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Chronic gastritis: support treatment with micronutrient medicine

An inflammation of the lining of the stomach (gastritis) can manifest itself as stomach pain, nausea or a feeling of fullness. It is triggered by irritants, infections or immune diseases. This can seriously damage the stomach lining. With a chronic gastric mucosal inflammation, deficiencies arise. Micronutrient medicine can make a valuable contribution to the relief of gastritis and help to avoid secondary diseases. Find out which micronutrients are particularly useful and how to use them correctly.


Chronic gastritis can also be through the germ Helicobacter pylori to be triggered. All important information on micronutrient medicine for such an infection can be found in the text "Helicobacter pylori infection".

Causes and symptoms

What is gastritis?

Gastritis is an inflammation of the stomach lining. The symptoms vary depending on the form: In the event of a sudden onset (acute) Gastritis usually leads to a feeling of fullness (indefinite feeling of pressure) or abdominal pain - especially when you press on the stomach. Those affected have problems eating: this ranges from loss of appetite to nausea with vomiting. You may also experience acidic burping (heartburn), bad breath, and gas.

If the (chronic) Gastritis, on the other hand, often has only mild symptoms or no symptoms at all. However, the risk of secondary diseases such as stomach cancer increases.

Severe gastritis can lead to gastric bleeding and ulcers. Then the stool turns black from the blood. If vomiting is caused by gastric bleeding, the vomit is colored black-brown by the gastric acids (breakage of coffee grounds).


If you are bleeding, a doctor should check your iron supply. Because iron is also lost through the loss of blood. The risk of a deficiency increases.

What causes chronic gastritis?

Most gastritis diseases are triggered by toxins such as alcohol and tobacco as well as by germs in the stomach Helicobacter pylori .

Other (or worsening) causes of gastritis include:

  • psychological stress from stress or shift work
  • Autoimmune diseases such as what is known as autoimmune gastritis (immune attack that destroys stomach cells)
  • inflammatory diseases such as Crohn's disease or sarcoid
  • Taking certain medications like
    • Painkillers (e.g. Aspirin®, Brufen® and Diclac®)
    • Anticoagulants (such as Marcumar® and Falithrom®)
    • Glucocorticoids (such as Dexagalen® and Dexaflam®)
    • Medicines to suppress the immune system (such as Imurek® and Cicloral®)
    • Osteoporosis drugs (bisphosphonates such as Ostac® and Pamifos®)
    • Antidepressants such as serotonin reuptake inhibitors (for example Fevarin® and Fluoxetin-Teva®)

With one through Helicobacter pylori caused gastritis, severe damage to the gastric lining can occur. Persistent inflammation of the stomach can develop into an autoimmune disease (atrophic gastritis) or cancer over many years.

Treatment goals

How is chronic gastritis traditionally treated?

The aim is to find the cause of the gastric mucosal inflammation and to contain it. If this is possible, the damage to the mucous membrane heals quickly. Often, however, permanent complaints remain because the trigger is not always clear.

If the gastritis has existed for a short time (acute), it usually goes away on its own. Patients should avoid irritants for a few days and follow a light diet. This includes avoiding gas that is flatulent, spicy, and high in fat. As a rule, there are no secondary diseases.

If the gastritis was caused by a certain lifestyle, those affected should avoid the corresponding disease triggers - for example:

If this is not enough, drugs are used. They reduce stomach acid so that the stomach is not damaged any further. Because if the stomach lining is injured, it can no longer protect the stomach from the acid. The means of choice are:

  • Proton pump inhibitors (such as Antra MUPS® and Pantozol®) and H2-receptor antagonists (cimetidine such as Cimetidin acris®, CimLich®): They inhibit the production of gastric acid.
  • Antacids (like Talcid® and Rennie®): they neutralize stomach acid.

However, the use of the drugs is being discussed. In the long run, side effects can occur. Therefore, continuous use should be checked and always accompanied by a doctor. Some of the active ingredients are also available without a prescription.

Is there an infection Helicobacter pylori before, antibiotic treatment must also be carried out. Antibiotics kill the germ (Helicobacter eradication therapy).

Goals of micronutrient medicine

The targeted intake of micronutrients protects the stomach lining and helps damage heal better. Certain substances have an antioxidant effect and reduce inflammation.

