In this blog post I’ll show you research that reveals how H pylori and vitamin B12 levels are correlated.
In other words, I’ll show you how H pylori appears to cause vitamin B deficiency in some people, ultimately leading to symptoms such as low energy, depression, headaches and possibly even increasing the risk of developing heart disease.
In this blog series on H pylori and heart disease, you’ve so far learned how H pylori can result in:
If you haven’t yet read these posts, I recommend you do so, beginning here and following them in the recommended sequence.
Vitamin B12 and another nutrient, folic acid (also called vitamin B9, or “folate”) play numerous important roles in your body.
They are extremely powerful nutrients.
Vitamin B12 and folate deficiencies can make you feel really unwell, and they are risk factors for cardiovascular disease.
According to the UK NHS:
“Vitamin B12 or folate deficiency anaemia can cause a wide range of symptoms. These usually develop gradually at first, and can worsen if the condition goes untreated.” 1
The WebMD site, another big-hitting medical website, asks”
“Are you getting enough vitamin B12? Many people don’t, and that deficiency can cause some serious problems.” 2
Clearly the western medical system – despite its apparent lack of interest in nutrition – values vitamin B12 and is aware of problems associated with deficiencies in this important nutrient.
Vitamin B12 and folate are also involved in detoxification, and in a critically important process called methylation, which we’ll discuss below.
I’m sure you’ll agree that many of the above symptoms are life changing and can severely disrupt quality of life.
What the medical websites don’t tell you is that there is a causal association between H pylori and vitamin B12 deficiency
There may also be a link between H pylori and folate deficiency, although this has not yet been proven.
If vitamin B12 deficiencies can lead to the above symptoms, and H pylori causes vitamin B12 deficiency, then isn’t it reasonable to say that H pylori is actually the cause of these symptoms?
As I say many times on this website, if you think H pylori is just a tummy bug that causes a few digestive complaints and the odd ulcer here or there, think again!
I’m certainly NOT saying H pylori causes vitamin B12 deficiency in everyone.
What I AM saying is that under certain conditions, H pylori has the potential to cause or contribute to vitamin B12 (and possibly folate deficiency) in some people.
Parietal cells in the stomach are responsible for the production of both stomach acid and a substance called intrinsic factor.
Intrinsic factor is needed for the absorption of vitamin B12 once food has been digested. Without intrinsic factor, it’s hard to get vitamin B12 into the body.
H pylori can damage parietal cells, resulting in reduced stomach acid production as well as reduced intrinsic factor levels.
Over time, chronic H pylori infection may lead to a condition called atrophic gastritis, where the stomach lining is severely degraded and worn away.
Atrophic gastritis patients often struggle with chronic malnutrition and are at increased risk for developing stomach cancer. 3
Low stomach acid and intrinsic factor levels result in poor digestion and absorption of vitamin B12 and folic acid, as well as other vitamins and minerals, including iron (in fact, H pylori has conclusively been shown to cause iron deficiency anaemia).
Poor digestion and absorption of nutrients can, of course, lead to a range of nutritional deficiencies that have the ability to cause a multitude of symptoms.
When vitamin B12 and folic acid levels are inadequate an important metabolic process called methylation cannot function properly.
The methylation cycle is shown in the diagram.
There are some long words there, but I want you just to notice the fact that vitamins B12 (and to a lesser extent B6) are needed.
When these cycles don’t work properly, the blood level of a substance called homocysteine can creep up.
Importantly, homocysteine is a known risk factor for the development of heart disease.
Thus, chronic B12 and folate deficiencies increase heart disease risk by causing increased homocysteine levels.
This isn’t new news…
As far back as 1996, H. V. Markel, from the Centenary Health Center in Scarborough, Ontario, Canada, wrote:
“Reduced folate absorption can occur in an environment of increased gastric juice pH and/or decreased ascorbic acid (vitamin C). This can, relatively rapidly, result in inadequate folate status, which inhibits the methionine synthase reaction. Reduced methionine synthase activity increases the blood concentration of homocysteine, which is known to be toxic to endothelial cells, and an independent risk factor for atherosclerosis. Decreased folate availability may help explain the increased risk of coronary artery disease, which has been observed in populations infected with H pylori.” 4
It’s interesting that an association between H pylori and heart disease was noted as far back as 1996, yet hardly anyone talks about it.
One would have thought such an important issue should be common knowledge but instead, most people still believe the false idea that genetics, smoking and eating saturated fat cause heart disease!
In a 2006 study, researchers studied the effect of H pylori eradication on homocysteine, vitamin B12 and folic acid levels (note that folic acid is only one form of folate and doesn’t encompass the entire folate family).
The researchers found that folic acid and B12 levels increased during the twelve months after successful H pylori treatment.
The increase in folic acid level following H pylori eradication was statistically significant.
Furthermore, homocysteine levels decreased after H pylori eradication, and the decrease was statistically significant.
