Is it safe to take systemic enzymes?

Thanks Clive for your reply. In my experience pharmacists (here in Oz) wouldn't know what systemic enzymes are. My b12 levels always come back pretty high and I only have an injection once ever 3 or 4 months. Tried activated folate (thought I had MTHFR issues) but just made me nauseous.

What I'm really curious about is how other PA sufferers have experienced their stomach lining ( eg with supplemental betaine HCL for low stomach acid and systemic enzymes) over the years? Chronic gastritis?? Pain in stomach area?? Stomach polyps etc. I personally find doctors hopeless but I do live in a rural area and Drs come and go a lot. Thanks for your thoughts.

My P.A. came about as a result of gastric surgery for a perforated peptic ulcer at the age of 17 in 1959 - I had two thirds of my stomach removed.

I don't think that the association berween gastric surgery and P.A. was generally known back then because all my surgeon advised was for me "get a sedentary job" which meant giving up my electrical apprenticeship.

I of course ignored his advice, finished the course and qualified but in my early twenties I found my energy levels depleting and in 1968 I was sent for a "Schilling" test which involved a huge injection and drinking radioactive B12 then measuring the amount passed via my urine.  The test was inconclusive.

Ironically the B12 injected probably enabled me to struggle on for the next four years during which time I weaned myself of the Valium, Toftranil and Librium antidepressants I'd been prescribed, passed a government sponsored retraining course in accountancy and got myself a job as book-keeper for Rexel Limited (you may have one of our stapling machines).

Sadly, by 1972 my health was going down hill badly again and I was like a walking Zombie so was sent for a second (unheard of) Schilling test which this time proved positive for P.A. and I was given the option of eating raw liver three times a day or having a cyanocobamalin B12 injection every four weeks for the rest of my life.  I opted for the injections and I'm still on them today only now every three weeks.

For nearly forty years from then I lived in total ignorance of what it was all about as I knew no-one else with P.A. and neither the succession of doctors and nurses (who gave me the injections) ever asked me how I was coping.

Ignorance is not bliss

Six years ago I was noticing a return of some neurological symptoms in the third and fourth weeks.  My then "one size fits all" doctor told me it couldn't be anything to do with my P.A. because I was having the injections and refused to increase their frequency. So I joined the Pernicious Anaemia Society and on their then forum asked the question "Am I the only person with a return of neuropathy in tne run up to my next injection?" I was astounded by the response - no I was not alone.

I learned all I could and eventully convinced my doctor to increase the frequency and determined to try and be of some small help to fellow sufferers.

I do hope that you get some answers to your questions - I'm just sorry not to have been of any help.

I wish you well

PA is generally seen in elderly people who not longer have the intrinsic factor in the small intestine that allows absorption of B12.  In younger people it is generally due to abuse of medications that are used to control stomach acid. There is no such thing as too much stomach acid as acid is produced by specialized cells in the lining of the stomach when food is ingested. The problem arises when the acid travels into areas; like the esophagus that the problem exists. The medications that are prescribed are safe for very short term use but once they are taken long term they completely prohibit the absorption of B12. Once the cells are destroyed it takes a very long time for the stomach to produced the necessary acid to digest your food properly. So you will end up with PA and a whole host of other digestive problems. 

You might also want to determine if you have food allergies (like wheat) as that can cause absorption problem particularly if you have celiacs. 

Antidepressants are a commonly prescribed for people with PA due to your symptoms but they are of little value because there is no clinical depression present.

It has taken many long years for me to repair the damage that acid controlling medications did to my stomach. I still have low B12 levels but I am able to keep it at a decent level with oral B12.

Good luck.

Thanks for your comments Jace.

In my case fifty-seven years ago it was "too much stomach acid" which led to my having a perforated peptic ulcer at the age of 17 and the removal of two thirds of my stomach.

In a normal healthy person the stomach lining has what are called "Gastric parietal cells" which produce "Intrinsic Factor" which travels with food through the small intestine which is made up of three parts - the Duodenum, the Jejunum and the Ileum.

Iron is absorbed in the Duodenum, most other nutrients in the Jejunum and our friend Vitamin B12 in the Ileum. Here the Intrinsic Factor binds to the B12 and the "B12/IF Complex" enters the cells on the wall of the Ileum after binding to receptors on the surface of the Ileal cells, allowing it to enter the blood stream.

Sadly some people with "traditional P,A." either do not produce Intrinsic Factor or if they do, they also produce an antibody which destroys it and it is then called "Autoimmune Pernicious Anaemia".

In addition it can happen that we produce "Parietal cell Antibodies" and "Intrinsic Factor Antibodies" which totally wipes out any chance of absorbing the B12.

The IFA test is unreliable in that it gives false negatives in people with PA half the time. So a negative result doesn't mean that you don't have PA. However, a positive result is a sure-fire, 95% certain indicator of PA.

I had a 13 year wait before I got the diagnosis and treatment by B12 injections for Pernicious Anaemia.now more than 45 years ago and I'm still "clivealive" at over 75.

I wish you well