Pernicious Anaemia Society
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Can drinking water make your deficiencies worse?

I'm pretty sure i have a mineral deficiency and anemia. My nutritionist put me on iron supplements a few days ago and i also have very low gut immunity. Anyways whenever i drink water or any drink it seems to make my symptoms worse for the next hour or so. Is there any reason behind this? Could the water be flushing more minerals out of my body? It seems to happen almost instantly though.

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Drinking water makes you wee more. You may be flushing B12 along with the water.

Are you drinking bottled mineral water or tap water (with minerals). B12 helps cleans out minerals and metals. So these may also use up B12.

However, as you already said, these probably don’t happen immediately and may only show up 24 hours later.

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It happens as soon as i drink the water or within a few minutes. I usually drink tap water and herbal teas. Also is it possible to be iron deficient or anemic and have your blood tests be normal? I had a full blood test not so long ago and it came back normal my doctor said. But i have all the symptoms of iron deficiency and my natrupath even told me to get iron supplements. I haave the cold hands and feet.... the paleness...i get really bad chest pain sometimes too,weakness, fatigue, dizziness, lightheadedness, headaches... etc

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healthiskey, whilst this forum has anaemia in the title it is actually about an auto-immune condition which can cause a particular type of anaemia - macrocytic.

This forum is not a substitute for professional medical advise. Your symptoms could be a down to a number of conditions including B12, and thyroid, anaemia.

You need to get hold of a copy of the blood test - if the test was comprehensive and everything on it was normal then it is extremely unlikely to be iron deficiency.

This is an article on the tests for iron deficiency and their meaning

labtestsonline.org/tests/ir...

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I have a friend whose sister in law can't drink water - some rare genetic condition I think - but she can drink milk, if I remember correctly. I'm afraid I don't know what the condition is.

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No. Drinking lots of water cannot ‘flush’ minerals from you system apart from sodium.

No. B12 does not help clean out minerals and metals.

No. Drinking more water will not flush out B12.

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If I understand you right, elevated B12 (which is what I have - I think I'm not utilising it though) cannot cause deficiencies in other minerals and things? Just for clarification. Because I have wondered about this too.

And do you know how much water is too much - my own sodium level is low. The GP just told me to use more salt at table and in cooking, which I don't think is going to help (but hoping the other things i'm learning about will fix the hyponatraemia as "collateral").

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Muddlemand. Your reply to fbirder will only be seen by fbirder or those who read this string - it will not be seen by the whole forum and so you will only get a very limited response to your questions. You'll get a better response if you put up a new post of your own, so that the whole forum can see it.

In short, elevated levels of B12 cannot cause other vitamin and mineral deficiencies.

If you have been having B12 injections or taking high dose B12 supplements this will cause high B12 levels. If not your GP should investigate further (liver or kidney problems can cause elevated levels of B12 - and some people do have naturally high B12 levels).

An MMA test will help clarify whether you have a functional B12 deficiency (I.e. if the cells are metabolising B12 properly). Methylmalonic acid builds up if the cells are not processing B12, so MMA levels will be high.

Not really sure what you mean about other things you're learning that will 'fix' your hyponatremia as 'collateral'. If you mean taking other supplements, then this is perhaps not the best choice, since supplementing with things you don't really need can cause more problems. So...

GP should want to investigate the cause of your hyponatremia and prescribe calcium supplements if your levels are really low (assume that there are plans to re-check your levels again to see how things are going?). Persistent low calcium levels can cause issues with the bones (osteoporosis etc.) so it's important that this is monitored to ensure levels are raised to adequate levels. And it might be that if your levels are low (as opposed to deficient ) then dietary changes might do the trick (you can search the internet for calcium rich foods (e.g. dairy etc.).

Again, if you post your questions in a new post, you'll get more responses 😉.

Good luck 👍

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Hi healthiskey. First, I agree with what fbirder and Gambit62 say.

And second, I'm a bit concerned that your naurupath has told you to take iron supplements because you have the symptoms of iron deficiency anaemia. The symptoms of iron deficiency anaemia can also be the symptoms of many other conditions. Taking iron supplements if you don't need them can be dangerous - it can lead to a condition called iron overload, so I would urge you to only take iron supplements under medical supervision - that is, if your blood tests actually show that you have iron deficiency anaemia (ferritin and full iron panels will show this). If you've had these tests and they are normal, you don't have iron deficiency anaemia - and you don't need to take iron supplements.

