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25 Nov 2004

Vegetarian – lack of B12 absorption & diarrhoea symptoms
I am now a 37 old male strict vegetarian (no meat, sea food, eggs and have significantly reduced my diary product intake through fear of high levels of cholesterol). I have been diagnosed with low levels of B12 and iron. Other symptoms include diarrhoea and tiredness and muscle aches. I have an office job but run at least 20 miles /week and quit active on DIY at weekends. My diet does include fortified cereals with orange juice, fruit, plenty of nuts & seeds (sesame, pumpkin pine kernels), vegetable casseroles & curries, pasta rice, wholemeal bread and herbal tea as well as moderate intake of fats in processed food. I am now taking iron supplement and do want to progressively increase and run a marathon in under 3.5 hours in April.
I would like to raise my levels of iron and b12 through food /naturally but will take supplements if this is not working. What combination of foods should I be taking at meals to maximise my intake and absorption?
My doctor suspects my B12 deficiency may be due to lack of the stomach acid and that the pepsin enzyme has become inactive. Is it possible that my relatively recent increase in endurance running (over last 18 months with a 6 month break in between) and reduction in dairy products (last 2 months) has resulted in this condition?
How can the acid and enzyme be reactivated (if at all)?
As well as increasing my running I have also increased my intake of food particularly carbohydrates and protein (soya, fond of olives & nuts) but I am concerned that all this extra nourishment is not effective due to problems of diarrhoea. Any advice would be greatly appreciated.
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Expert
DietDoc
DietDoc

01 Jan 0001

Dear HS
What does the dr say about the diarrhoea? This could be a reason why you are tired as constant or chronic diarrhoea will deplete you of various nutrients. The iron deficiency will also make you tired and I can't imagine how you are going to maintain your strenuous exercise programme with the iron and B12 deficiencies and accompanying anaemias. Did the dr prescribe anything to improve the acidity of your stomach secretions? If not, then I think you need to ask him/her about this as your digestion and absorption of nutrients will be hampered by this deficiency. I trust he/she has also prescribed iron and B12 supplements together with the so-called 'intrinsic factor' (the factor that helps humans to absorb B12)? If not, go back and ask for these supplements. Unfortunately B12 is only found in foods derived from animals (meat, fish, eggs, milk and dairy), so you will have to reply on supplements to provide the B12 you require. The same also applies to iron. Although plant foods contain lots of iron it is in a highly unavailable form (bound by chemicals called phytates) and esp if you have a stomach acid deficiency you won't be able to absorb iron from plant foods properly. So you will have to use stomach acid replacement, intrinsic factor, B12 and iron supplements to rectify these nutritional problems. The more you exercise the more iron you will require. I would also strongly urge you to start eating eggs and dairy products again and drinking milk. If you use fat-free diary products and milk THERE IS NO DANGER OF CHOLESTEROL. The cholesterol is REMOVED when the fat in these foods is removed. Also get the dr to sort out your diarrhoea (you may well be sensitive or allergic to one of the plant foods like soya, or you could have an infection, or irritable bowel disease) ASAP.
Take care
DietDoc
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