Low Stomach Acid

[TrillumHunter]

Hi all,

I've have a recurring issue with iron and b-12 anemia despite being gluten-free for two years. It has not gotten any better and all the iron, 130 mg a day, is killing my stomach. I have an appt with a hematologist to discuss iron infusion but I wonder if I should look at this as a possibility first? My celiac started with neuro issues before gi so I wonder if there is nerve damage to my stomach. I have an okay gi but he's been pretty willing to push the standard acid reflux line. Have any of you had the Heidelburg test? I took the baking soda test on here and never did burp at all--although my kid did!

I bought some betaine hcl today because I am pretty miserable. I'm unsure how to use it effectively.

Any and all help appreciated. I am hopeful is the issue because I really don't want the iron infusion.....

[rinne]

Sorry to hear you are still struggling after two years gluten free, that is a long time I know.

I can't help you with how to take the betaine although I am sure someone here will know the answer to that. I have found that supplements don't agree with me, I too have problems with low stomach acid. Only a small burp after the five minutes! I have been eating finely grated beet with lemon juice or apple cider vinegar which is recommended as a support for the bilary system and it seems to be helping.

What's your diet like?

[georgie]

Have you been checked for Pernicious Anaemia ? PA is an autoimmune disease that causes low B12. It also can mean you have atrophic gastritis of the stomach and have damage to the stomach walls - leading to poor digestion and B12 deficiency. Might be a good idea to get a scope done to check for this - as there is a slightly increased risk of stomach cancer if you have PA or gastritis. Not something to ignore or play guessing games with. You need to see a good Gastro Dr and if you are dx - then have regular endoscopes to check.

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In autoimmune atrophic gastritis, autoantbodies cause destruction of the parietal cell mass that makes up the gastric mucosa. The autoimmune response causes an infiltration of white blood cells and the release of chemical cytokines that accelerate the disease process. Ultimately, the autoimmune response impairs the mucosal cells' ability to produce hydrochloric acid, digestive enzymes such as pepsin, and intrinsic factor, a substance needed for the absorption of vitamin B12.

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[rinne]

Check out this thread, there is an interesting discussion of B12.

HERE

[Jestgar]

I take my iron with vitamin C, which is acidic.

[TrillumHunter]

I have been scoped--about a year ago. I had mild gastritis at the time. The first step in figuring out I had celiac was finding my low b12. That was six years ago. When it didn't clear up the dr started calling it PA without any additional testing. I asked about it and was told the test wasn't usually done as it was so easily treated. I went to the gi a year after my positive blood panel because of nausea. It turned out my gallbladder was infected so out it came. The nausea is much, much better but these issues persist. I don't believe he considered anything beyond that.

My diet is very healthy. I avoid most prepackaged foods. I try to follow the no more than five ingredients rule. I avoid milk and recently gave up xanthan gum.

I don't want to guess but really no one seems too jazzed to help me figure things out, if you know what I mean. It seems like I've gotten my dx of celiac so how could I have anything else? We all know that's a crock 'o cr*p. Especially considering it took at least 16 years for me to be diagnosed.

[georgie]

So you are dx as PA then ...how often do you have the B12 shots and did you ever have a loading dose ? Have you had the blood tests for PA ? I know they are only 50% accurate but may show how your stomach is.

I usually sip water with a little lemon juice in it with my meals. I find that helps the digestion a bit. Or a glass of wine. We often cook with vinegar type sauces too. Keep up the scopes - it should be a regular check...

[rinne]

I have been scoped--about a year ago. I had mild gastritis at the time. The first step in figuring out I had celiac was finding my low b12. That was six years ago. When it didn't clear up the dr started calling it PA without any additional testing. I asked about it and was told the test wasn't usually done as it was so easily treated. I went to the gi a year after my positive blood panel because of nausea. It turned out my gallbladder was infected so out it came. The nausea is much, much better but these issues persist. I don't believe he considered anything beyond that.

My diet is very healthy. I avoid most prepackaged foods. I try to follow the no more than five ingredients rule. I avoid milk and recently gave up xanthan gum.

I don't want to guess but really no one seems too jazzed to help me figure things out, if you know what I mean. It seems like I've gotten my dx of celiac so how could I have anything else? We all know that's a crock 'o cr*p. Especially considering it took at least 16 years for me to be diagnosed.

I know it takes some time to adjust to life without a gallbladder. When did you have the surgery? My husband had his out and for about five - eight years when he needed a bathroom, he needed it right that minute, it has improved considerably in the past few years.

I know what you mean about not getting help to figure it out, 16 years is unacceptable. I am sure there are good doctors out there but I ran into a number of idiots myself. The experience did not inspire confidence in them just a determination in myself to figure it out.

I keep at it, after learning that one study showed 18% of celiacs don't get well just by going gluten free, and after two and some years of being strictly gluten/dairy free and still having symptoms I decided to try the SCD, Specific Carbohydrate Diet. I am seeing positive changes.

[RiceGuy]

About the betaine HCL, the typical recommendation is to take it at the very beginning of a meal. There are many brands out there, and most I've seen are between 320-650mg of betaine, and 35-165mg pepsin. Which one do you have?

[TrillumHunter]

I'm taking the Twin Lab brand. Do you have any recommendations?

I actually took one last night before dinner. I had less pain after eating. I took two this morning with breakfast. My stomach was hurting a bit before from the coffee I'd had. I have no pain--really the first time in a long while. I even took my iron a half hour after eating and I still have no pain.

Pain-free and not nauseated. What a concept!

Jestgar--the brand of iron I take has 125mg of vit C in it already. I can't absorb iron at all without vit C.

[rumbles]

I would recommend starting with a low dose, - like the 250 mg.

HCL/150 mg. pepsin, if possible, start with a one with each meal,

and give your body time to adjust. When you start with too high

of a dosage, your body lets you know with ~ how do I say this?

~ a sticky output. If your digestive tract has been trying to run

without stomach acid, it will need time to get use using it again.

After you start taking it, you'll remember what it feels like to digest

food normally in the stomach again. You'll know when to increase

the dosage, as you'll get the feeling back in your stomach like you're

not totally digesting the food again, or will start getting acid reflux

issues again (sometimes within minutes of eating, sometimes hours later;

some of us find that taking HCL + betaine at that point will stop the

reflux, but it's always good to have a foaming agent like Gaviscon on

standby, just in case).

You'll learn that the dosage will vary depending on what your body needs,

depending on what you ate. After your system adjusts to having and

using HCL and betaine again, you'll learn to recognize how much you will

need based on the type of meal/amount of protein in the meal.

Continue to take B12 sublingually or by injection; the HCL with betaine

helps some with B12 breakdown, but it doesn't appear to fix the problem.