About the gastric symptoms (symptoms getting worse after drinking - and food?) this can be caused by a number of gastric issues (heliobactor pylori, gastritis, gastric ulcers, pernicious anaemia, to name but a few). Gastric issues can cause absorption problems which may lead to vitamin and mineral deficiencies. So just wondering what your GP has suggested about this? Referral to a gastroenterologist could help you to get to the bottom of these issues.

As gambit says above, your symptoms could be caused by vitamin B12 deficency...or by a number of other conditions (has your GP tested for B12 deficiency? Hypothyroidism? Diabetes?).

As others have said, it would really be a good idea to go back to your GP for further discussions - and also find out exactly what you were tested for (getting a copy of all your results would be a good idea - and it's your right to do so).

Your GP should be working with you to try and determine what exactly is causing your symptoms.

Good luck. Hope you find some answers soon.

👍

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I got a test done recently that showed i have very low gut immunity so it makes sense that i'm not absorbing minerals properly. I'll call up my doctor tomorrow and ask for my bloodwork results to be sent to me. It was a couple of months ago though so i wonder if they'd still have a record of them?

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Blood test results will be on your medical records and so the surgery will be able to print them off for you.

Did you discuss the gut immunity tests with your GP (not sure what you had done, or how reliable these tests are). Any action?

Would also urge you to follow up gastric issue with your GP - as suggested above (also things like coeliac's, Crohn’s disease, IBS etc).

Good luck 👍

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Well it's something i've suspected for a while due to all the symptoms i was having and the source is reliable, it was a stool and saliva test.

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Yes, hear what you're saying but it's also a good idea to get other possible causes for your symptoms ruled out by a medical professional. Gut Dysbiosis can do-exist with other underlying conditions (IBS, Crohn’s etc.).😉.

Here's more information about that:

ncbi.nlm.nih.gov/pmc/articl...

Your symptoms really do warrant further investigation 😉

👍

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Yup.

You need to go see a real doctor.

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Hi healthiskey. Yes, and that is called an electrolyte imbalance. Common electrolytes are: calcium, magnesium, potassium and sodium. Certain health conditions can cause an electrolyte imbalance, as can certain medications. If you have a predisposition to an electrolyte imbalance, drinking water might just put your system over the edge for an hour or so, as you've expressed. Drinking too much water in general depletes your electrolyte stores from your body, leading to electrolyte imbalance. Many of your symptoms could be from electrolyte imbalance, an autoimmune disease, or something else entirely. How much water are you drinking when this occurs, and how much are you drinking every day?

Electrolyte imbalance symptoms: weakness, fatigue, irregular heart beat, muscle spasms, tingling nerves, headaches, numbness, etc.

Low secretory IgA can be an inherited or an acquire condition. It can lead to increased intestinal permeability, or leaky gut, which can trigger autoimmune diseases.

Your symptoms that could indicate an autoimmune disorder: cold hands and feet, and paleness. Do you hands and feet turn white, blue and red? If so, this sounds like it could be something called Raynaud Syndrome, as syndrome that is often associated with autoimmune diseases. I have Raynaud's in my feet, and I have Hashimoto's.

Have you been tested for any autoimmune markers, any autoimmune diseases or inflammatory markers? ANA, Compliment Proteins, SED rate or ESR, CRP, thyroid antibodies TPOab and TGab, Rheumatoid factor, and others? Since you already have low secretory IgA, it would be worth testing for autoimmune diseases now while you are treating the gut. You want to catch autoimmune diseases as early as possible and not let them go untreated.

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My natrupath said i'm just very deficient and my gut needs healing she didn't say i have autoimmune but i never got a blood test for it i don't think? I got a full blood test done at the doctors not long ago would that catch autoimmune disease if i had one? I'll call up my doctor today and ask for the tests and results.

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Naturopaths are supposed to treat the whole person and get to the cause of the symptoms by running lots of tests, and then treating according to those results. If your naturopath knows about leaky gut, they should know that autoimmune diseases are often triggered by that condition. You’ve got immunity problems already. Now is the time to be testing to be sure to catch autoimmune diseases early, not years later as your symptoms increase.

Depends. What are the full blood tests? Did he/she run the above tests? These are basic tests that most doctors run in situations like yours, and are tests very commonly used by naturopaths. If he/she didn’t run the the above basics, then no, autoimmune conditions will not be apparent.

