Scientific research suggests that H pylori can cause vitamin B12 deficiency. This may be one of the reasons why patients feel tired, depressed or anxious as a result of having chronic H pylori infection. It may also explain why some patients also struggle with headaches and migraines that disappear when H pylori bacteria are eradicated.
Unfortunately, conventionally trained medical professionals tend not to associate digestive infections with symptoms outside the gut. But anything that disrupts the proper digestion and absorption of food has the potential to cause nutritional deficiencies which, themselves can cause problems in any and every area of the body.
H pylori is known to have the ability to cause autoimmune reactions against the parietal cells of the stomach. These parietal cells are very important because they make and secrete stomach acid and intrinsic factor - a substance that is needed for vitamin B12 absorption - into the stomach.
Stomach acid helps to break down food, releasing vitamins and minerals from the food you eat so that your body can absorb them. Intrinsic factor is absolutely critical for the absorption of vitamin B12. In fact, you can take as many vitamin B12 pills as you want, but without intrinsic factor you will not be able to absorb them.
Therefore, anything that slows down or prevents the production of stomach acid and intrinsic factor can cause symptoms associated with vitamin B12 deficiency.
If you have H pylori and it is causing problems related to parietal cell function, there is a good chance that you are going to have low stomach acid levels and decreased intrinsic factor secretion.
Antacid medications such as Omeprazole, Pantoprazole and other members of the proton pump inhibitor family of drugs can also shut down stomach acid production. H2 blockers and over the counter medications can also suppress acid production.
This acid suppression is an important consideration because the antacids drugs are commonly prescribed to treat the heartburn and reflux symptoms commonly experienced with H pylori.
Symptoms of Vitamin B12 Deficiency
Deficiency in vitamin B12 is know to cause neurological symptoms, some of which can be serious. The brain commands the nervous system so inadequate vitamin B12 may lead to a range of symptoms:
Behavioural and Personality Disorders
When Helicobacter pylori and other digestive infections are present, these neurological symptoms may or may not be accompanied by digestive symptoms. In other words, you can have H pylori and feel tired and depressed, but you may not have the common digestive symptoms that lead doctors to recommend testing and treatment.
Many symptoms can develop elsewhere in the body as a result of the collateral damage that is being done by stomach and intestinal infections.
Other Causes of B12 Deficiency
Whilst H pylori can certainly contribute to vitamin B12 deficiency and its associated symptoms, it is not the only cause. Other causes include:
Inadequate dietary intake of vitamin B12, especially in vegetarian and vegan diets.
Surgical removal of the small bowel due to chronic or serious disease.
Genetic polymorphisms (e.g. MTHFR)
Gluten intolerance and celiac disease.
Chronic intestinal infestation by the fish tapeworm, which competes for vitamin B12 for its own use.
Bacterial overgrowth in parts of the small bowel are thought to be able to absorb B12, making it unavailable to the body.
Some studies have shown that Giardia infestation can also lead to the malabsorption of vitamin B12. Giardia parasites can coat the small intestine and often result in fatigue in addition to classic diarrhoea symptoms.
Chronic alcohol abuse.
Treatment of B12 Deficiency
The medical approach to the treatment of B12 deficiency would typically be to prescribe B12 supplements (sprays, pills, sublingual drops) or injections. These treatment options may bring benefit and many patients will testify that B12 repletion has improved their quality of life considerably.
But when you look at the true underlying causes of the deficiency, it becomes apparent that a more holistic view to treating B12 deficiency is likely to bring better results.
Simply taking B12 supplements really does not address the underlying cause of the problem. Taking B12 on its own does not address low stomach acid or intrinsic factor levels, H pylori, parasites and other reasons why the deficiency occurred in the first place.
The Functional Medicine Approach To B12 Deficiency
I functional medicine, we look to address symptoms from the root cause. We do not simply recommend taking medications or supplements to mask the symptoms.
We have identified several possible causes of vitamin B12 deficiency and so it makes sense to address all the possible causes in addition to using B12 to top up levels. When we do use B12 supplements, we make sure they are taken under the tongue so that they absorbed better.
Testing & Assessing Vitamin B12 Levels
It is possible to check vitamin B12 levels in a blood sample and this will certainly provide useful information. A blood test is available from your doctor.
In order to perform its functions, vitamin B12 must move out of the blood and into the tissues of the body. Therefore, we also use urine testing called Organic Acid testing to evaluate B12 levels in our clients.
The advantage of this testing is that it tells us whether certain key metabolic pathways are being blocked because there is not enough vitamin B12.
Research cited in several textbooks has now informed us that Organic Acid testing is able to detect B12 deficiency at a much earlier stage than basic blood testing.
Make no mistake, H pylori and other factors that disrupt digestion can cause vitamin B12 deficiency and make you feel depressed, anxious and tired. If you know you have H pylori and you are suffering with these symptoms, be aware that simply eliminating H pylori may not be enough. You may need to have your B12 status checked and corrected, along with other nutrients such as B6 and folic acid.
If you have already been tested for B12 levels and have been told they are too low, it would be advisable for you to get checked for H pylori, gluten intolerance, celiac disease and other potential causes of the deficiency. If you do not do this it may be very hard to correct your symptoms.
Finally, if B12 capsules or tablets are not working for you, try sublingual drops or injections under the care of a qualified professional.