I was wondering if anyone might be honest enough to say whether they had a B12 deficiency from alcohol use?
It's anonymous here and so no one will know if we share.
For example, I have a family member who has been in recovery for many years. And when they went into rehab they were given B12 shots because 'alcoholics are at greater risk'.
And it got me thinking about why/how they are at greater risk.
One theory is that large amounts of alcohol can irritate the mucosal lining of the stomach and intestines. And in the stomach, this can harm or even destroy the parietal cells and lead to auto-immune gastritis/PA.
So that's one thing.
But if an alcoholic continues to drink, even when PA emerges, something else happens as a consequence, i.e. alcohol strips B vitamins, including B12, out of the liver stores.
Further to this, alcohol prevents absorption from food as it irritates the intestines and blocks any B12 and other nutrients from being absorbed. At least if it's consumed at the same time as food (or B12-rich food).
So it seems to me it would be quite a complex thing for an alcoholic to get B12 deficiency. And they would need to drink enough over time to harm their stomach lining.
But what if someone wasn't an alcoholic?
What if they had PA and drank moderately? Would the body still strip out the B12 from the liver stores and slowly use them up until a full-blown B12 deficiency occurs?
Or would they need to be drinking huge volumes every day for this to happen?
Just curious since alcohol is almost never given as a reason for PA or B12D anemia in literature. Or it's not put up against diet or PA/autoimmune gastritis as the two main reasons.
Is this because it is a possible cause of PA/Autoimmune gastritis but could not necessarily be proven to be?
Lots to think about if it's appropriate to explore this.
Thanks
Written by
Pickle500
To view profiles and participate in discussions please or .
Interesting. But not sure I follow. Are you say excessive alcohol consumption might be a cause of PA? Highly unlikely IMO. However alcohol can cause 'reactive gastropathy' where antrum cells are damaged/destroyed, which could account for absorption issues.
I do believe excessive alcohol consumption is commonly recognized in the literature as a cause of B12, but perhaps awareness campaigns and patient forums/groups don't stress it. Is that what you are referring to? Likewise, PPI & metformin use are usually listed in that category. If the b12d literature you're referring lacks discussion about alcohol but also doesn't mention PPIs/metformin, then it's incomplete anyway.
On the flip side, H pylori is a recognized cause of atrophic gastritis so that is thought to perhaps be a trigger for PA in some. If alcohol use would make you more succeptible to H pylori then there might be a link there.
Not sure if I addressed your question properly but definitely an interesting & important topic.
Also, no clue what moderate consumption would do. If it's not enough to block cellular processes or damage cells, i guess it woukdn't have any strong effect.
Thanks. Yes, I think I'm pondering whether heavy alcohol use over an extended time could create ongoing inflammation in the stomach and result in the atrophic gastritis you suggest comes mainly from H. pylori.
i.e. alcoholics are at risk because they wear away the stomach lining. And it leads to PA as would atrophic gastritis caused by H. Pylori ?
Then if they keep drinking they erode supplies of b12 in the liver.
Hmmm yes well maybe this is splitting hairs, but PA will be autoimmune in nature, where it's the autoimmune attack that causes the damage, whereas alcohol will cause direct chemical damage to the stomach. Also the damage will be located in different areas of the stomach. The end results may potentially be similar, but looking through some publications I remembered that excessive alcohol can also cause low thiamine. So I think probably these are still two distinct mechanisms of damage. There's also the point that excessive alcohol will damage the liver, whereas there is no link with PA. And looking at the links below, the effects of alcohol are even more complicated than what we're discussing here.
Here's a paper on the mechanism of thiamin deficiency academic.oup.com/alcalc/art... [Allan D. Thomson, Mechanisms of Vitamin Deficiency in Chronic Alcohol Misusers and the Development of the Wernicke-Korsakoff Syndrome, Alcohol and Alcoholism, Volume 35, Issue Supplement_1, May/June 2000, Pages 2–1]
And one on B6 & B12 degruyter.com/document/doi/... [Halsted, Charles H.. "B-Vitamin dependent methionine metabolism and alcoholic liver disease" Clinical Chemistry and Laboratory Medicine, vol. 51, no. 3, 2013, pp. 457-465.]
Another thing to consider is that alcohol consumption disrupts / reduces sleep, which can be hugely detrimental to health, across the board, impacting upon a lot of bodily processes (I would give examples but I am really struggling with fatigue at the moment, and it all seems a bit beyond me). I read a brilliant book ‘Why we sleep’ by Matthew Walker (a British academic (sleep specialist) currently in the US). There are so many links between poor sleep and poor health outcomes, that it wouldn’t surprise me if alcohol (and the resultant poor sleep) could contribute to B12 deficiency / absorption issues / PA..?
