Anemia is a major global public health problem and is most commonly associated with iron deficiency; however, deficiencies in other micronutrients, including vitamin B12, may also contribute to its development. Increasing evidence suggests that Helicobacter pylori infection may influence the occurrence of anemia through several mechanisms related to alterations in the gastric environment. Chronic gastric inflammation and increased gastric pH associated with H. pylori infection may impair the absorption of non-heme iron and reduce the concentration of vitamin C in gastric juice. Since vitamin C enhances iron bioavailability by reducing ferric iron (Fe3+) to the more absorbable ferrous form (Fe2+), decreased levels of this vitamin may further limit iron absorption. At the same time, the increase in gastric pH may hinder the release of vitamin B12 from food proteins, potentially contributing to disturbances in its absorption. This review aimed to present an integrated overview of the relationships between H. pylori infection, alterations in the gastric environment, and mechanisms that may contribute to the development of anemia, including disturbances in vitamin B12 absorption, with particular emphasis on the potential role of vitamin C.
Wróblewska et al. (Fri,) studied this question.