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Resolving potential 'pernicious anemia' with Paleo diet

Answered on August 19, 2014
Created November 02, 2012 at 11:00 PM

Hi,

After suffering with severe stomach pain and recently having blood tests my girlfriend has tentatively been diagnosed with 'pernicious anemia', her results showed B12 & folate deficiency along with 'abnormally large' red blood cells. Tests are still ongoing but the doctor has prescribed her a series of B12 shots along with iron tables. She isn't Paleo but she rarely eats any gluten as she knows this causes her gut problems.

She is prepared to give the Paleo diet a good go but I would like advice on how best to approach it under these circumstances, I'm guessing that the autoimmune protocol is a good place to start (no nightshades, eggs, dairy, nus or seeds) along with Vitamin D & fish oil supplementation. Maybe low-ish carb as well, could there potentially be a SIBO issue, maybe the addition of some fermented foods such as home made kimchi (which I already have) & sauerkraut would be good also?

Any advice is greatly appreciated.

Regards, Jason

1b7ce4aec094380e5530dba3c6bcecf9

(20)

on November 03, 2012
at 09:20 AM

Thanks for the comments, my girlfriend hasn't 100% been diagnosed with PA just yet, although the doctor thinks that what it is from the test results so far. I don't want to radically change her diet but just clean it up as much as possible to aid whatever treatment the doctor recommends, certainly I will ask her to speak to the doctor about her diet on her next visit but I think vegetables, meat, liver & fermented foods will not be a problem. Let's face it what other food are "better" than that anyway?

1b7ce4aec094380e5530dba3c6bcecf9

(20)

on November 03, 2012
at 09:14 AM

Thanks for pointing me to the site, I will definitely spend some time there soon. Her main symptom is pain in the stomach, she hasn't mentioned fatigue or brain fog & her mood is good.

1b7ce4aec094380e5530dba3c6bcecf9

(20)

on November 03, 2012
at 08:45 AM

Thanks for sharing your story Syrahna. You are 100% correct about gluten but I don't think it will be a problem to completely eliminate it as she generally only succumbs on rare occasions & doesn't miss most gluten containing foods, such as bread or pasta. I think we will feel our way gently to start with, well cooked veges, as much meat as she feel comfortable with as well as some fermented foods should be a good start. It's great to hear that you are doing so well after three years, I hope things continue to improve for you.

1b7ce4aec094380e5530dba3c6bcecf9

(20)

on November 03, 2012
at 08:26 AM

Thanks for the recommendation, I've looked at this book in the past so I will probably give it a shot. I'm very much a fan of fermented foods myself.

D5d982a898721d3392c85f951d0bf0aa

(2417)

on November 03, 2012
at 04:27 AM

Pernicious anemia doesn't cause all the gut problems that gluten can. That's why. He said bad gut pain.

E0e9255281093b2d518b56d5217a0955

(184)

on November 03, 2012
at 01:57 AM

That's what I'm saying. She has definitely been diagnosed with PA, not gluten intolerance, so why would she think gluten has anything to do with it?

D5d982a898721d3392c85f951d0bf0aa

(2417)

on November 03, 2012
at 01:53 AM

No, not necessarily. You can have PA and not have gluten issues. Or gluten destroyed your gut and you just don't absorb stuff worth a darn.

0a9ad4e577fe24a6b8aafa1dd7a50c79

(5150)

on November 02, 2012
at 11:29 PM

Nourishing Traditions is a good place to start depending on the state of her digestive system. Fermented food isn't optional in my opinion. You should be eating fermented food regularly no matter who you are.

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3 Answers

2
D5d982a898721d3392c85f951d0bf0aa

(2417)

on November 03, 2012
at 02:01 AM

All I can say is, as someone who takes TWO B-12 shots a month and has for over three years, TELL HER TO ENJOY THE HECK OUT OF THE B-12 and then worry about her diet. The whole point of PA is that she isn't going to get that vitamin any other way right now, and she may find (like I did) that she feels awesomely (this is worth a made-up word) better.

