Are these symptoms from B12 deficiency? - Pernicious Anaemi...

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Are these symptoms from B12 deficiency?

GastritisB12 profile image
11 Replies

Hello everyone.

I have been diagnosed with chronic gastritis and mild oesophagitis, and finally last week as B12 deficient (blood test) but I had no symptoms, no acid reflux that I could feel, until 7 weeks ago I got woken up suddenly by stomach cramps (no pain) icey cold feeling in stomach which rose up the chest, cold arms, shivering and shaking, and a dizzy/lightheaded confused feeling in the head.

The next day I also noticed shaky legs when walking, and faster heart rate just walking up the stairs slowly.

I went to A&E first but they said its all fine nothing urgent, probably just a virus.

Since then I have had a regular but faster thumping heart rate when sitting (around 80-90) and about 100-110 when standing / walking slowly. Also I have had broken sleep get woken up around every hour, and after 6am I feel so alert I cant go back to sleep. Heart is often thumping at night too. Sometimes that's what wakes me up the heart rate gets faster then when I wake up it slows back down.

About 4 weeks in I was diagnosed by endoscopy as having chronic gastritis, oesophagitis, but no H.Pylori. He got me started on lansoprazol 2 times a day I am on my 4th week before I go down to 1 a day for another 6 weeks!

I have also been to a cardiologist who did a ecg and echo and bloods and says heart is fine. He didn't think the dizzyness or faster heart rate is caused by gastritis. The gastroenterologis didnt think so either. Searching the internet I found that read that gastritis can reduce B12 absorption so at my request I had a blood test and it was indeed low, the gastroenterologist has notified my GP that I need injection.

Both docs are at a loss to explain the symptoms that frustrate me the most the dizzy/foggy head and the faster heart rate I can feel, which prevents me from sleeping normally, walking fast, exercising and living normally.

Do these symptoms sound familiar to anyone? Could they be linked to B12 deficiency? Or gastritis?

I started taking Methylcobalamin 1000mg yesterday on my own accord, should I be taking more than 1/day?

Should I ask the doc to test me for pernicious anemia?

Thanks everyone wish you all the best of health.

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clivealive profile image
clivealiveForum Support

Hi GastritisB12

Firstly a whole list of symptoms associated with P.A/B12 deficiency.

1.1 General Symptoms

The following general symptoms are common in those with PA:

The Strange Tiredness

Fog days, where you have difficulty in thinking clearly

 Weakness

 Fatigue

 Upset stomach

Abnormally rapid heartbeat (tachycardia) and/or chest pains

 Abnormal yellow colouration of the skin (jaundice)

 Heightened sensitivity to hearing, smell, and taste

 Vision distortion, e.g. seeing stars, or double vision

 Breathlessness

 Headache

 Cankers (ulcers) in the mouth

Sleep disorders

 Intolerance to loud sounds, flashing lights

 Intolerance to crowded malls (needing personal space)

 Tinnitus – ringing in ears

1.2 Neurological Symptoms

The neurological symptoms of vitamin B12 deficiency may include:

Numbness and tingling of the arms and more commonly the legs

Difficulty walking

Loss of balance

 Hands feel gloved with loss of sensitivity

 Loss of vibration sense, having to look down to see where you are walking

 Unable to close your eyes and stand on one foot

 Night vision

 Memory loss

 Disorientation

 Dementia

 Extreme mood changes

 Short term memory loss

Some experience many of these symptoms and some none of them. It depends on how quickly the PA is treated and on how well managed it is.

1.3 Gastrointestinal Symptoms

The gastrointestinal symptoms of vitamin B12 deficiency may include:

A sore tongue

 Appetite loss

 Diarrhoea and/or constipation

Stomach pain

You may tick off others I have not highlighted.

Simply put - to properly absorb Vitamin B12 via the digestive system require there to be high hydrochloric acid levels in the stomach and also Intrinsic Factor, both produced by gastric parietal cells.

The B12 from your food travels down with the Intrinsic Factor to the Ileum of the small intestine where they "bind together", pass through the wall of the ileum into the blood stream.

Unfortunately some people produce Intrinsic Factor Antibodies (IFA) which totally rule out the possibility of processing the B12 via the digestion thus causing Pernicious Anaemia

Low acid levels caused by medications such as Lansoprazole will adversely affect absorption of Vitamin B12 leading to a B12 deficiency.

Anyone at any age, can become B12 deficient. However, certain people are at an elevated risk. They include the following:

Vegetarians, vegans and people eating macrobiotic diets.

People aged sixty and over

People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).

People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications, or infections such as h-pylori that can interfere with B12 absorption.

People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.

People with a history of eating disorders (anorexia or bulimia).

People with a history of alcoholism.

People with a family history of pernicious anaemia.

People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).

People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), Pancreatic insufficiency, or any other disease that cause malabsorption of nutrients.

People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.

Women with a history of infertility or multiple miscarriages.

Do you "see yourself" among any other of the above people?

