B vitamins make inflammation worse? Then how cure gut inflammation w/o them if deficient?

Answered on August 19, 2014
Created May 01, 2013 at 7:51 PM

I have anemic tendencies and digestion issues (mainly bloating, but also incomplete elimination). Part of this is genetic, due to folate and B12 metabolism issues (I'm compound heterozygous for MTHFR, and I have a variant in the TCN2 gene that puts me at higher risk of B12 deficiency, it seems).

More specifically, I seem to have problems digesting proteins (my amino acid levels were low on a NutrEval test, despite the fact that I eat a LOT of meat). And I guess I have trouble digesting fats, because my stools have been floating (they didn't always do this, but I recently began eating a lot more saturated vs. unsaturated fat, and maybe that change set it off). I also don't seem to produce a lot of saliva at times, so I have trouble chewing some foods, like roast beef or starchy foods, if they're not accompanied with plenty of fat and/or salt. My understanding is that all of these problems can be caused by low B12 and/or folate.

fwiw, my serum B12 levels were high, and my methylmalonic acid levels were normal (but I also have a B2 and B3 deficiency, per my NutrEval test, and that can apparently mask the MMA indicator for B12 deficiency). I read that B12 deficiency should be fixed before moving on to other B vitamin deficiencies, and that the only reliable way to know if you have a B12 deficiency is to try taking supplements of methylcobalamin and see if you feel better. But here is my quandary: I read that inflammation should be resolved before taking B vitamin supplements, because they can make inflammation worse. I'm pretty sure I have gut inflammation (though not systemic inflammation), so do I really need to resolve the gut inflammation first, and how do I do that without taking B vitamin supplements to fix my digestion? It seems like a vicious circle.

Some of the other SNP mutations I have (from my 23andme test): I am a fast metabolizer (of caffeine and many other substances converted by CYP1A2 liver enzyme); MAO-A: homozygous mutation;
COMT (V158M): homozygous mutation; Not sure about some others, like NOS and SUOX.

My CRP levels are very low, and my IL-this and IL-that levels are all normal, so the standard markers of systemic inflammation are not showing problems. However, I have ongoing bloating issues, and a colonic I had done years ago showed chronic inflammation (a more recent colonic report last year didn't mention it, but reading Chris Kresser's site, it seems a given that I have leaky gut and therefore gut inflammation). Also, I have mild psoriasis that comes and goes, and chronic sinus congestion to some extent, and some mild seasonal allergies. All of which seem to suggest inflammation of some type or other.

I've been on a Paleo diet for nine months, but the bloating hasn't resolved (it does go away from time to time for a day or so, and I seem to recall not being bloated at all when I tried GAPS for a week, but I couldn't continue on that diet due to low energy). I've now again been advised, for helping with my digestion, to stick to cooked vegetables rather than raw, so I recently made that change. But as far as I can figure out, that also means I'm not getting any B12 or folate in their active forms, and since my body's not good at converting them, I should be using supplements.

I should add that I tried HCl+pepsin, and also digestive enzymes, but that didn't do the trick. I've been eating a lot of fermented foods, too. I just ordered ox bile (Bilex) to give that a try.

So, any advice about B supplements in such a situation? Sorry for such a long post; I hope it was all clear, at least.


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3 Answers



on May 02, 2013
at 11:54 AM

If you had a colonic biopsy showing inflammation then it seems likely you have an inflammatory bowel disease (Crohn's, ulcerative colitis). Like most autoimmune diseases, folks with IBD can experience periods of remission and relapse. So it wouldn't be terribly shocking if you've had multiple colonic biopsies showing differing results. It might be that your dietary efforts have eliminated the inflammation but you still suffer from a gut flora imbalance. Fair chance it is yeast (Candida) causing you gas pains.

I suggest you read Breaking the Vicious Cycle (Gottschall). She promotes what is essentially a low carb Paleo diet. Her diet has worked wonders for many with IBS and IBD. It helped me tame my IBS but I admit for the first few weeks my symptoms were highly volatile.

You might also want to get tested for H. pylori, a common bacteria that can cause all sorts of digestive grief. After being treated for H. pylori my symptoms improved further.

Best of luck.




on May 01, 2013
at 08:03 PM

Eat less saturated fat IMO, especially low fat dairy, full fat dairy or a high sat fat diet gives me gut issues also. If you want to lower inflammation supplement with zinc and exercise, seriously.



on May 02, 2013
at 10:40 AM

Again, I will repeat myself - I do not believe in all that inflammation theory. I mean, I believe in inflammation, it is just works differently in my understanding. I bet it has something to do with gut flora.

The only way we get vitamins/minerals is by extracting them out of food. Once this whole processing gets messed up, your body can no longer digest the important nutrients so the whole array of problems suddenly appear to haunt us.

I was lucky enough to find a half-decent doctor and came to him with all the prior diagnostics I have done myself (so much for the medical community that is completely incompetent).

He figured I had gut dysbiosis and prescribed me a very weird routine. I thought he would give me probiotics but that's not the case. But probiotics will follow in two weeks.


Have you tried finding a good doctor who can help you to restore your digestive system back to normal? I have listened to the podcast of the Underground Wellness - the guy (I forgot his name) talks about gut biology and it makes a lot of sense. Eliminate, eradicate, repair, repopulate, etc.

What Paleo is designed to do is to repair our gut flora. But sometimes Paleo is not enough.

Hope you find some answers.

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