Vitamin B12 Effective for Heartburn

February 5, 2004—Supplementing with vitamin B12 can relieve the symptoms of heartburn (dyspepsia) in a subset of people who suffer from the problem, according to a report in the Journal of Clinical Gastroenterology (2003;37:230–3). People who responded to vitamin B12 in this study had the combination of (1) symptoms suggesting slow passage of food from the stomach, (2) intestinal infection with Helicobacter pylori, and (3) low blood levels of vitamin B12.

A common form of dyspepsia is characterized by a sensation of fullness, bloating, nausea after meals, and difficulty consuming large meals. This cluster of symptoms, which appears to be due in many cases to an impaired ability of the stomach to move its contents into the small intestine, is called dysmotility-like dyspepsia. Many people who suffer from dysmotility-like dyspepsia are infected with H. pylori, the organism associated with peptic ulcers, although these people do not themselves have ulcers. While the relationship between H. pylori infection and dysmotility-like dyspepsia is still unclear, infection with this organism can promote the development of vitamin B12 deficiency by reducing the secretion of stomach acid, which is necessary for the absorption of vitamin B12 from food. Vitamin B12 plays a role in normal gastrointestinal function, but whether or not vitamin B12 deficiency causes dyspepsia has not been studied.

In the new study, 34 individuals with dysmotility-like dyspepsia, H. pylori infection, and low serum vitamin B12 levels were assessed before and after a three-month course of vitamin B12 therapy. Each person received daily intramuscular injections of vitamin B12 (1,000 mcg) for 10 days, followed by 1,000 mcg per day orally for 80 days. The rate of gastric emptying and the severity of symptoms were determined before and at the end of the treatment period. The average time required to empty the stomach contents decreased from 230 minutes at the start of the study to 98 minutes after vitamin B12 therapy. In addition, the severity of the intestinal symptoms improved by an average of 78%. These results suggest that correction of vitamin B12 deficiency can improve delayed gastric emptying and relieve symptoms in this particular subset of individuals with dyspepsia.

While vitamin B12 deficiency is believed to occur primarily in older people, the participants in the current study had an average age of 41 years. It is important, therefore, not to overlook the possibility of vitamin B12 deficiency in anyone suffering from dysmotility-like dyspepsia. Other risk factors for vitamin B12 deficiency include long-term use of antacids or acid-blocking drugs, use of metformin (Glucophage®) for diabetes, HIV infection, and consumption of a vegan diet (free of all animal products). The presence of vitamin B12 deficiency can be identified by a blood test.

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Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Prima, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Prima, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.

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