Did he/she run a complete thyroid panel? If your thyroid shows low thyroid function or hypothyroidism, the most common cause of hypothyroid is Hashimoto’s.

You should always get copies of all your test resultat each appointment.

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Im gonna ring up now and ask for the results but i doubt they'll give them to me right now i'll probably have to wait for them to be sent out in the post. The doctor knew my dad was celiac so i think she did test for autoimmune disease. Also i don't actually have leaky gut. Just low secretory igA and a yeast infection in my mouth.

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Really? Celiac Disease is an autoimmune disease. Many autoimmune diseases are hereditary. Did he/she test you for Celiac? The fact that your dad had an autoimmune disease means you probably have a greater chance of having one.

There is no one test for all autoimmune diseases. You need to test for antibodies and specific tests for each specific condition. ANA is usually tested because a positive ANA means you have some condition causing a positive ANA, which is often times autoimmune. However, you can still have autoimmune diseases without a positive ANA, it’s just that certain diseases are not as likely without a positive ANA. High CRP can indicate certain diseases. Low Compliment Proteins can mean autoimmune disease or other diseases. SED rate is an inflammatory marker that is commonly tested.

How do you know you do t have leaky gut, which is gut permeability. You have low secretory IgA, so likely have gut permeability.

Candida and low IgA means your system is compromised. Candida overgrowth probably came about due to gut permeability. Your gut is supposed to keep bad things out of your system. If it can’t, bad things get in. This is often what triggers autoimmune disease.

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I just read your other posts where you were wondering about Lupus, and other posts where you’re talking about all your symptoms. You got great advice on that Lupus post Lupus is an autoimmune disease. You don’t have to have a butterfly shaped rash, but some people do. Did you ever get tested for it?

Puffy face, brain fog, fatigue, insomnia, muscle pains, joint pains, heart pains, digestive problems, Raynauds. These can all be symptoms of autoimmune diseases. This makes me think of Hashimoto’s, but it could be something else. Eye problems could be Graves.

Have you seen an eye doctor fir a vision test for all your eye problems?

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Yeah it was some good information they gave me. I am actually very short sighted so i get my eyes tested every now and then and i wear contact lenses and glasses. It could all be stemming from my digestive health either though and malabsorption.

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Like I said, and for the reasons you suspected Lupus autoimmune, you’ve got notable symptoms. They don’t sound like symptoms caused by just gut issues and malabsorption. Raynauds certainly isn’t. Eye problems also don’t typically come from digestive and malabsorption problems.

Since you have suspected malabsorption, your doctor tested your B12, MMA, complete iron panel, vitamin D and RBC magnesium?

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Just called the doctors office now and they are gonna print all the tests i had done and i can collect them. I'll let you know what they are when i get them.

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I have a feeling i'm going through a "healing crisis" right now and my bodies releasing too many toxins at once. The reason why i think this is because i've been eating healthy lately and also i started a new food plan that my nutritionist gave me for my digestive health and i started taking probiotics, prebiotics and digestive enzymes and also this is the longest i've been without drinking alcohol in like a few years. So it wouldn't make sense for my health to just rapidly decrease out of no where like this since i've struggled with these health issues for years now and usually it only goes downhill if i drink too much alcohol or eat too much junk food over a prolonged period of time.

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The fact that your father had Celiac Disease should be an obvious possibility with you. Actually, yes. If you've been struggling with these issues for years, then yes, there comes a point where you suddenly become worse and have a health crisis out of no where. That's usually how it works. Something puts the body even more over the edge. Left undiagnosed and untreated for so long, this is exactly what can happen. Your body gets to a point where it just can't take it any more and reacts strongly.

Many of us felt the same when we got to the point where we felt we were in some sort of a health crisis. Then we discovered we have autoimmune disease, or something else.

Feeling like being in a health crisis is exactly what leads people on a mission to find out the cause. People come to this website looking for answers because they are not finding them elsewhere, nor are they feeling better.

I don't know that your body is releasing toxins. More likely your body is reacting to antigens by creating an immune response. You have immunity problems and what sounds like gut permeability. In these conditions, when your body encounters an antigen such as yeast, bacteria, viruses, pollen, food particles, these molecules can create an immune response.

Something is causing all of your symptoms, and it's probably not just gut permeability. It's more likely what the gut permeability has triggered something else, and that's what's causing your symptoms. Besides, Raynaud's (which sounds like what you've described) is not caused by gut permeability.

