Autoimmune Gastritis: A Silent Yet Highly Prevalent Condition

Amidst the hum of digestion, a silent assailant known as autoimmune gastritis can wreak havoc without sounding alarm bells until it's too late. Autoimmune gastritis is a silent yet highly prevalent condition that many people don't even know exists.

In this comprehensive guide, we'll walk you through what autoimmune gastritis is, its symptoms, how it develops, and how it affects the body. We'll also discuss the tests available with functional medicine that can help diagnose gastritis.

Learn more about our approach to Digestive Health at CentreSpringMD

Understanding Autoimmune Gastritis

Autoimmune gastritis is an inflammatory disease of the stomach lining caused by the immune system attacking the cells that produce stomach acid and enzymes required to break down food in the stomach.

Autoimmune gastritis is a type of atrophic gastritis, which essentially means chronic stomach inflammation. Autoimmune gastritis may also be called “autoimmune metaplastic atrophic gastritis,” or “chronic autoimmune atrophic gastritis". Atrophic gastritis is quite common, affecting nearly a quarter of all people, by some estimates (1). Autoimmune gastritis affects around 2% of people, or about 1 in 50.

Atrophic gastritis or chronic atrophic gastritis involves atrophy (or wasting away) of a part of the stomach lining. This part of the stomach lining includes parietal cells that produce stomach acid, as well as the substance known as intrinsic factor, which is essential for vitamin B12 absorption. It also includes destruction of cells that produce the main digestive enzyme pepsin in the stomach. Both atrophic gastritis and autoimmune gastritis involve the destruction of these important digestive components (2). 

Our body needs vitamin B12 for red blood cell production, proper functioning of the nervous system, and DNA synthesis. The chronic inflammation damages the stomach lining, leading to atrophy, resulting in reduced stomach acid production, and ultimately affecting the absorption of key nutrients.

The Silent Saboteur: Symptoms of Autoimmune Gastritis

Autoimmune gastritis is often asymptomatic or has mild symptoms until later stages, making it difficult to diagnose. However, when symptoms occur, they include bloating, abdominal pain, nausea, and vomiting. Other symptoms may include excessive fatigue, anemia, and sometimes tingling or numbness in the hands and feet due to vitamin B12 deficiency.

Diagnosing autoimmune gastritis is challenging due to its subtlety. Symptoms can be elusive as the condition progresses silently. However, careful observation may reveal signs such as:

  • Digestive Discomfort: Persistent bloating, indigestion, and post-meal discomfort signaling underlying gastric distress.
  • Iron Deficiency Anemia: Impaired intrinsic factor production hindering vitamin B12 absorption, leading to anemia.
  • Fatigue and Weakness: Reduced nutrient absorption affecting energy levels, causing persistent fatigue.
  • Weight Loss: Unintentional weight loss due to compromised nutrient absorption.

In later stages of autoimmune atrophic gastritis, the presence of intestinal metaplasia (abnormal intestinal cells) increases the risk of some gastric cancers, including gastric adenocarcinoma (3). For this reason, it's crucial to address digestive symptoms associated with autoimmune gastritis and receive treatment as soon as possible.

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Low Stomach Acid

Almost all symptoms associated with autoimmune gastritis occur due to the absence of stomach acids and enzymes, which are essential for proper digestion. Low stomach acid can result in malabsorption of key nutrients such as iron, vitamin B12, and calcium.

Additionally, low stomach acid also leads to an overgrowth of harmful bacteria in the gut, causing inflammation and further damage to the stomach lining. This creates a vicious cycle where the reduced acidic environment in the stomach leads to increased inflammation, further damaging the stomach lining.

Related: Is SIBO the Missing Link to IBS & IBD?

Development of Autoimmune Gastritis

Triggers for autoimmune gastritis are multifaceted, involving genetic predisposition, environmental factors, and an overactive immune response. While genetics set the groundwork, chronic stress, infections, and specific dietary components act as catalysts, exacerbating immune system reactivity.

Family history of autoimmune disease, gender (females are more susceptible), age (people over 50 years), and having other autoimmune diseases can also increase the risk of developing autoimmune gastritis.

Read: The Hidden Triggers of Autoimmune Disease

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Functional Medicine and Autoimmune Gastritis Diagnosis

Functional medicine adopts a holistic approach to diagnose and manage autoimmune gastritis. Innovative tests beyond conventional measures provide a nuanced understanding, including (4): 

  • Autoimmune Antibody Panels: Assessing anti-parietal cell antibodies and anti-intrinsic factor antibodies indicates immune system activity against gastric cells.
  • Comprehensive Stool Analysis: Unraveling the gut’s microbial landscape offers insights into dysbiosis or imbalance contributing to inflammation.
  • Nutrient Testing: Evaluating essential nutrients like vitamin B12 and iron for a comprehensive view of potential deficiencies.
  • Food Sensitivity Testing: Identifying and mitigating food triggers alleviates stress on the digestive system.

Testing serum gastrin and pepsinogen levels, and measuring gastric acid secretion levels may also be helpful. Your provider may also identify the presence of underlying pathogens (such as Helicobacter pylori infection). These tests assist in establishing an accurate and comprehensive diagnosis, leading to better management and possible reversal.

Shop: Microbiome & Gut Health Testing

H. pylori and Autoimmune Gastritis

  1. pylori is a common gastric pathogen affecting almost half the population of the world. Some researchers believe there’s evidence to suggest molecular mimicry between H. pylori and certain gastric cells, and the immune system mistakenly tags these gastric cells for destruction. This could be a possible explanation for the occurrence of autoimmune gastritis in some people who have H. pylori present in their gut (5).
  2. pylori infection is also linked to vitamin B12 deficiency, which can lead to anemia and other complications if left untreated. In some cases, eradicating the H. pylori infection may improve or even reverse autoimmune gastritis symptoms.

Learn more: H. pylori Affects Half the Population, but Is It Harmful?

Hashimoto’s and Autoimmune Gastritis

Hashimoto’s thyroiditis is the most common autoimmune disease, and it’s associated with gastric disorders in 10–40% of patients, while about 40% of patients with autoimmune gastritis also have Hashimoto’s (6). 

Treating Autoimmune Gastritis with Functional Medicine Interventions

Once diagnosed, functional medicine provides a personalized roadmap for managing autoimmune gastritis, including nutrient supplementation, dietary changes, gut health restoration, and strategies to balance your immune response.

A functional medicine provider will also work to support proper gastric acid secretion. This is important to ensure you have adequate levels of vitamin B12, which you can also get from supplementation or B12-fortified foods.

If you’re living with autoimmune gastritis, lifestyle modifications may significantly improve your symptoms. Limiting alcohol, caffeine, spicy food, and smoking can reduce inflammation and irritation to your stomach lining.

Symptoms may also improve with a nutrient-dense, whole-foods-based diet, avoiding inflammatory foods like gluten, dairy, and processed sugars.

Related: B Vitamins: Miracle Micronutrients

Decoding the Silence of Autoimmune Gastritis

Autoimmune gastritis may be silent, but some research suggests it’s a highly prevalent condition with severe consequences. Early detection, proper diagnosis, and treatment can help manage and reverse the effects of autoimmune gastritis. If you experience digestive upset or other unexplained painful digestive symptoms, it’s essential to speak with your healthcare practitioner, get functional medicine diagnostic tests, and adopt a diet and lifestyle that supports your gut health for optimal wellness and quality of life.


autoimmune disease, gut health

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These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any diseases.
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