PA Diet

[Destiny79]

Hello,

Does anyone know if they're any foods to avoid with having P.A? Just started taking B12 injections , didn't know if there's anything I should avoid.

[wedgewood]

If you have P.A . always chew very thoroughly, and eat smaller meals more often . P.A patients have low or no stomach acid ( hypochlorhydria/ Achlorhydria, due to the destruction of the parietal cells by intrinsic Factor antibodies . These cells produce stomach acid and the intrinsic factor.)

Saliva has some enzymes which start the breakdown of food .

If you have Achlorhydria, you may find Betaine hydrochloric acid with pepsin capsules helpful to breakdown proteins like meat . Other wise organic apple cider vinegar tablets with the mother are milder and very useful with protein meals .

Best wishes .

[Destiny79 in reply to wedgewood]

This was helpful. Thank you

[Nackapan]

I agree . Routine tines of meals snd snacks.

I have apple cider vinegar with mother on food at the end of a meal.

Or lemon juice oe similar to drink .

I'm personally less tolerant of spicy foods sbd garlic so add a big blob of live yoghurt.

I generally eat more plain live yoghurt

[Destiny79 in reply to Nackapan]

This was helpful. Thanks!

[PlatypusProfit8077]

A few of us seem to have issues with alcohol - I can’t tolerate much more than half a glass of cider without getting symptoms spiking again

[deniseinmilden]

Brilliant answers by some of the best, to a very good question!

I'll add that, other than avoiding alcohol (alcohol is a poison and B12 is used up in its additional role in the body as an antitoxicology agent), your diet shouldn't be about avoiding things, but more about making sure you have plenty of all of the vitamins and minerals needed to support the B12:

Primarily folate (B9) and all the other B vitamins, vitamin D, and iron, potassium, and magnesium, but all vitamins and minerals are needed in the myriad processes that use B12 for DNA synthesis in cell repair, nerve functions, and energy release.

Look each one up and see what the best sources are, that you like.

The broader the spectrum of foods you can eat, with red meat and fish being balanced by vegetables and fruit in a wide colour range, the better you will do.

Different foods supply various vitamins and minerals and also have a lot of "magic compounds" that can help with absorption and metabolism.

Unless there's a specific health reason not to, it's a good idea to take a broad spectrum multivitamin and mineral supplement. Supermarket A-Z ones are as good as, if not better than, more expensive branded ones.

[Destiny79 in reply to deniseinmilden]

This is great 👍

[Sleepybunny]

Hi,

Welcome to the forum.

A few B12 websites that might be useful.

1) Pernicious Anaemia Society

Based in UK. Has overseas members.

pernicious-anaemia-society....

PAS membership is separate to membership of this forum.

pernicious-anaemia-society....

There are PAS support groups in UK, USA, Sweden and Australia - New Zealand.

pernicious-anaemia-society....

2) B12info.com

b12info.com/

Set up by a UK campaigner on B12 deficiency issues.

3) B12d.org

Organises interesting online talks.

b12d.org/event/

4) B12 Awareness (US website)

b12awareness.org/

Set up by Sally Pacholok, US campaigner on B12 deficiency issues.

She has some online articles and videos.

5) Stichting B12 Tekort (Dutch B12 website with English articles)

stichtingb12tekort.nl/english/

Two B12 books I found useful

Published some years ago so some bits may need updating.

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

Martyn Hooper is the former chair of PAS (Pernicious Anaemia Society).

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

Very comprehensive with lots of case studies.

If you're in UK, there's lots more info I could pass on.

I'm not a health professional just someone who suffered for years from unrecognised and untreated B12 deficiency.

[B12life]

There is a cause and effect to everything.

Finding the cause, identifies the right solution to take.

So it all comes down to cause. The problem with PA is there are so many causes and few of them have tests.

If it caused solely by diet, then diet can help. B12 metabolism requires folate. So get enough b12 (daily) and folate in the foods eaten.

If it's caused by medications that inhibit folate or b12 absorption. Platypus mentioned alcohol! This is a big one that inhibits b12 absorption. Stay away entirely until your b12 levels are good indicated by resolution of symptoms. Metformin also blocks b12 absorption. Medicines for stomach acid I believe are some. Then the solution will depend on what can be done if anything to avoid those.

If its stomach related, there may be things that can be tested and solved to alleviate the need for b12 injections or heavy supplementation.

But if all that fails or doesn't apply and it's a malabsorption issue of folate and/or b12, then diet may not help. Although, despite definitively being in this case, I still try.

So to improve levels of b12 and folate through diet, be sure to identify foods that provide those nutrients. B12 RDA must be obtained daily, not periodically.

Be aware that If one has PA, or a very low level of b12 it may take high dosing b12 with supplements or injections above just diet, to get back to normal and avoid permanent neurological damage (nerves, spine, brain function)

Then continue with diet.

I believe though the simple answer you were looking for is what to avoid: any medications that block absorption: metformin alcohol, others.

Don't space out injections until your symptoms resolve.

[wedgewood in reply to B12life]

Sorry , but I have to disagree with you stating that diet or medication can cause Pernicious Anaemia. Pernicious Anaemia is an autoimmune condition caused by antibodies that attack and destroy the parietal cells in the stomach . These cells produce stomach acid and the intrinsic factor , both of which are required to absorb Vitamin B12 from meat, fish, dairy products and eggs . The condition is incurable , but can be remedied by b12 injections that are needed lifelong . The test for P.A. is the Intrinsic Factor Antibodies test , which unfortunately shows up negative in about 50% of P.A. patients . Often requires several tests before they show up . Many doctors do not know this , and only perform one test , and ignore the patient’s symptoms .

[B12life in reply to wedgewood]

No apology needed. You are 100% correct.

[Destiny79]

Very informative. Thanks

[Oneash]

Definitely avoid alcohol. Whilst you need plenty of good folic acid, I'd go easy on anything high in oxalates as your kidneys have enough to be dealing with as you reverse out.

Avoid non organic grains and soya, particularly oats. They can be dessicated when ripe with herbicides, chemicals which can disrupt vitamin and mineral absorbtion. Whilst the jury is out on a direct causal link, we are vulnerable and sick and need every drop of vitamin.

[Wwwdot]

Hi Destiny

Brilliant question!

I have autoimmune Pernicious Anaemia which causes my B12 deficiency but as B12life and wedgewood have explained there are other causes of B12 deficiency too. I have low stomach acid which means I don’t feel hungry very often.

I had to make a radical change to my diet because although I had good B12 levels with frequent and regular injections and my cofactors levels were good too, I was still suffering diarrhoea, bloating, stomach cramps and nausea.

As Wedgewood mentioned Betaine and Pepsin before a meal helps hugely and if I eat, protein in particular, without B&P I suffer abdominal cramps.

But B&P didn’t stop the diarrhoea, bloating etc I adopted an autoimmune paleo diet and switched to A2 dairy and that made a big difference- I also only eat grass fed meat (not organic necessarily as organic meat can be grain fed) and wild seafood and fish (not farmed). I brew kefir and kombucha.

My family menu looks very similar to what it’s always been just that now ingredients are sourced differently and food prepared differently and some staples like wheat flour swapped out. I have adapted my favourite recipes and we still enjoy gluten, paleo, dairy and sugarcane free cakes and spaghetti bolognaise but no wheat!

It’s a fascinating area to research and experiment and the revelation of a new insight into foods that taste good and my family enjoy but don’t give me symptoms has been a big boost to my acceptance of my diagnosis.

Happy cooking!

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