The other thing that occurred to me was an alternative question about alcohol consumption / alcoholism… in an article about the MMACHC Proteome (Hallmarks of Functional Cobalamin Deficiency), the authors identify that high metabolites (MMA and / or homocysteine), as seen in persistent B12 deficiency, have a knock-on effect on a huge number of other genes, including CLIC4, (Chloride Intracellular Channel 4), which is expressed within the brain (and in other places), and is linked to a number of different disorders / functions, including eg autism, but also risk / reward centres in the brain (ie addiction). This makes me wonder whether high metabolites (from B12 deficiency) could result in addictions due to downregulation of CLIC4? So maybe persistent (or early) B12D could contribute to alcoholism or other addictive behaviours? Who knows!
I am not a medical professional, and these are just some wild ponderings that I have had!
When I was ill with chronic fatigue I found b12 deficiency a massive part of my symptoms and self inject now and with a couple of other things feel much better. During my years ill I found that one glass of wine would really feel like I had drunk a whole bottle the next day - worse sleep than normal and foggy feeling. I became tee total, though I mean from the the odd glass of wine, I wasn’t alcoholic. When I was reading around b12 I am sure I read in a few places that alcohol depletes b12. Don’t remember looking at how or why though!
I have not read everyone's answers in depth but here is mine.
I was bulimic for 20 years
I dabbled with drugs both prescription and street.
I was on PPI
Diagnosed with complex post traumatic stress disorder
I wad addicted to sugar
I was addicted to alcohol and drank daily towards the end.
I really do not want to sound rude but your question has triggered me so I have answered as honestly as I can for the benefit of people in my position and not your question.
As you can see from my beautiful list of society finger pointing list you can say any one of those disorders or addictions caused my B12 deficiency especially as I didn't test positive for PA.
The person who mentioned B1 is correct and that is the most important B vitamin to replace when either an alcoholic or in recovery as lack of B1 can cause similar symptoms and also brain damage.
Alcohol can affect you after one glass, binges or daily in take as we are all different.
It's so important to remember alcohol like sugar is poison and harmful for the body in any amount. That's why there is a term used "in moderation".
So it's best not to look for something to blame especially if a person is an alcoholic or in recovery as they will not thank you for it and it's impossible to ever know. Your wanting to find the answer that alcohol is to blame could result in more stress for the person which inturn isn't going to help their recovery or B12 levels.
I say just be there for the person and know if they are looking after themselves like I am and self injecting then life's good.
If the question is really about you then be kind to yourself. Eat well, seek support for any poor mental health as that's pretty much why people drink to self medicate some kind of pain.
Thanks for your reply. No, I wasn't looking to blame anyone or anything. No judgement here at all.
As I say, I have a family member who entered rehab for alcohol recovery and was given B12 injections just like that - no test. And they felt fine/didn't have symptoms. Perhaps they also took B1 and probably other meds to cope with the withdrawal.
For me, yes alcohol eventually triggered my B12 deficiency. But it was after many problems with abdominal pain.
And while I drank too much in my youth, I drank moderately in my adult life. The painful stomach aches led towards further investigations for bowel cancer. I also had a thryroid nodule and salivary gland tumor appear at a similar time.
So were they all linked to a 'history' of heavy drinking? Mainly in a London financial services culture in the early 2000s that reduced around 2010?
Or was it a reaction from my gut or stomach being overloaded?
Either way, small amounts of alcohol - which became infrequent over time - eventually did set off B12d. But this was after belly pain and sickness.
I think that no enough is known about alcohol and B12. Particularly since heavy alcohol use increases homocysteine as it depletes B12. And I think its why many people feel dizzy, hot, have a burning feeling when B12 deficient.
For me, perhaps it was a collection of many issues - stress in a job and from family, a hiuse move, lack of sleep, poor diet, wine with my partner at the odd occasion, job loss all leading up to the pandemic. Which was pretty stressful too.
It.may have been that I did not enough B12 to counter all of that. But that may also suggest vegans and vegetarians should not drink heavily. And I know quite a few who do.
I think that further research is warranted on alcohols effects on B12.
Lovely reply and yes I agree that there is so much more needed when it comes to research.I'm soba, vegan, ex smoker and ex drug user but I still struggle.
I'm sat at the top of a wainright typing this and every ounce of my being is exhausted.
Your message today has really triggered me but that is good as it means growth for me.
I'm sorry that you feel triggered by this. I suppose there was always a risk of that in my post, but I hope that it has helped you in some way in terms of hearing someone else's story?
