If one is deficient in the B complex of vitamins, minerals are low, antioxidants low, have heavy metals etc, should B12 be the starting point

[renski]

If one is deficient in the B complex of vitamins, minerals are low, antioxidants low, have heavy metals etc, should B12 be the starting point? Oral Hydroxy/adenosyl B12 makes me worse, oral methyl B12 is bit better but is stimulating, all the other B’s make me worse, B2 in particular causes more oxidative stress by interfering with my transsulfuration. I have gut issues so believe not absorbing the oral B12, but then why does it make me feel much worse. I have B12 injections but am not sure whether I should be using.

 

[kangaSue]

If you have gut issues too, vitamin D and magnesium status may be more important to address too.
https://www.ncbi.nlm.nih.gov/pubmed/27515213
https://academic.oup.com/ajcn/article/108/6/1249/5239886
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5588633/

 

[BeADocToGoTo1]

Malabsorption

Do you know why you are deficient and not absorbing those nutrients? It is very important to dig into the underlying causes. There are many reasons for malabsorption and nutrient deficiencies so it would be good to rule out things like exocrine pancreatic insufficiency (EPI), small intestinal bacterial overgrowth (SIBO), Candida yeast overgrowth, food sensitivities or allergies, gluten sensititivity, Chrohn's, gallbladder issues, stomach acid issues, etc.

Have you had an honest and careful look at everything you eat and drink to see whether there are any imbalances? How is your water quality?

B12

Are you able to handle a high quality multi vitamin/mineral? You can go overboard with the B12 injections (personal experience) too. Have you had IV drip of multi vitamins?

Also perhaps dig a little deeper to look at why you are so B12 deficient. B12 deficiencies can be due to, for
example, pernicious anemia, gastritis, Crohn's, celiac's, SIBO, Candida overgrowth, EPI, malabsorption issues to name a few. Are you a vegetarian or vegan, or is your diet lacking in B12 type of foods, as that might also be something to look into.

These are some tests to consider:

Antiparietal Cell Antibody (APCA)
Methylmalonic Acid (MMA)
Intrinsic Factor Antibody (IFA)

 

[renski]

@BeADocToGoTo1: I have malabsorption, about 25kgs underweight, have deficiencies of every nutrient but anything to try improve gut function just makes me worse so am trying injections to improve B12 and possibly some chelation with ALA. Have no idea why gut won't respond to any therapy but assuming methylation or heavy metals has to be addressed first (although I don't see how this is supposed to work).

 

[LINE]

Gut is likely damaged due to infection, this can cause problems in absorbtion.

Toxicity is a problem with chronic infections due to several reasons. Good chelators include Pascalite clay or zeolite (I used rnaresults zeolite which is very good but switched to pascalite for money reasons). rLipoic acid is better than ALA in my opinion. A product called Clean Chlorella is better than generic chlorella. Vitamins C and E and very good to curtail oxidative stress (toxicity).

 

[BeADocToGoTo1]

@BeADocToGoTo1: I have malabsorption, about 25kgs underweight, have deficiencies of every nutrient but anything to try improve gut function just makes me worse so am trying injections to improve B12 and possibly some chelation with ALA. Have no idea why gut won't respond to any therapy but assuming methylation or heavy metals has to be addressed first (although I don't see how this is supposed to work).

Hi @renski ,

Has your doctor peformed any of the following tests to rule out exocrine pancreatic insufficiency? The tests #4-9 listed below are standard ones to discuss with your doc. Those stool tests are a no brainer to do.

Have you confirmed through heavy metals tests and chemical exposure tests that you have issues there, and if so which ones? I do not think you should wait with asking for the standard pancreas/gallbladder tests until after chelation. Chelation is no joke, quite taxing, will take out more useful minerals, and should only be undertaken after toxic panel testing, and only done by a highly qualified and experienced MD. If you are already weak, this can slam you.

Has your doctor taken a good look at all your input and outputs; analyzed a week long diary of anything taken in (food, drink, water, meds, supplements), and stool and urine quality and frequency? Most doctors for some inexplicable reason, even some gastroenterologists, do not take a close look.

Tests

There is a lab in the UK for Genova Diagnostics that do helpful nutrient testing. Sadly, often insurance does not cover it.

If you have not already, here are a few tests you could look into:

1. Genova Diagnostics - FMV - Gives a great overall picture of nutrient deficiencies, neurotransmitter metabolites, microbiome dysbiosis including SIBO and candida, pancreatic enzyme issues, and many more. Biochemistry and metabolomics in practice. This test should be standard for all primary care and family practice doctors as a regular preventative maintenance test, and for anything chronic or hard to diagnose. Great Plains Laboratories has similar tests.

2. Genova Diagnostics - Comprehensive Digestive Stool Analysis 2.0 with Parasitology (microbiome dysbiosis indicators), Fecal Fat Distribution (checks if you have issues with different types of fat intake and digestion), Elastase (for EPI, pancreas enzyme marker)and Chymotrypsin (for EPI, pancreas enzyme marker). Doctor's Data has similar tests.