Since your father has Celiac Disease and you have had all kinds of symptoms for way too long, it makes sense that you could have Celiac Disease, or other autoimmune conditions. If your doctors have not tests you for Celiac of any other conditions, shame on them! Gut issues, all those symptoms for many year, low IgA, father has an autoimmune disease, this is logically what you should have already been tested for, as well as other conditions.

The only way to know if you do not have Celiac Disease or any other autoimmune disease as the cause of your symptoms is to test for them. If you have antibodies that have been activated in your body, you need to know so that you can receive the right treatment. Yes, helping to heal the gut problems should help, but once you have an autoimmune disease, you will always have that disease.

Aside from what is the root of your symptoms , what is the root of your gut permeability? Something caused it. Could be genetic or it could be from an illness. Since you were a child, have you ever had any kinds of illnesses? Any viruses, fevers, etc?

There are a many medical studies about intestinal barrier and the immune system, as well as many websites with articles on this subject. This website with an article about gut permeability and a dysfunctional immune system. There is a graphic that helps explain the gut barrier and what happens when the barrier is not functioning.

thepaleomom.com/comes-first...

Here are a few more that are well worth the read:

schoolafm.com/ws_clinical_k...

academic.oup.com/biohorizon...

ifm.org/news-insights/rise-...

sciencedaily.com/releases/2...

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My mother has very similar symptoms to me though not as bad so i'm pretty sure i got it from her. I've had these issues since i was like 15 and i'm not 21. I've actually "healed" myself in the past a few times just by eating relatively healthy and exercising and it got to the point where i was nearly symptom free, at one stage i was totally symptoms free and felt very healthy, that was when i just turned 19. I remember going to the doctor when i was like 16 and having blood work done that came back normal. I get really bad social anxiety when my health is down like this due to low self esteem of how it affects my physical appearance so going to the doctors when i'm like this is really hard. Im gonna be getting the blood test results and stuff within the next hour hopefully though.

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As others have said, should have really started another post in a different area. Sorry, everyone! healthiskey, our conversation has strayed way off from this particular group and it's purpose. I know you're trying to find out the cause of your symptoms. What lead you to think that you might have Pernicious Anaemia? Many symptoms cross over into other areas. Without the right diagnostics, a diagnosis cannot be made.

Without testing and knowing what caused your mother's symptoms or what is the exact cause of your symptoms, it is an unknown as to if you got "it" from her. What is it? There is always a cause to symptoms. What is the real cause of your mom's symptoms? Does she have Celiac Disease or Crohns, or other conditions?

"Blood work" being normal provide much information. Exactly which blood work? There are a million or two different blood tests available. If you mean standard blood panels like a comprehensive metabolic panel and a CBC, these are only testing the basics and can be completely normal while having all kinds of health problems.

Anxiety can be caused by many things. A thyroid problem is a common cause. Have you had a complete thyroid panel, TSH, FT3 and FT4? You mentioned some swelling in your face and elsewhere. Do you have any swelling in your neck?

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Also my acid reflux seems to have improved even though everything else has gotten worse. My skin has gotten the worst out of everything though and i look like absolute crap at the moment.

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I'm sorry to hear that. I hope you can find a doctor who will take into consideration all of your symptoms, run the right diagnostics and get to the cause of your symptoms soon.

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is red knuckles a symptom of rheumatoid?

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Red, warm and swollen joints can be symptoms of Rheumatoid Arthritis. RA is an autoimmune disease. If you have these symptoms, then yes, you really do need to get proper diagnostics. I cannot believe that it sounds like naturopath didn't test you for much of anything. You have many prominent and obvious symptoms and there is always a cause.

