How Gastric and Anemia are related? Types, Causes, Medications

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Gastritis can also cause Anemia. This is can lead to a type of Pernicious anemia. Generally, Anemia is a condition, where the body does not have enough red blood cells (RBCs), which provide oxygen to body tissues. Since oxygen is necessary for proper functioning of all parts, this condition creates other diseases. But due to gastritis also, intestines do not properly absorb vitamin B12. In such a case, there will be a decrease in RBCs.


From this source, it is quoted that (

Gastritis is simply an inflammation or irritation of the lining of the stomach, which has many causes. You mentioned that you read that as a result of PA some people develop gastritis. It really works the other way in that you have developed PA ,or vitamin b12 deficiency, as a result of the problem. I don’t think that treating your b12 deficiency will cure your gastritis, they will have to look at that problem and see what they can do for it. I take omeprazole, which reduces the production of acid in my stomach, and has helped a great deal with the discomfort I had caused by the inflammation.

Pernicious Anemia is type of vitamin-deficiency anemia (B12). The body makes Vitamin B12 from different foods we eat like poultry, eggs, meat, shellfish and dairy products. Since the growth of red blood cells depend on this vitamin B12, the more we eat such food, we will be able to cope up with Pernicious Anemia. (


A special protein, called intrinsic factor (IF) is present in your intestine. Proteins are large biological molecules or macromolecules, consisting of one or more long chains of amino acid residues and belong to the class of nitrogenous organic compounds, which are essential for all living organisms. Generally, these proteins are found in meat, poultry, seafood, beans and peas, eggs, processed soy products, nuts and seeds.

This special protein IF plays a major role in absorbing Vitamin B12. In other words, this prevents the occurrence of Pernicious Anemia. This protein is released by cells in the stomach. So when the stomach does not make enough IF, the intestine fails to absorb vitamin B12.

What are the Common Causes of Pernicious Anemia and Vitamin Deficiency Anemia?

Weakened stomach lining (atrophic gastritis) – This is a condition, known as Type A or Type B Gastritis. It is a chronic inflammation of the stomach mucosa. It leads to loss of gastric glandular cells and their eventual replacement by intestinal and fibrous tissues. The inflammation is most probably caused by an infection of the bacterium H. pylori. The infection gradually destroys cells in the stomach lining. So as a result, the IF protein is not produced properly and the intestine fails to absorb Vitamin B12.


An autoimmune condition in which the body’s immune system attacks the actual intrinsic factor protein or the cells in the lining of your stomach that make it. The immune system generally protects your body against diseases. But in autoimmune condition, the immune system decides that the healthy cells are foreign. As a result, the autoimmune disease can affect one or many different types of body tissue. Then there is no proper supply of oxygen to the tissues. This can also result in Anemia.

Malabsorption in the Small Intestine – This happens when the body’s small intestine cannot properly absorb Vitamin B12. This can result in pernicious anemia.

Generally there are good and bad bacteria in the intestine. But sometimes too many of the wrong kind of bacteria may be present in the small intestine. This can result in pernicious anemia in older adults. The bacteria use up the available vitamin B12 before the small intestine can absorb it.

Sometimes there can be other illnesses that can interfere with the absorption of B12. One example is celiac disease. This is a genetic disorder. In this disease, the small intestine is hypersensitive to gluten, leading to difficulty in digesting food. Gluten is one type of protein. People with celiac disease should avoid wheat, barley, rye and triticale.

Another example is Crohn’s disease, an inflammatory bowel disease. This is a chronic disease of the intestine, especially the colon and ileum associated with ulcers and fistulae. HIV also may interfere with vitamin B12 absorption.

Certain antibiotic medications alter the bacterial growth. This prevents the small intestine from properly absorbing vitamin B12. People taking certain acid-reflux medications and proton pump inhibitors (PPIs) might have increased risk of Vitamin- B12 deficiency. Also using acid-suppressing drugs like H2 blockers (histamine-2 receptor antagonists) can increase the risk of B12 deficincy by 25 percent. ( Certain diabetes and seizure medicines can also cause pernicious anemia.

Surgical removal of part or all of the small intestine. This can be due to gastric sleeve surgery and any other such operations.

A tapeworm infection. The tapeworm feeds off of the vitamin B12. Eating undercooked, infected fish may cause this type of infection. Generally this happens when the fish is not stored properly.

Folate deficiency anemia. This is also known as Vitamin B-9. It is a nutrient mainly found in fruits and leafy green vegetables. An inability to absorb folate can also lead to anemia. Generally, people with celiac disease or have undergone surgery to remove small intestine may have difficulty in absorbing folate or folic acid.

Vitamin C deficiency anemia – This can develop in your body if you don’t get enough vitamin C from the foods we eat. This can also be caused if some disease prevents your ability to absorb Vitamin C from food. For example smoking reduces the ability of the intestine to absorb Vitamin C.


Iron deficiency can also lead to Anemia. This can be caused by gastric problems also. The amount of iron stored is dependent on the age, gender and size. Iron is absorbed by our body through the foods we eat from the GI tract. This generally occurs in a portion of the small intestine called the duodenum. So when you have gastritis or any other gastric related problem, this part gets infected. This in-turn creates a situation where there is inability to absorb iron. Just like Vitamin- B12, Iron is also necessary for the production of RBCs. Some of the symptoms of iron deficiency include tiredness, fatique, weakness, headache, exercise intolerance, pica, beeturia, restless leg syndrome etc. (


Medications that reduce levels of Vitamin B12 in the body include: (Bad for Gastric Problems and Anemia)

  • Anticonvulsants — include phenytoin (Dilantin), phenobarbital, primidone (Mysoline)
  • Chemotherapy medications — particularly methotrexate
  • Colchicine — used to treat gout
  • Bile acid sequestrants — used to lower cholesterol; include colestipol (Colestid), cholestyramine (Questran), and colsevelam (Welchol)
  • H2 blockers — used to reduce stomach acid; include cimetidine (Tagamet), famotidine (Pepcid AC), ranitidine (Zantac)
  • Metformin (Glucophage) — medication taken for diabetes
  • Proton pump inhibitors — used to reduce stomach acid; include esomeprazole (Nexium), lansprazole (Prevacid), omeprazole (Prilosec), rabeprazole (Aciphex)

Source: Possible Interactions with: Vitamin B12 (Cobalamin) | University of Maryland Medical Center

Common Medications to Treat Pernicious Anemia

  • cyanocobalamin (vit B-12) injection
  • Vitamin B-12 injection
  • Nascobal nasal
  • hydroxocobalamin intramuscular
  • cyanocobalamin (vitamin B-12) nasal
  • Physicians EZ Use B-12 injection

 This YouTube video talks about how spinach juice can be useful to treat your digestive and gastric problems. Once this is treated, other anemia conditions like lack of absorption of Vitamin B12, B9, Folia, Iron can also be improved. 

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  • February 19, 2016


    Great post! Very informative. Thank you so much for sharing this article.