The conclusion was:
“In the group of patients studied, decreasing serum level of homocysteine and increasing level of folic acid were found after H pylori eradication.” 5
A further study, this time from 2003, showed that males aged 51-65 with H pylori-related atrophic gastritis had significantly lower levels of both vitamin B12 and folate.
They also had significantly higher levels of homocysteine, leading the authors to conclude:
Yet another study from the Helicobacter Journal, this time from 2004, showed that H pylori infection in a group of elderly male patients was significantly associated with decreased vitamin B12 levels and elevated homocysteine.
Upon the eradication of H pylori, vitamin B12 levels increased by approximately 30% after three months and 40% after six months.
At the same time a 50% reduction in homocysteine level was observed. The researchers concluded:
“Our results demonstrated that in the elderly, H. pylori infection is associated with B12 deficiency and high homocysteine. Also these patients may have a benefit with H. pylori eradication by improving their quality of life and by decreasing risk of cardiovascular diseases associated with hyperhomocysteinemia.” 8
A 2012 statement published in the medical journal “Gut” stated:
“There is evidence linking H pylori to the aetiology of otherwise unexplained iron-deficiency anaemia, idiopathic thrombocytopenic purpura (ITP) and vitamin B12 deficiency. In these disorders, H pylori should be sought and eradicated.” 9
In this statement, note the strong assertion that, “In these disorders, H pylori should be sought and eradicated.”
Yet when I’ve consulted patients diagnosed with B12 deficiency, barely a single one had been tested for H pylori by their doctor.
A 2011 paper titled Nutritional Aspects of Helicobacter Pylori Infection concluded:
“On the other hand, H pylori eradication has been shown to improve serum level of iron and vitamin B12.” 10
Again, this indicates a role for H pylori in determining iron and vitamin B12 status in some people.
In a very interesting study just published in 2015, researchers were able to show that H pylori infection may predict future B12 deficiency.
“The study provided a good screening system that may predict vB12 deficiency before its actual manifestation. If not treated, asymptomatic subjects showing increased anti-H pylori IgA titers (> 15 NTU/mL) are likely to be at risk of developing vB12 deficiency.” 11
A key point here is that B12 deficiency may be predicted even when H pylori is not causing symptoms.
An asymptomatic H pylori infection may still cause insidious damage that leads to future problems.
Finally, a meta-analysis examining data from 64 different studies on H pylori and nutritional status, found that H pylori infection is associated with lower levels of iron and vitamin B12.
In conclusion, the authors stated:
“Meta-analyses indicate that H pylori infection is associated with reduced levels of ascorbic acid and cobalamin (vitamin B12), supported by the positive effect of eradication treatment.” 12
Folate and B12 are both needed for optimal methylation function, and deficiencies in either nutrient can cause problems.
Unfortunately, although Dr. Markel noted a possible association between H pylori and folate levels back in 1996, few studies have investigated the relationship between folate and H pylori infection.
Some authors have reported associations between H pylori and folate, in which it’s postulated that H pylori infections may cause a reduction of folate levels.
Decreased folate absorption may take place as a consequence of decreased concentration of vitamin C in gastric juice and/or low stomach acid pH, as frequently occurs in H pylori infection. 13
As noted near the top of this post, vitamin B12 deficiency (and folate deficiency) can cause some really serious symptoms relating to energy, mood, neurological function and cardiovascular health.
The research seems to suggest that H pylori and vitamin B12 deficiency are closely related.
It appears that H pylori infection has the potential to reduce vitamin B12 status, whilst increasing homocysteine levels, even when obvious H pylori symptoms are not being experienced.
Homocysteine – which increases heart disease risk when it’s too high – most probably increases because of impaired methylation (remember that fancy diagram I showed you?)
Methylation occurs in every cell, and is associated with mood, energy, psychological and behavioural disorders, detoxification and a whole host of other issues when it’s not working properly.
I believe it’s wise to view H pylori-induced B12 deficiency very seriously.
I realise this might all be a little confusing, especially when in previous posts I’ve shown you how H pylori seems to affect many cardiovascular disease risk factors (blood pressure, insulin resistance, inflammation, etc.)
First, if you know you have H pylori, get rid of it. Use my H Pylori Diet book for guidance, or get some antibiotics from your doctor (or use my program and the antibiotics back to back, NOT at the same time).
Second, if you’re concerned about your nutritional status, or about your cardiovascular health (or anything else, for that matter), contact us and arrange a so we can offer some case review and one on one guidance.
Third, if you’re not sure whether you have H pylori, your doctor doesn’t want to test because your symptoms aren’t bad enough, or you want to get your digestive function tested, consider getting a home stool test.
As this is the final part of my blog mini-series on H pylori and heart disease, I’d love to invite you to the summary page where I pull all the information together in one short post.
Please to read the H pylori and heart disease summary.
Do you have a vitamin B12 deficiency? Did your H pylori infection cause some of the symptoms in this article?
Let us know how we can help you, or how you can help us, enter the discussion by leaving a comment below!