3. Small intestinal bacterial overgrowth (SIBO) breath test, for example, Commonwealth Diagnostics International. But the first one will also provide you with SIBO indicators.

4. 24 hour fecal fat test (indicator of pancreatic enzymes and malabsorption)

5. MRI MRCP with contrast - Gives a great picture of pancreas and ducts, gallbladder and ducts, liver, stomach, intestines.

6. Stool test: fecal fat level and distribution (checks if you have issues with different types of fat intake and digestion). A 24 hour collection test is pretty standard.

7. Stool test pancreatic elastase (indicator of pancreatic issues and malabsorption)

8. Blood test fasting trypsin (to see if you produce enough enzyme for protein breakdown)

9. Stool test chymotrypsin (similar to, but not as accurate as elastase test)

10. Intestinal permeability. Intestinal permeability (a.k.a. leaky gut) is something that your Gastro can also test for. The one I did was: Cyrex Laboratories - Intestinal Antigenic Permeability Screen. It measures intestinal permeability to large molecules, which can cause autoimmune reactions, inflammation, food sensitivities, malabsorption, etc.

Another element to check is:

Stomach acid: Is your pH low enough to start digesting food? If it is too high this will exacerbate any SIBO, candida overgrowths, and malabsorption. Are you taking antacids or PPI? Have you tried the simple selftest

A simple unscientific test to approximate acid level is by drinking a quarter teaspoon of baking soda (sodium bicarbonate) mixed in a glass of water on an empty stomach in the morning. This creates bubbles within two to three minutes when mixed with the hydrochloric acid in your stomach. If after five minutes nothing happens, there is a very good chance the pH of your stomach acid is too high (i.e., low stomach acid).

Gallbladder: Yet another element that is important in breaking down food and thus any gallbladder issues can cause malabsorption. Another thing that should be ruled out is any gallbladder issues and functioning.

Another thread that may help:

A thread regarding exocrine pancreatic insufficiency (EPI), microbiome dysbiosis, malabsorption and other related downstream symptoms is here:

https://forums.phoenixrising.me/thr...y-epi-and-chronic-fatigue-syndrome-cfs.62997/

 

[renski]

@BeADocToGoTo1: Thanks, I've done most of those tests, except for #5, I do have high fecal fat in stool, pancreatic enzymes generally OK on stool tests (don't tolerate digestive enzymes anyway so), all of my tests are quite bad, you can only look at my hair analysis to see that I have a lot of issues. I've had heavy metals show up on red blood cell panels, and my first hair analysis. Also had GPL-tox done which showed other toxicity. I am working with a ND but not completely sure she is able to help me. Something that has been suggested is reducing neuro inflammation with Butyrate, resveratrol, the idea being to improve gut-brain communication.

 

[BeADocToGoTo1]

@BeADocToGoTo1: Thanks, I've done most of those tests, except for #5, I do have high fecal fat in stool, pancreatic enzymes generally OK on stool tests (don't tolerate digestive enzymes anyway so), all of my tests are quite bad, you can only look at my hair analysis to see that I have a lot of issues. I've had heavy metals show up on red blood cell panels, and my first hair analysis. Also had GPL-tox done which showed other toxicity. I am working with a ND but not completely sure she is able to help me. Something that has been suggested is reducing neuro inflammation with Butyrate, resveratrol, the idea being to improve gut-brain communication.

If you had fecal fat in the stool it is highly likely that you have some form of exocrine pancreatic insufficiency and would benefit from using pancrelipase for all your meals. Please do not confuse them with 'digestive enzymes' that you see in every grocery store. Pancrelipase, like Creon, are tightly controlled quantities of lipase, protease and amylase made from pig's pancreas, and come in different strengths. It is shocking how much of a health impact this can have, as you would not be getting the necessary nutrients from your food, undigested particles can cause auto-immune reactions, systemic inflammation, leaky gut, bacterial and yeast overgrowths can result and subsequent downward spiral of health issues. They are usually so varied in nature that they confuse most doctors and specialists.

Regarding hair tests, I would take the results with a healthy does of scepticism due to possible inaccuracies. The toxic metals screen looks fine based on the report you had attached.

 

[renski]

Pancreatic enzymes cause similar side effects :/ Not excreting metals in the hair analysis, was more showing how low my minerals are, B12 status, B6, etc

 

[kangaSue]

Pancreatic enzymes cause similar side effects :/ Not excreting metals in the hair analysis, was more showing how low my minerals are, B12 status, B6, etc

Not all pancreatic enzymes are created alike and you may need to try one of the prescription types such as Creon.
Do you have a lot of food intolerance issues too? If yes, look into symptoms of gastroparesis which often goes with having malabsorption problems too.

 

[renski]

Not all pancreatic enzymes are created alike and you may need to try one of the prescription types such as Creon.
Do you have a lot of food intolerance issues too? If yes, look into symptoms of gastroparesis which often goes with having malabsorption problems too.

@kangaSue: I tried Creon a while ago, similar issues, I've tried Metagenics pan 9x, pure encapsulations pancreatic enzymes. I have food intolerances but that only started after I used the antimicrobials a few years ago. My oxalates are high, have leaky gut, etc.

