Anemia causing indigestion?

[Ed123]

2 years ago I developed POTS which included lots of lightheadedness and orthostatic nausea. I was diagnosed 6 months later and successfully treated my symptoms w/ salt, water and exercise over the next 6 months until they were basically gone. However, since I started treating my POTS 1.5 years ago, I developed lots of gas and bloating, as well as nightly leg cramps and eye twitches which got progressively worse. I thought it may be salt irritating my stomach or an electrolyte balance so took a PPI for 6 months, which initially seemed to help but then it got worse again. I recently went for a blood test and found my haemoglobin has decreased from 12.5 when I was first investigated for POTS, to 9. something. Weirdly I don't feel my POTS/typical anemia symptoms are any worse than they were, except I haven't been doing much exercise lately which always makes me more lightheaded. I'm going for a follow up blood test in a few days time but am feeling at a complete dead end with my symptoms. Has anyone been diagnosed with anemia and what symptoms did you have.

[H. Potsland, Oregon]

Which type of anemia are your referring to? There are 8. GI disturbances are common with POTS.  I am currently trying to find a doctor and to see if I have H.POTS. I've had GI disturbances since I was around age 20. My GI disturbances have run the gamut. I also have thyroid disease which effects every aspect of the metabolism, including the digestive tract.  I have hypothyroidism caused by an autoimmune disease. Hypothyroidism slows everything down and is known for causing low stomach acid. I am all too familiar with have all sorts of GI issues! Unfortunately all of the GI doctors that I saw early on did not listen to my symptoms and were very confused about treatment. The last one that I saw was not able to discuss the thyroid's influence on digestion and/or autoimmune disease because he said he didn't know anything about either. Plus, he did not listen at all to my symptoms and how I tried to make the thyroid/metabolism connection. Not listening to my symptoms, not knowing about my disease and how it effects the GI tract, he prescribed the wrong medication: a PPI. That incorrect prescription, coupled with the fact that he did not understand how the thyroid and it's relationship with the GI tract made that visit the first and last time I ever saw that doctor. I knew he was totally wrong. I did not fill the prescription. Instead, I went to work increasing my stomach acid and then my symptoms went away. 

When you mention PPI, I assume you are meaning the same medication, a proton pump inhibitor? PPI's decrease stomach acid and they don't increase electrolytes. You already had symptoms of low stomach acid: gas, bloating, stomach irritation. Stomach acid is needed to absorb nutrients, minerals and vitamins, specifically B12. It is needed to digest food and pass it through the digestive tract. Night cramps and eye twitches can be caused by B12 deficiency.  B12 is needed to make healthy red blood cells and if you are deficient in B12, then yes, your hemoglobin can become too low. It sounds like the PPI for 6 months may have decreased your stomach acid when it wasn't needed, which then decreased your ability to absorb B12, which then possibly caused B12 deficiency anemia, which then caused reduction in your hemoglobin. Do you already take B12 supplements? You may want to get your stomach acid production back to normal and not deficient, plus maybe take methyl-B12. Iron deficiency anemia can also cause reduced hemoglobin. Low stomach acid also can cause reduced ability to absorb iron. It is possible that you could have both B12 deficiency anemia and iron deficiency anemia. If you had both would probably have more irregular blood work than a reduction in hemoglobin. Do you test your B-12 and iron panel regularly? Both would be very helpful in this situation.

For electrolytes, your levels included and tested whith a standard and routine blood test called a Comprehensive Metabolic Panel. It includes sodium, potassium, chloride and calcium.  Do you supplement electrolytes?