍

[gillsie in reply to Foggyme]

Thank you very much for the information. I will avoid ibuprofen from now on and see what the GP advises on thursday for the arthritis. I have dry eye syndrome also but it has never been classified as sjogrens by my GP. I have just had another dreadful stomach today. I think i will ask for a blood check on iron levels because i sometimes take iron and it can also upset things. PA is hard to manage as you never know where you are in terms of supplements and if you have enough or too much. Feeling rough at the moment. Thanks again.

[Foggyme Administrator in reply to gillsie]

Sorry you're still feeling so rough Gillsie54. Just a couple of thoughts...

A) have your been tested for heliobactor pylori (GP can do a breath test). Those with PA are more prone to catching this and it can cause havoc with all things gastric (I've had it four times already).

B) are you getting symptom relief with your B12 injections? If your PA symptoms return before your next injection and then resolve once you've been jabbed, it's likely that more frequent injections would help - though getting these from some GP's is easier said then done (put up a new post if you need advice about getting more frequent injections).

C) those with one autoimmune condition often (but not always) develop other autoimmune conditions (I.e. Sjogren's etc), so if you are having symptoms that are not relieved at all by B12 injections, then it's worth asking your GP to investigate the possibility of other underlying autoimmune conditions. A good place to start would be with an antibody screen - and referral to a rheumatologist for further investigations if any of your antibody levels are raised.

D) have you had full thyroid screen done (TSH, FT3, FT4 and thyroid antibodies TPO and Tg (Hashimoto’s thyroiditis often present in those with PA - and there are many cross-over symptoms with B12 deficiency). Guidelines suggest that those with PA should routinely be tested for Hashimoto's - and vice versa, I think.

Also assuming you've had referral to gastrologist for assessment and endoscopy etc? Usual to do this for those with gastric symptoms associated with PA.

Likewise, if you have neurolgical problems, usual to refer to a neurologist to rule out the possibility of other underlying medical conditions.

Good luck and post again if you need further support or advice.

👍

[Gillsie54 in reply to Foggyme]

Hi Foggyme

I will ask about helico bacter. I get regular monthly injections of B12 but they seem less effective the older I get. I resort to methyl sublinguals and occassional self injection but am not sure about increasing the frequency of jabs further. I do not tell my GP if I get extra jabs elsewhere for fear of losing the monthly prescribed ones. It took 10 years of ill health and stomach problems, for which I was prescribed omeprazole!! and neuro issues before I myself asked for a B12 check having read some info about it. My serum B12 was 75 and had positive antibodies for both IF and parietal cells. I had an endoscopy in 2013 and was shown to have atrophic gastrtis and some odd bulges which they said were extrinsic (outside) the stomach. We never got to the bottom of that. I have not had an endoscopy since. I was never referred to a neurologist or gastro expert but my GP wrote to both. The neurologist letter said there was no harm in more frequent injections and that some people needed monthly. The gastro enterologist replied to the questions I had raised with my GP about bacterial overgrowth and iron. He seemed to think that the bacterial problem was not likely to be causing my symptoms and that it was all due to the PA and that I could take a low dose iron if wanted. He seemed to think that despite low acidity the iron could be absorbed elsewhere. However I am prone to low iron and often get a sore mouth so I supplement some of the time. I have never had a full immune profile done and only get TSH done by GP which tends to run at 3 to 4. Goes up and down a bit. As my digestive upset has occurred with severe back pain I am getting suspicious it is pancreatitis . My sister used to get this and had an IPMN tumour which necessitated a total pancreatectomy. I may be worrying unnecessarily . I will post again after seeing GP.Thank you for the advice and info.

[Patjamber]

My doctor took me off ibuprofen years ago as I was diagnosed with an eroded gut. I Then was prescribed paracetamol and dihydrocodeine. My gut continued to deteriorate heart burn acid etc. I have just had surgery three months ago repair hiatus hernia and a wrap. Feel so much better off all the ppi medication gaviscon less pain killers.