low folate

[Gwelos]

I gave PBC for 15 years and I’m on urso. My levels are reasonable. I have acid reflux, and I’m on Nexium 10 daily. In the last few months my folate has dropped below the low end of the range. I’m wondering if anyone else has this and is it related to PBC or Nexium. I don’t have anaemia. Thank you

[butterflyEi]

I believe that long term use of Nexium (esomeprazole) can be a contributory factor. Proton pump inhibitors (PPIs), can affect how much of B9 (folate) and B12 vitamins your body absorbs.

What has your doctor suggested?

Are you able to keep a food diary and see which foods stimulate the acid reflux. An elimination diet may help. I used to suffer with reflux, lost weight and stopped jumping up after every meal. I have regained a few pounds and have noticed the reflux after fatty foods. I rarely have fish and chips from the chippy now but did last night - paid the price so will avoid that again!

[Gwelos in reply to butterflyEi]

Thanks for your reply. I have tried to come off the Nexium slowly but the rebound is too much. I do eat unhealthily at times. I know I can change my eating habits if I take it seriously. I suppose I was concerned it was related to PBC

[butterflyEi in reply to Gwelos]

I do believe that people with PBC get tummy issues sometimes from the URSO, I also believe that women with PBC are more susceptible to UTIs.

I am a great believer in good gut bacteria which can be improved with fermented foods, kefir and yoghurts etc. I also take a Proven50+ as I am over 70. Proven have a good range so you may like to investigate their products (I use Bodykind in the UK) I suspect you will have a similar company in Ireland but if not I am sure they would post out to you.

Gaviscon might also be a help if you are trying to reduce the Nexium. I usually have a packet of the double action when travelling as food can be tricky if and when on an airplane.

hope something from the above will be helpful, if you continue to struggle the PBC Foundation have a help line which you may benefit from, they also have specialists who participate in a Q&A session, normally a Thursday about 2 p.m., if you are a member of the PBC Foundation you can find details on their web site, if not it is free to subscribe to them.

[Gwelos in reply to butterflyEi]

Many thanks for all that useful information 🙏