Damage to the gastric mucosa can also disrupt the absorption and utilization of some vitamins. Above all, this includes vitamin B12. An important goal of micronutrient medicine is therefore to avoid a deficiency in these nutrients.

The following substances are often used in chronic gastritis:

In addition, vitamins, minerals and other substances can alleviate some of the side effects of the drugs or support their effects.


Home remedies have also been used for gastritis for a long time. A hot water bottle or a cherry stone pillow as well as the intake of healing earth can help to alleviate the symptoms. For example, gruel, rusks, grated apples, cooked white rice, low-fat soups or mashed potatoes are well tolerated by the stomach.

Treatment with micronutrients

Compensate for vitamin B12 deficiency in chronic gastritis

How vitamin B12 works

Gastritis increases the risk of vitamin B12 deficiency. If the gastric mucosa is damaged, it produces too little a certain protein - the intrinsic factor (IF). However, this factor is needed for the absorption of vitamin B12. It brings vitamin B12 into the small intestine, where it is absorbed. If the factor is missing, there will be a vitamin B12 deficiency in the long term. This shows up, among other things, through exhaustion, tiredness, physical inefficiency and anemia. Nerve disorders and psychological symptoms are also possible consequences.

Patients with chronic type A gastritis (atrophic autoimmune gastritis) in particular need to watch their vitamin B12 levels. In this form, the immune system specifically damages the stomach cells (parietal cells), which are responsible for the production of the intrinsic factor. More than half of the patients with Helicobacter pylori infections also show an inadequate supply of vitamin B12 - according to the result of an observational study.

Since vitamin B12, together with vitamin B6 and folic acid, is also needed to break down the cell toxin homocysteine, this can lead to increased homocysteine ​​levels. This in turn increases the risk of a blood clot (thrombosis), cardiovascular disease or a stroke. In a high-quality study with over 200 seniors, daily intake of 500 micrograms of vitamin B12, 800 micrograms of folic acid and 3 milligrams of vitamin B6 led to an improvement in homocysteine ​​levels in the blood. Patients with and without gastritis were compared.

The bottom line is: In patients with gastric diseases, it is essential to keep an eye on the supply of B vitamins - especially vitamin B12.

Dosage and recommended use of vitamin B12

Micronutrient experts usually recommend taking 500 micrograms of vitamin B12 per day for gastritis. An ideal form is methylcobalamin. In the case of a severe deficiency and the complete absence of the intrinsic factor, higher doses may also be necessary (for example 1,000 micrograms). Sometimes doctors also prescribe vitamin B12 injections. There is also vitamin B12 in the form of lozenges. This is particularly useful in the case of gastritis, because vitamin B12 is also absorbed through the oral mucosa.

Expert knowledge

Even if the intrinsic factor is absent, small amounts are absorbed through the intestine (passive absorption). However, vitamin B12 has to be present in high concentration, because only around one percent is absorbed in this way. In two high-quality studies, no difference was found between oral vitamin B12 supplements and injections. Both successfully raised the vitamin B12 level.

Micronutrient experts usually advise combining vitamin B12 with other B vitamins. Because a vitamin B12 deficiency often does not occur alone. 200 to 400 micrograms of folic acid (as 5-methyltetrahydrofolate) are useful (5-MTHF)) and 1 to 2 milligrams of vitamin B6. If the homocysteine ​​levels are already elevated, higher dosages may be necessary. B vitamins are best taken with a meal.

Have vitamin B12 determined in the laboratory

In patients with chronic gastritis, the doctor should always check the vitamin B12 status. There are several possibilities for this. The best method is to determine holotranscobalamin (HoloTC). This measurement is more informative than the determination of vitamin B12. A value above 54 picomoles per liter is normal.

Since the symptoms of a vitamin B12 deficiency and a folic acid deficiency are very similar, folic acid should ideally also be examined in the case of a vitamin B12 deficiency. Here the normal values ​​in the blood serum are more than 5.9 micrograms per liter or over 13.3 nanomoles per liter.

Vitamin B12: to be considered during pregnancy, illness and medication

B vitamins should only be taken in the recommended high dosage during pregnancy and breastfeeding if there is a proven deficiency. Consult with the doctor.