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people aren't taking me seriously either. I was told i should just get on with my life because its not a life threatening disease i have. Whatever this is, whether its life threatening or not is ruining my life and has ruined my life in many ways since i was a teenager. I actually dropped out of school and everything because of this. When i was a teen i was always told it was just puberty or depression and i believed it until i was 18, nearly 19 when i realized that my diet and lifestyle choices played a big part and thats when i first got "symptom free" and i felt like a new person, i felt amazing. Then i went and ruined it by partying and drinking and eating junk food again and that cycle kept going on and on, where i would heal myself enough so that i could function and then ruin it again through partying and drinking and now its a lot harder for me to get mostly symptom free. I went to the doctor when i was 16 and my health was actually worse then it is now because i was eating REALLY badly and not exercising and drinking a lot and smoking. When i went to the doctor i was having purple feet, especially after a shower and stuff like that and he done a blood test and it came back normal and so i began thinking it was all just in my head again and that i was just depressed and had anxiety. I even went to a rehab for teens with mental health issues when i was 17-18 for a month. But when i healed myself when i was 19 that's when i realized it was all to do with my health because my depression and anxiety and self esteem vanished. I can't get the blood tests today i'll have to go in tomorrow and get them. I'm pretty sure she done all the standard blood tests though and it came back normal. I do suspect it's autoimmune disease but if it doesn't show up on a blood test then it most likely isn't. I even look at people with autoimmune diseases and the people who have the skin issues and stuff like me always look very similar to me. Like the same pale blotchy skin and puffy eyes and washed out looking.

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I hope others here in this particular autoimmune disease forum, Pernicious Anaemia, will also respond to you. The principles of autoimmune diseases are all the same. The body is attacking things it should be not: cells and tissues, resulting in all kinds of strange symptoms.

healthisky, I am taking you very seriously and so are all the other people on this site. I hear what you are saying about your concerns, all of your frustrations and all of your symptoms. Because I've been where you are, I wanted to reach out to you. :-) Just as the others have here who have responded to your posts. :-) I hear your pain! We hear your pain! Many of us were once were you are asking for help from doctors and not getting it, and some still are. You are much too young to be suffering like this! No one should suffer excessively, regardless of their age. Everyone deserves to get proper diagnosis and treatment so they can go on and enjoy life!

First of all, how does anyone know it's not a life threatening disease? No diagnosis has been made to account for all of your symptoms. It likely is not life threatening, but in absence of ruling out many disorders and diseases, it is anyone's guess as the cause.

Secondly, grrr! The doctor running a blood test for you purple feet?! What blood test could he have possibly ran? There is no blood test for Raynaud's. It's circulatory problem often associated with autoimmune diseases.

Thirdly, grrrr again! Anxiety is so often misdiagnosed when a commonly overlooked cause of anxiety can be a thyroid disease or something else. Not that you know if you have a thyroid disease, but you certainly could based on some of your symptoms. I had severe anxiety at one time or another before I found out I have Hashimoto's, started treatment and then the anxiety went away.

Fourthly, you say you also suspect autoimmune disease. That could very well be the case given your symptoms and family history. Autoimmune diseases are very complicated, can be very difficult to diagnose and can take many years for diagnosis.___Like I said previously, autoimmune diseases will not show up on standard blood tests.___Standard blood results can be completely normal even if you have autoimmune disease._____(mine are and always have been, and I have an autoimmune disease). The right very specific tests have to be ran to make a diagnosis. Some of the basic tests I've previously mentioned can lead way and help narrow things down to direct you to the right tests to make a diagnosis. If the right tests have not be tested, then you will never know the correct diagnosis. There are also instances where tests will be negative, but over time they turn positive. Then there are complicated seronegative possibilities, too.

Were their specific symptoms that made you think you have Pernicious Anaemia? B12 tests that came back deficient? Intrinsic factor deficiency?

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I really appreciate everyone on this forum it makes me feel less alone and understood in all of this. I'll go back to my doctor with a list written out of my symptoms so she can help me get to the bottom of it. In my ignorance i didn't realize there was different types of anemia. I have symptoms of anemia so i typed in anemia in the "browse communities" tab and that was the only one i saw with the word anemia in it so i thought it would be best suited to post here. If i do have an autoimmune disease the doctors are just going to prescribe me medication for it which i dont trust will even help me in the long run especially with my skin issues if they're caused by an autoimmune disease.

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Hi healthisky. Only have time for a quick post right now but thought I'd like to say that I agree with ShootingStars comments on autoimmune disease as a possibility for your symptoms (amongst other things), especially as you have autoimmune conditions in the family (autoimmune disease can tend to run in families and the diseases themselves can come in clusters - it's possible to have several at the same time).

Like you, I was very unwell with illness 'flares' for many years, dismissed by my GP (ME/CFS/fibromyalgia), and eventually had a severe health crisis, following which I started researching and insisting on a whole battery of tests, investigations, and specialist referrals. It turns out that I have Pernicous Anaemai (an autoimmune condition that causes B12 deficency) and another autoimmune condition called undifferentiated connective tissue disease (features of lupus, Sjögren’s syndrome, and rheumatoid arthritis).