If you can get to see a doctor please also ask him/her to check your Folate level as this and B12 help your iron to make red blood cells and to function properly.

I am not a medically trained person but I've had Pernicious Anaemia (one of many causes of B12 deficiency) for more than 46 years.

I wish you well. and bid you goodnight.

Sleepybunny profile image
Sleepybunny

Hi,

Link about "What to do next" if B12 deficiency is suspected.

b12deficiency.info/what-to-...

B12 books I found useful

"What You Need to Know About Pernicious Anaemia and B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society). Book is up to date with most UK b12 guidelines.

"Living with Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper

Has several case studies.

"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)

Very comprehensive with lots of case studies. There is also a paediatric version of this book "Could It Be B12? Paediatric Edition: What Every Parent Needs to Know".

PAS (Pernicious Anaemia Society)

Based in Wales, UK. Offers support and info about PA.

pernicious-anaemia-society....

PAS tel no +44 (0)1656 769717 answerphone

B12 Deficiency Info website

b12deficiency.info/

If you're in UK, I suggest reading all of following documents/articles

UK B12 documents

BSH Cobalamin and Folate Guidelines

b-s-h.org.uk/guidelines/gui...

Flowchart from BSH Cobalamin and Folate Guidelines

stichtingb12tekort.nl/weten...

BMJ B12 article

bmj.com/content/349/bmj.g5226

BNF

bnf.nice.org.uk/drug/hydrox...

NICE CKS

cks.nice.org.uk/anaemia-b12...

UK B12 Blogs

Martyn Hooper's blog about PA

martynhooper.com/

B12 Deficiency Info blog

b12deficiency.info/blog/

Coeliac disease

Have you been tested for Coeliac disease?

NICE guidelines Coeliac Disease (2015 version) ....UK document

nice.org.uk/guidance/ng20/c...

NICE guidelines above suggest anyone with unexplained B12, folate or iron deficiencies should be tested for Coeliac.

Coeliac Blood Tests

coeliac.org.uk/coeliac-dise...

I have written more detailed posts recently, may be worth searching for them.

More B12 info in pinned posts on this forum.

GastritisB12 profile image
GastritisB12

Hi, thanks very much that is loads of great info. Yes some of the symptoms definitely sound like my symptoms. I have had some hand numbness too 'feels like a glove'.And the strange tiredness, usually after walking gently for just 10 minutes.

I hope the B12 injections will resolve the symptoms.

Yes, this symptoms sound very familiar. However, gastritis does NOT cause this symptoms directly. Why you are experiencing is what I would call an "across the board" vitamin/mineral deficiency caused by the acid blocker. By this I mean that you are inducing a deficiency of all water soluble vitamins and most minerals. You should STOP using the acid blocker right away as this will only get worse over time. Also, avoid using any other acid blocker, acid reducer, etc, as they will have the same effect. DON'T USE FIBER SUPPLEMENTS such as metamucil. Fiber, such as psyllium husk, will interfere with nutrient absorption, as will high fiber foods such as beans (red beans, kidney beans, etc). Needless to say, don't drink alcohol as alcohol is there worst for people with vitamin deficiency. Stay away from coffee and caffeinated drinks as diuretics also cause you to lose nutrients via urination. If you are doing that "8 glasses of water a day" fad diet, stop. Excessive urination can cause nutrient loss and "over hydration". You will likely need supplementation not just for vitamin B12, but for all 26 vitamins and minerals. The first step is to stop what is causing the malnutrition, which is the acid blocker, and any other substance that can malnourish you such as diuretics, alcohol, coffee and caffeine, drinking many glasses of water a day, and fiber supplements. A racing heart is often a first symptom of nutrient deficiency. Dizziness does sound like B12 deficiency but I cannot stress enough that you are likely deficient on most if not all water soluble vitamins (vitamin C and all B complex vitamins) and all minerals except maybe calcium (as calcium is abundantly stored in the bones). Now, about your heart, if you do an EKG, it will come back normal as your heart is not really racing, meaning the pulse is less than 100 bpm. Why you are feeling is very powerful pumps. This pumps are so powerful that you feel your heart wants to jump out. The EKG machine cannot measure the power of the pump, only the frequency, meaning the pulse. There are various other tests out there for the heart but none will reveal anything wrong with your heart, except maybe the Holter test. At this point your cardiologist will refer you to a psychiatrist to treat you for "panic and anxiety". Gastritis can be treated naturally with a cabbage juice therapy. Please google it. But stay away from the antacids as they will malnourish you. I know you will make another post when your doctors send you to the psychiatrist. At this point you will be in a state of desperation as you pumping heart will not let you sleep for even a minute. Hope everything works out and God bless you.

p.s. I forgot to mention that with the possibility of pernicious anemia, it might be a good idea to add sublingual B-complex to a multivitamin. You are taking B12 Methylcobalamin but if you have pernicious anemia or more accurately, no intrinsic factor, then this supplement won't help. A B-complex injection would be better. Also, in the United Kingdom they sell sublingual multivitamins by the brand name G&G Xtra Protecta. It is the only one of its kind in the world and has more nutrients than you could get from a Total Parenteral Nutrition injection. And last, eating yogurt or probiotic supplements might help as these aid in digestion, and therefor improve absorption of nutrients.