 

[kangaSue]

@kangaSue: I tried Creon a while ago, similar issues, I've tried Metagenics pan 9x, pure encapsulations pancreatic enzymes. I have food intolerances but that only started after I used the antimicrobials a few years ago. My oxalates are high, have leaky gut, etc.

Do you have any kidney symptoms from high oxalates, as in from calcium oxalate crystals in the urine?

 

[renski]

Do you have any kidney symptoms from high oxalates, as in from calcium oxalate crystals in the urine?

Nope.. all my symptoms are fatigue and psychological.

 

[BeADocToGoTo1]

Pancreatic enzymes cause similar side effects :/ Not excreting metals in the hair analysis, was more showing how low my minerals are, B12 status, B6, etc

I hope you are not basing your actions and these conclusions on a hair analysis test. It will unnecessarily give you stress, which also uses up a lot of nutrients. Have you had recent blood and/or urine tests done to confirm that you are in fact low in those minerals?

Heavy metals will show up in almost all humans these days, but is it high enough that would require action, beside analyzing and changing the inputs (food, drink, water)? For example, if I eat a lot of fish, my mercury levels would go up. But if I change my diet, those levels will also change.

If you are willing to share (perhaps through pm) I can have a look at your diet to see if anything jumps out. A side question, but what is your HbA1c level? It is a simple indicator of carb/sugar intake which impacts an immense amount of health issues, including the whole gastro tract.

Sorry if I have asked this already, but especially with mineral imbalances I have to ask. What type of water are you drinking, e.g. mineral, well, tap, bottled (plastic or glass), chlorinated, fluoridated, reverse osmosis, reverse osmosis with minerals added back in, filtered (what kind?), restaurant or cafe water, etc.?

Confirming whether you have SIBO, Candida overgrowth, low stomach pH are also easy and useful. Tackling those will be uncomfortable, take time but have an immense effect on quality of life.

Really taking a hard and honest look at your diet is absolutely crucial and one of the few things you have complete control over. Do you know how many calories you should be eating for your metabolic rate? Are you eating enough calories? Have you tested for food sensitivities and allergies, and followed up with a temporary elimination diet?

What are the specific symptoms you get from taking enzymes with food? How much did you take and what was the meal? When during the meal did you take them? How long did you try them for? When your body is systemically inflamed, your immune system is on high alert for anything. I remember during the worst days that I needed anti-nausea pills just to keep down a bit of chicken soup. I was sensitive to everything, whereas I grew up being able to eat absolutely everything without issues. It took a few weeks for me to be able to handle pancrelipase. When there are so many things going on and you feel so poorely, it is tough to stick with something. And it is hard to determine what specifically in the diet is causing those symptoms.

 

[renski]

@BeADocToGoTo1: Yes I have done blood tests as well, and I've found hair to be accurate with certain minerals. Did my first urine test last week so will be interesting to see.

I haven't had HbA1c checked, only fasting glucose. I drink bottled spring water. I have have high yeast on GPL oats, probably a little SIBO but I can't take anything for it, and I've read yeast is caused by another issues so killing it isn't the answer. I eat lot of healthy food, I lost all my weight after using antimicrobial treatment so I assume it's leakygut/lack of good flora causing digestion issues.

Enzymes make me more depressed or hyped up/anxious. I don't feel good on them at all, not sure whether to persist with anything because of how bad I feel.

 

[Tammy]

I was sensitive to B12 when I first started taking it. I buy a liquid B12 (Global Healing) that is a combo of methyl and adeno. With the liquid I could start out with 1 drop and slowly increase dosage as my body adjusted. A friend of mine was so sensitive, she had to start with 1 drop in a small glass of water and then drink small amount of the water. I do fine with B12 now without sensitivity. To answer your question...........I would say yes..........B12 is a good place to start.

 

[LINE]

@BeADocToGoTo1: Thanks, I've done most of those tests, except for #5, I do have high fecal fat in stool, pancreatic enzymes generally OK on stool tests (don't tolerate digestive enzymes anyway so), all of my tests are quite bad, you can only look at my hair analysis to see that I have a lot of issues. I've had heavy metals show up on red blood cell panels, and my first hair analysis. Also had GPL-tox done which showed other toxicity. I am working with a ND but not completely sure she is able to help me. Something that has been suggested is reducing neuro inflammation with Butyrate, resveratrol, the idea being to improve gut-brain communication.

I looked at the hair analysis, many deficiencies in the trace mineral area such as manganese https://lpi.oregonstate.edu/mic/minerals/manganese

Hopefully the doctor should address these deficiencies which can cause underlying problems. Heavy metals will not show up in hair unless provoked, but I would caution about provokation unless you are using something to vacuum up the metals such as Zeolite or Pascalite or others I mentioned in the above msg. Provokation without vacuums is dangerous since they will redeposite elsewhere in the body.

Note that minerals (and other nutrients) such as manganese participate in the class of endogenous antioxidants (SOD etc) that play key roles in managing toxins. Endogenous antioxidants would be the ones the body manufactures, SOD, glutathione and catalase. These are all important for managing oxidative stress which damages cells.