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For vitamin B12 absorption, there are a few steps that are needed for dietary B12 absorption:
* Good levels of stomach acid (HCI): B12 must first be separated from the protein that binds it. This requires HCI. Low stomach acid is common as this lowers with age. Reflux is a common symptom of low stomach acid
* Intrinsic factor (IF): B12 cannot pass through the intestinal wall and into the bloodstream without IF.
* Good bacteria in the gut: an imbalance in the beneficial bacteria of the digestive system can separate B12 from IF.
Eat a diet high in vitamin B12 and see if this improves your serum levels. The best sources of vitamin B12 include eggs, milk, cheese, milk products, meat, fish, shellfish and poultry. Take probiotics to help increase good bacteria in the gut and make sure you have adequate stomach acid. If low, then supplement with betaine HCI with pepsin; supplements found at health food stores.
Try the baking soda (sodium bicarbonate, not baking powder) test...
The following steps help to determine your stomach's acidity:
1. Perform this test first thing in the morning on an empty stomach (before
eating or drinking)
2. Dissolve ¼ teaspoon of baking soda into an 8 oz glass of cold water
3. Drink the solution and start timing
4. Record the time until you first burp up gas
5. Perform this test for 5 consecutive days (or longer) at the same time each day to give a better estimation of your stomach’s acidity
Time until first burp:
If you burp immediately and excessively your stomach acid level is probably too high
Under 2 min: indicates normal acidity
2 - 5 min: low normal acidity
Over 5 min: possible hypochlorhydria (low stomach acid)
No burping indicates possible achlorhydria (no stomach acid).