Vit B12 and diarrhoea

[mickeymouse42]

How well is the link between Vit B12 and diarrhoea understood? Does it just amount to observation that people with Vit B12 deficiency can have diarrhoea.

This link: nhlbi.nih.gov/health-topics....

"Other symptoms of vitamin B12 deficiency involve the digestive tract. These symptoms include nausea (feeling sick to your stomach) and vomiting, heartburn, abdominal bloating and gas, constipation or diarrhea, loss of appetite, and weight loss. An enlarged liver is another symptom."

It doesn't seem to be suggest that vitamin B12 deficiency itself can cause diarrhoea. I guess the underlying factors (intrinsic factor enzyme and parietal cell issues) are the underlying causes but it's not understood very well?

[fbirder]

If you have PA then you have low stomach acid (the cells that the immune system attack in the stomach make the acid). Low stomach acid (achlorhydria) can have various results. One of these is diarrhoea and other gastric problems: healthline.com/health/achlo...

It's quite likely that many of these symptoms are the result of bacteria from the large intestine invading the small intestine . sibotesting.com/what-causes...

[mickeymouse42 in reply to fbirder]

Very helpful. Did PA suddenly happen to you or did it creep on you? I get the feeling that insidious anaemia would be an equally appropriate name. I guess Vit B12 levels drop gradually over time and then you start getting symptoms like dizziness that are diagnosed as BPPV because GPs rarely do Vitamin tests.

[Nackapan in reply to mickeymouse42]

That's what happened to me!!

[fbirder in reply to mickeymouse42]

I reckon I'd had it for at least five years.

I was fine when I was 50 (walked 5 miles up and down the African Rift Valley on my 50th Birthday). By 55 I was finding it difficult to walk 5 miles on the flat. But I put it down to age. By 59 I could barely walk 0.5 miles.

[mickeymouse42 in reply to fbirder]

Can you test for low stomach acid (achlorhydria)? Is it a blood test or a sample via endoscopy?

[wedgewood in reply to mickeymouse42]

My gastroenterologist told me that a test for Achlorhydria/ Hypochlorhydria could only be done in research conditions . I don’t know if this is true as I don't take doctor’s information as Gospel anymore after my experiences with Pernicious Anaemia . You can do a home-test with bicarbonate of soda . Google to find out about it .It entails drinking a bicarbonate of soda solution , and waiting to see how long it takes to “ burp” ! If it takes over 5 minutes , it means you have low/no stomach acid !

[fbirder in reply to wedgewood]

Baking soda test for stomach acid.

This is best done first thing in the morning.

Add 1/4 tsp of baking soda (not baking powder*) to a glass of water (about 150 mL) and swallow the lot. The sodium bicarbonate (which is what baking soda is) will react with any acid to produce carbon dioxide. Swallowed air may make a few burps initially, but of you have acid in your stomach you will soon produce a large volume of gas, which will escape as burps.

Very little burping after 5 minutes is a good sign of low stomach acid.

*Baking powder already contains an acid, so it produces carbon dioxide when it's put into water.

[wedgewood in reply to fbirder]

Thanks for good clarification 👍

[Nackapan in reply to wedgewood]

Isnt baking soda and bicarbonate of soda the same stuff?

[wedgewood in reply to Nackapan]

Yes .

[Hedgeree in reply to fbirder]

Hi fbirder,

It may also be helpful to check the baking soda first before ingesting it.

I know from experience how my baking hasn't worked when I've used out of date or expired baking soda!

You don't want anyone thinking they've got low stomach acid when they've just used old baking soda from the back of the cupboard!!

So take a small amount on a teaspoon and mix a couple of drops of vinegar to it and if it fizzes then you know that the baking soda is fresh or at least useable.

Then you know that the baking soda is viable and others can follow your instructions.

I've just done it and had no burps at all!

[fbirder in reply to Hedgeree]

I'm not sure if sodium bicarbonate can go off.

At high temperatures it will decompose to form water, carbon dioxide and sodium carbonate. That reaction probably happens very slowly at room temperature. But the sodium carbonate it leaves behind would also react with acid.

But, there is no harm checking with a bit of vinegar.

[Hedgeree in reply to fbirder]

Oh no! That means I now have no excuses for when my baking doesn't rise!

Thank you for the explanation fbirder, yes sadly I'm not a scientist😀

[JanD236]

Whilst most people seem to have had diarrhoea I had constipation (I can’t believe I’m discussing this on a forum)!

I think most of the other symptoms I had with PA built up slowly over months or maybe even a year or 2. However, the constipation happened over the course of a matter of weeks.

[Nackapan in reply to JanD236]

Same here. I blamed it on the menopause I changed my diet a little to have more fibre , pulses ect .