I believe society is in a collective denial over the health risks of alcohol, including Doctors. And while we should avoid judging ourselves or others, science can sometimes bring the answers that may help us avoid self-flagellation from what we've done wrong or feel that we've done to ourselves over time.
Like you say, heavy drinking is usually emotionally driven. Or in the case of addicts, sometimes something deeper that we can never fully understand unless we are one.
Perhaps I liked to tell myself I didn't drink much. But compared to friends who drink every day or 4/5 times a week, I never did that. I would usually be sober for the week and have a few at the weekend from time to time. But back in the day, I used it as a crutch and did drink a lot.
But I do struggle to accept, and my Doctor did too, that the amount I drank would lead to B12 deficiency. Instead, I believe that my intestines were inflamed over time as the result of stress, lack of sleep, and not thinking about my diet.
And this inflammation and lack of B12 stopped me from absorbing B12. And then alcohol started stripping B12 out of the liver.
I have no liver damage. I have no kidney damage. So I think it is very complicated.
Hope I haven't offended you or anyone else.
Maybe the B12 is the 'final straw' for our bodies to demand we look after them. That's the only way I can accept it and try to get better.
Definitely not offended me, you have enlightend me as when I read your first email I took it as if you wanted to blame alcohol and you was pointing the finger. Which I know is not the case.
I too came from a heavy corporate background however at the end of my drinking days I drank daily. I too do not have any liver or kidney issues and I did and do have terrible stomach issues that I'm trying to correct.
Today you have helped me realise that not everyone is trying to have a go at me. I can be hypa vigilant due to trauma which stops me seeing clearly at times. Always on the defence just in case.
I have read that the stomach is the brain to our bodies and I can quite believe that and agree that that for me I have damaged myself a lot through alcohol, drugs and bulimia.
I wish you well and on that note I'm off for a B12 jab haha
The gut is linked to the brain and they send each other messages. And if the brain says 'fight or flight' to the gut, if it's stressed or traumatised, it works for a while. But not if it's continuous. At some point, it has to stop.
Keep going with the B12. It's like magic juice that solves all our problems (kind of) so don't give up on it.
High alcohol intake damages the liver which is where B12 is stored. if the liver is damaged then it may not be able to store B12 in the same way and the normal process for maintaining serum B12 levels may no longer work. I think this is the most likely explanation for people with alcohol dependency issues being more at risk from B12 deficiency
I believe that's one reason. But for a lot of alcoholics, the liver is relatively intact upon recovery. And it takes many years of heavy daily abuse to really start to show damage in the liver.
Other reasons, I believe, include stomach lining erosion from inflammation. But also intestinal inflammation. And the small intestine is where a lot of nutrients are absorbed including B12 and in transportation to the liver.
So B12 deficiency could potentially occur from small intestinal inflammation caused by alcohol, stress, chemicals, processed/toxic foods and accompany other deficiencies?
All substances, alcohol, illicit drugs, as well as some prescription drugs deplete vitamins and minerals.My PA was caused by years of being over prescribed Oxycodone and OxyContin.
My alcohol intake has always been very low but I was prescribed biophosphates for my osteoporosis. I stopped taking them some years ago because of awful side effects which included stomach pain and problems for which I was given omeprazole. I think these prescribed medications could well have damaged my stomach lining, eventually leading to my severe b12 deficiency and autoimmune PA diagnosis. Although it’s an autoimmune condition as I have both Intrinsic factor and PC antibodies I think it could be triggered by substances that damage the stomach lining.
Thanks for this. I think it's fair to say that alcohol is a toxin. And in certain quantities it can be poisonous.
Good to know about the detoxification benefits of B12. In fact, I don't think many people consider meat as detoxifying. We're now all being told that meat in large quantities leads to heart disease and bowel problems.
But this is incorrect, really. Its the processing of meats - cured, smoked, etc and preservatives that creates more toxins for the body to sort through. So only organic meat seems to be a good idea.
So alcohol can be a major toxin, but so can polluted air, household chemicals, and other processed foods. And that's alot for b12 and the liver to sort through.
I think the medical community is currently underestimating/doesn't know enough about gut health. Because if you have a healthy liver, heart and kidneys, with a sufficient supply of B12 in the diet, that should be enough right?
Unless there's an absorption issue. And that could be PA as an autoimmune disease but it could also be a problem in the intestines (SIBO).
In which case stopping all toxins and increasing organic meat intake may recover things?
Why are there no gut health specialists in the NHS?
When I went to see a hematologist after I was diagnosed with low B12 he asked me how much alcohol I drank on a regular basis. I realized he was asking if I was an alcoholic. I told him the truth, I rarely have more than one or two glasses of wine a month.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
PA and Alcohol
Concern about PA and Cancer
Iron Deficiency and PA