GastritisB12 profile image
GastritisB12

Thanks very much for the huge amount of info!

I have gone down to a reduced lansoprazol only once daily. I dont think its doing anything for me as I dont feel any reflux symptoms anyway. I'll be off it soon cant wait.

Thankfully my other tests came out ok (so far), Folate, potassium, magnesium, calcium and some other tests all ok. Maybe I should do a vitamin C & D test they didn't test those?

I am on the intramuscular hydroxocobalamin injections now, 3 a week for 2 weeks loading dose then one every 3 months for life!

Nurse says I'll only start feeling better after the 6th loading dose injection.

Luckily both doctors have been good, neither one wants to send me to a psychiatrist. I tested one of them by asking am I just anxious/panicking, he said he doesn't think so the symptoms are real.

in reply to GastritisB12

I'm happy things have stabilized. I was worried about you. Make sure you get all the vitamins and minerals. There are about 26 of them. Please read my post. While injections are restricted to the B-complex, there is one sublingual vitamin and mineral supplement that can deliver everything directly into your system while bypassing the digestive system. Its call G&G Xtra Protecta. I know this sounds like spam but trust me I'm just a customer. I'm glad you are coming off those acid reducers, they can be dangerous to people that are already deficient.

Get well soon and God bless you.

GastritisB12 profile image
GastritisB12 in reply to

Thanks very much for your advice. Its funny the day after I said I was ok I felt worse again. The only thing I had different for breakfast was I added just 1 date and 1 lentil/corn cracker.

I am taking your advice and had a glass of juiced cabbage this morning it felt good. I also added 1 apple and 1 carrot.

I'll look into the sublingual multivitamins. At some point soon I want to have another blood test for all the vitamins and minerals.

My potassium was 3.8 just before I stared lansoprazol which is already near the bottom of the range. Definitely need to check that again.

in reply to GastritisB12

I think you definitely have a vitamin deficiency. You said that the day you felt better you got worse again. This is exactly what happens to me. I can feel "excellent" and within a minute or two the dizziness and tiredness sets in. The opposite has happened too, where I feel horrible and suddenly I get better. Don't try to figure out what you ate or what you did, there is not trigger. I have had this for 2 months now. What is helping me are the B-complex injections. I've been taking nutritional shakes that are fortified and also I'm taking probiotics that help digest the nutrients that you eat. My sublingual vitamins and minerals are on the way, I just recently ordered them. They were hard to find. I ordered G&G Xtra Protect sublingual multivitamin and mineral all the way from the UK. I live in the US. You can get them at gandgvitamins.com or if you live in the UK at amazon.co.uk. Thank God I am feeling a little better.

God bless you and hope you feel better soon.

GastritisB12 profile image
GastritisB12

I'm glad you are feeling better. Thanks, I really hope you are right and its just vitamin deficiency. Now I really want my blood test done again to check the other vitamins they didn't check before. Hope you get better soon.

GastritisB12 profile image
GastritisB12

Oh no, just found out my Red Cell Folate is low too, 221 nmol/L.

I am going to get some Cytoplan Methylfolate, is this good?

If my Folate was low during my loading doses of B12, should I get more loading doses after my Folate is back to normal?

GastritisB12 profile image
GastritisB12

Does anyone else feel unwell after taking hydroxocobalamin sublinguals (Cytoplan)?

I have been taking 400ug Boots folic acid twice a day together with 1000ug hydroxocobalamin once daily, but after taking them in the morning I feel unwell in the head and a bit all over for about 2-4 hours.

I finished my 6x injection loading dose 2 weeks ago but I dont think it was enough some symptoms were still there, head pressure, dizzy spells, shakey legs. Palpitations were mostly gone. I asked the GP for more loading doses but they refused. Now trying to get gastroenterologist to write to GP to give me more.

My B12 before injections was 145ng/L

Folate was 4.9ug/L

Iron was 7.5umol/L

Potassium was 4.2

After injections I went for a private blood test because GP wouldn't do one.

Red Cell folate was 221nmol/L (I should have asked for serum folate)

Iron was 18.9umol/L

Potassium was 4.7mmol/L

Intrinsic Factor antibody - negative

Parietal cell antibody - positive! titre 1:40

Private GP said I should take 5mg folic acid but he didnt give a prescription.

So I bought 400ug from Boots, I'm not sure about taking a high dose I I still need more B12. Plus they didn't do my serum folate after injections. Should I take more folate since the red cell folate was low?

The private GP says he was surprised the GP or the private gastroenterologist didn't order the intrinsic factor and parietal cell tests once they found out my B12 was low and knew that I had chronic gastritis. I am a bit disappointed in both doctors.

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