B12 deficiency and diarrhoea

[Hephzi]

Diagnosed low B12 138 and have had loading injections and due the 3 monthly one later this month.

I have recently been suffering bouts of recurring diarrhoea with no obvious reason. Could this also be linked to the deficiency? I will be calling GP but just wanted to get my facts straight before I get fobbed off.

Thanks

[fbirder]

It could be linked. If your B12 deficiency is caused by Pernicious Anaemia.

PA is an autoimmune disease where your own immune system attacks cells in your stomach called Gastric Parietal Cells (GPCs). These have two main jobs -

The GPCs make a protein called Intrinsic Factor (IF). The B12 molecule is too large to cross biological membranes without help. The IF protein attaches itself to B12 and carries it across the gut and into the bloodstream. If you have PA then you don't have GPCs, so you have no IF, so B12 cannot get into the blood, so you have a B12 deficiency.

GPCs also make stomach acid. If you have PA then you make little, or no, stomach acid. This has a variety of effects. Two important ones are - that acid is needed to help digest proteins and also kills of a good number of bacteria you ingest with your food. Without the acid you can have bacteria growing in your small intestine (SIBO - small intestine bacterial overgrowth) which can cause symptoms similar to Irritable Bowel Syndrome (IBS). You also have a lot of undigested protein getting into the large intestine - and the bacteria there have a big party.

The overall effect is that the lack of stomach acid produces, bloating, wind, constipation and diarrhoea.

Many of us find that drinking something acidic with large meals helps. I take about 25 mL of lime juice in a glass of tonic water or fizzy orange. Others swear by apple cider vinegar. Taking probiotics can also help.

[Hephzi in reply to fbirder]

Thank you. This is really useful.

[Nackapan]

Also for alot of people 3 months is too long a wait . If symptoms get bad again go back and ask for 2 monthly at least .Point out guidelines are 2-3 monthly

Guidelines . They can and should presctibe on need and control of symptoms