The symptoms you describe are very similar to many I had (including the raw red rash across the knuckles, skin rashes, severe gastric issues (I lost 2 stone in four weeks and was so,I’ll Imcoild barely get out of bed)...livido reticularis (blue lacy legs), blue/red/white hands and feet (Raynaud's syndrome)...and a whole host of other things that appeared to be unconnected - but they weren’t 😖.

I understand that you're concerned about the possibility of being prescribed medications, which you say you don't trust.

However, if you do have an autoimmune condition, then this is going to get worse and worse, unless it is diagnosed and treated appropriately. In autoimmune conditions, the treatment involves suppressing or turning off the overactive autoimmune response that basically causes the body to attack itself. This 'attack' mechanism can involve skin, joints, all the major organs, eyes, connective tissues - just about anything in the body (though not everybody is affected in the same way - depends what autoimmune disease is present).

The longer an autoimmune condition remains undiagnosed and untreated, the more damage can occur in the body (potentially to major organs). This makes any potential disease more difficult to treat and lessens the chance of a return to better health. Not trying to frighten you here, just saying this to emphasise how important it is to rule,out autoimmune disease...or rule,it and and get it treated.

The are a wide range of treatment options (I.e. steroids, disease modifying drugs - including immunosuppressants). Because autoimmune disease is so complicated, it's a matter of finding the right drug for the right individual and disease. And yes, these are powerful drugs...and for that reason, doctors work very hard to ensure that medications are kept to the lowest dose that brings a good clinical response (they take great care not to over-medicate).

Really just wanted to reassure you that medications for these conditions do work (though they can take up to a year to be fully effective). They work for skin conditions too 😉. And after a long-haul, they're just starting to work for me (small improvements which I'm hoping will become big ones, given more time on the right medications).

It sounds to me that your GP may only have run the most basic of blood tests - and there are a whole range of tests and investigations that could help identify what's happening in your case.

And when autoimmune disease is a possibility, referral to a rheumatologist is essential - they can run more specific (and essential) tests that your GP does not have access too. And it's worth noting that some autoimmune conditions can be seronegative (I.e. disease can present without having raised antibodies). A rheumatologist will (or should) have the specialist knowledge to factor this in as a potential and make a dignaosis based on the full clinical picture - they will look at your symptoms and not just rely on blood test results (which are only one small part of the 'story').

It's too late now to start listing all the tests that your GP ought to run so...

Can I suggest that when you get copies of your blood tests, post them in a new post (together with the reference ranges) so that a) we can see what's been done, suggest other tests that would be beneficial, and advise on interpretation of the tests already done (GP's often say that things are normal when they’re not - it's where the results sit in the range that counts, not just being in it. Too high or too low in the range can be significant).

Will look out for your new post with the results and reference ranges. Might be worth indicating in the title that you're looking for help with blood test interpretation, advice about tests for PA /B12 deficiency, and underlying autoimmune conditions.

👍

P.s. Did you see the link to a research paper I left in a reply above - it might help clarify the connections between gut dysbiosis and underlying autoimmune conditions (or at least, some of them).

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The thing is, over the years i've managed to greatly reduce my symptoms and even be symptom free at some stages by just eating healthy and avoiding alcohol and stuff like that. It's when i started eating really badly and not exercising and drinking alcohol that my symptoms flare up. That's why i feel like id rather do it naturally then get medications even if i do have an autoimmune disease which i will go back to my doctor about when i feel well enough to. I think it's all coming from my gut and i know about the link between gut and autoimmune diseases is very high in my opinion. It might be a few days before i get the blood tests sent to me now but i will post them on here as soon as i get them with an appropriate heading.

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B12 is stored in the liver for up to three years - excess B12 is excreted. I use filtered water as we have chlorine in the water supply, plus allergy to chlorine and ammonia as well as other food allergies. If you have high natural fluoride in the water it may affect your thyroid - some research in different counties has shown that high fluoride in the water may cause hypothyroid symptoms. A water filter such as maxtra is no good you have to buy a water distiller for fluoride. Certain teas grown in India and Sri Lanka are grown on soild which has high fluoride in it. This can affect some people along with tannins.

If your folate levels are too low you might find it difficult to absorb the B12.

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