I've been 100% gluten free for 3+ years, and primal for about a year, always eating top quality whole foods, and I still don't lab test as someone who gets adequate B-12. I have never been able to step down to the normal once a month shot. The doctors find that weird, but they don't argue with the lab results. But --- I absorb my other vitamins much better now, as my gut has healed a ton. I went from paper thin nails to lovely hard nails, and my skin no longer cracks on my face due to malnutrition (while quite chubby!). It takes time. I really notice a big difference at about 2 years gluten free. I don't think that "mostly" gluten free is good enough for most of us. That's the only place I think the dogma really holds true.

I suggest you help her focus on healing her gut with gentle, happy foods. Worry about the paleo dogma less than just healing. Routine nibbles of lacto-ferments, whatever meat she digests easily, lots of mineral rich greens (nettles!) and teas, homemade broth - whatever for her translates as gut TLC. Being anemic and unable to absorb B-12 in the gut doesn't mean she has any allergies. Getting all restrictive might just ensure noncompliance. It's a lifestyle change for most of us. I'd transition into the new and improved before I adopted a strict elimination diet.

1b7ce4aec094380e5530dba3c6bcecf9

(20)

on November 03, 2012
at 08:45 AM

Thanks for sharing your story Syrahna. You are 100% correct about gluten but I don't think it will be a problem to completely eliminate it as she generally only succumbs on rare occasions & doesn't miss most gluten containing foods, such as bread or pasta. I think we will feel our way gently to start with, well cooked veges, as much meat as she feel comfortable with as well as some fermented foods should be a good start. It's great to hear that you are doing so well after three years, I hope things continue to improve for you.

1
7841848bd0c27c64353c583fb7971242

(7275)

on November 02, 2012
at 11:25 PM

The most important thing will be for her to eat plenty of liver. Leafy greens are good, too.

Has she had any fatigue, mood disorders, or brain fog?

I highly recommend she or you check out the pernicious anemia society website.

1b7ce4aec094380e5530dba3c6bcecf9

(20)

on November 03, 2012
at 09:14 AM

Thanks for pointing me to the site, I will definitely spend some time there soon. Her main symptom is pain in the stomach, she hasn't mentioned fatigue or brain fog & her mood is good.

0
E0e9255281093b2d518b56d5217a0955

on November 03, 2012
at 12:01 AM

This is a complex issue. Your gf should follow her doctor's advice. Introducing a new diet at this stage will only complicate the diagnosis, because it introduces new variables.

Also, some of what you've posted doesn't quite add up. Your gf "knows" that gluten causes her gut problems, but she has just been diagnosed with pernicious anemia? Isn't it more likely that the PA is cause?

E0e9255281093b2d518b56d5217a0955

(184)

on November 03, 2012
at 01:57 AM

That's what I'm saying. She has definitely been diagnosed with PA, not gluten intolerance, so why would she think gluten has anything to do with it?

D5d982a898721d3392c85f951d0bf0aa

(2417)

on November 03, 2012
at 01:53 AM

No, not necessarily. You can have PA and not have gluten issues. Or gluten destroyed your gut and you just don't absorb stuff worth a darn.

D5d982a898721d3392c85f951d0bf0aa

(2417)

on November 03, 2012
at 04:27 AM

Pernicious anemia doesn't cause all the gut problems that gluten can. That's why. He said bad gut pain.

1b7ce4aec094380e5530dba3c6bcecf9

(20)

on November 03, 2012
at 09:20 AM

Thanks for the comments, my girlfriend hasn't 100% been diagnosed with PA just yet, although the doctor thinks that what it is from the test results so far. I don't want to radically change her diet but just clean it up as much as possible to aid whatever treatment the doctor recommends, certainly I will ask her to speak to the doctor about her diet on her next visit but I think vegetables, meat, liver & fermented foods will not be a problem. Let's face it what other food are "better" than that anyway?

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