More water. Probably ate less meat!!! .

J definitlye had symptoms that built slowly overc2 years

I hindsight its amazing g what tiu csn dismiss when 'told' stress menopause.

I'd rarely been to the doctor. As havi g more falks and fatigue di wish a simple blood test was done

Shows how fatigued as I had no fight .I normally woukdve asked or insisted on a blood test.

The more ill,the more reliant we get in so eo w 'stepping in'

[Hedgeree]

Hi jmc42,

I've just realised that I replied to fbirder but probably helpful to respond to you also...

Best check the baking soda for freshness before doing the baking soda test!

You don't want to think that you have low stomach acid when it's possibly just old or out of date baking soda!

So to check it put some on a teaspoon and add some vinegar to it and if it fizzes you know it's viable, wash that down the sink then continue with fbirder's instructions.

Then when you do the baking soda challenge you'll get accurate results.

[Cherylclaire Forum Support]

Since we're oversharing here:Daily diarrhoea for five years- and no burping after test !

According to Martyn Hooper, diarrhoea was once recorded as an early symptom, he has discussed this in all his books and it is always on symptoms lists compiled from surveys of those who actually have B12 deficiency. Sadly I doubt that many in the medical profession currently are aware of this.

[briarhillcat]

Being due for an injection can cause loose motions. I think a lot of us are so stressed with Covid that we have increased symptoms. Good luck

[Nackapan in reply to briarhillcat]

Initially with loading doses I had very yellow soft stools. I mentioned this on every medical consult. Ni comment was made . So never had an explanation. ??

I thought it liver connected??

I didnr understand them not commenting as 'stools' tell you alot.

I used to ask mothers/carers to describe babies stools when they were concerned. We even had a photographic chart!!

[mickeymouse42]

I did the sodium bicarbonate test and it seems that I have little or no stomach acid.

Is it worth double checking this with the Betaine HCL test to double check. Is the other Heidelberg test widely used in the NHS?

healthygut.com/3-tests-for-...

It is said that the traditional remedy that rectifies low stomach acid is a daily dose of apple cider vinegar in water? The alternative is HCL supplements. I guess it is a question of trying either and seeing if it stops the diarrhoea?

[fbirder in reply to mickeymouse42]

My chosen remedy is 25 mL of pure lime juice in about 200 mL of something else (fizzy orange, tonic water, plain water, gin and tonic, etc.) and drink it during any large(is) meal (everything except for breakfast). Sometimes, when eating out (when we used to do such things) I would take my lime juice with me and drink it neat.

I tried betaine.HCl but found it too difficult to get the right dose. Often 1 capsule wasn't enough but two was too much.

[mickeymouse42 in reply to fbirder]

Thanks. I have been keep a diet diary for an NHS dietitian whom I am seeing again next month. One of things that I have noticed is that there is a pattern to the diarrhoea. I drink white or red wine with meals at the weekend but hardly ever drink alcohol during the week. I rarely get diarrhoea at the weekend and it always occurs during the week. Would the acidity of wine have the same effect as apple cider vinegar or lime with water?

[fbirder in reply to mickeymouse42]

I'd never thought about it. Wine has a pH of 3 to 4 which is slightly less acidic than lime juice (2.3). But, you'll be drinking more than 25 mL of it (I hope). So it could well be enough to help that little bit that counts.

That would be a good experiment.

Spend three years drinking wine every day, then a week (or two, but don't overdo it) not drinking any wine at all.

[mickeymouse42 in reply to fbirder]

Is there a difference between pure lime juice and Rose's lime cordial? It's a fruit concentrate - does that make a difference? is PLj Lime Juice like ocado.com/products/plj-lime... more appropriate?

[fbirder in reply to mickeymouse42]

Lime cordial isn't very acidic. This is the stuff I use - smile.amazon.co.uk/Chefs-La... - but the PLJ (I presume Pure Lime Juice) should work.

[mickeymouse42 in reply to fbirder]

thanks.

[mickeymouse42 in reply to mickeymouse42]

What tests would the NHS do to establish low stomach acid? I guess a serum gastrine test would be the starting point? Beyond there appear to be 24 hour pH monitoring tests and there's also the Heidelberg test which seems to be widely used in Europe.

[Hidden in reply to fbirder]

I Have had diarrhoea for over 30 years, repeat prescription for imodium for 10 years.

This started three days after operation !!!!

I worked out the acid thing, so every morning I always

Eat a few red grapes with my toast. Never take medication now if I have a problem I have a few more grapes. IT works for me.

[mickeymouse42]

I noticed that serum gastrin is included in the PA's society blood test summary. Is it correct to say that you get high levels of serum gastrin when you have low stomach acid (hypochloridia or achloridia)? Has anyone had the serum gastrin levels tested?