People with kidney disease should only take vitamin B12 in the form of methylcobalamin and not as cyanocobalamin. There is some evidence that high doses of cyanocobalamin are harmful to kidney patients.

A good supply of folic acid can protect against cancer. Under certain conditions, long-term high doses of folic acid can also promote the progression of cancer or, in precancerous stages, promote the development of cancer. Therefore, in cancer, the supplement of folic acid over 200 micrograms per day should be discussed with the doctor. A consultation also applies to vitamin B12 in cancer.

Folic acid reduces the effect of certain antibiotics with the active ingredients trimethoprim (Infectotrimet®), proguanil (Paludrine®) and pyrimethamine (Daraprim®).

After the placement of stents and after a heart attack, the administration of combined B vitamins has not yet been adequately researched. B vitamins may have a negative effect here. High doses of vitamin B12 (from 60 micrograms per day), folic acid (from 800 micrograms per day) and vitamin B6 (40 to 50 milligrams per day) should then be avoided.

Vitamin C and E for inflammation damage and more

How vitamin C and E work

If the inflammation persists, some cells of the immune system are particularly active - for example certain white blood cells (granulocytes). In doing so, they form oxidative defense substances. These damage not only infectious bacteria, but also healthy tissue - in the case of gastritis, this is the gastric mucosa.

vitamin C is the main antioxidant of the gastric mucosa. It neutralizes free radicals and thus combats the oxidative stress that is triggered. This effect will too Vitamin E. awarded. In addition, vitamin E reduces the formation of inflammatory substances and relieves pain.

Vitamin C can also help fight the stomach germ Helicobacter pylori help: It helps to remove the acid protection of the germ. The germ normally produces basic ammonia to protect itself from stomach acid. Vitamin C inhibits the enzyme that makes ammonia. This makes the germ more vulnerable.

The vitamin C content in the stomach acid and in the blood is lower in all forms of gastritis. We also know from observational studies that a lack of vitamin C is related to the severity of gastritis. People with poor vitamin C supplies are likely to be more prone to stomach disorders. Therefore, taking vitamin C could protect against further consequences. These include stomach bleeding, stomach infections, and stomach cancer.


A diet rich in vitamin C could be triggered by stomach cancer Helicobacter pylori prevent: An observational study with almost 300 participants showed that infected patients who generally consumed little vitamin C had a higher risk of cancer. This was compared with patients who consumed a lot of vitamin C. Vitamin C, together with regular therapy, was also able to improve tissue condition in almost 900 patients: the first cancer precursors in the stomach were reduced. Without vitamin C the effect was less. High-quality studies have yet to follow.

Since gastritis is often exposed to increased exposure to oxidative stress, micronutrient experts recommend low-dose antioxidant basic protection with vitamins C and E.

Dosage and recommendation for vitamin C and E.

For gastritis, micronutrient experts usually recommend 200 milligrams of vitamin C daily to protect the stomach lining. Is the germ of the stomach Helicobacter pylori In addition to antibiotic therapy, doctors often use higher doses to trigger the inflammation (for example 400 milligrams of vitamin C).

Vitamin C can be ideally combined with vitamin E. In the case of gastritis, a daily dose of 20 to 40 milligrams of vitamin E makes sense. Micronutrient experts often recommend a combination preparation that also contains other antioxidants (for example selenium or plant substances). The fabrics complement each other.

Vitamin C can be taken with meals, but also in between. However, taking it with food improves tolerability. Vitamin E, on the other hand, should always be taken with meals. It is better absorbed together with fat from the food.

Have the oxidative stress determined in the laboratory

The addition of low-dose antioxidants is harmless. However, if you take in very high amounts, it makes sense to have the antioxidant status checked by the doctor. The determination provides information on whether the ratio of free radicals to antioxidants is balanced.

The antioxidant status can be determined with the help of various laboratory tests in a blood or urine sample. The values ​​and the methods used can vary depending on the laboratory. That is why the information from the respective laboratory counts.

Vitamins C and E: to be considered in case of illnesses and medication use

Since vitamin C improves iron absorption, people with pathological iron overload (hemochromatosis) should only take vitamin C under medical supervision.

In animal experiments, vitamin C reduced the effectiveness of the anti-cancer agent bortezomib (e.g. Velcade®). It should therefore only be taken during such therapy after consulting a doctor.

Anyone who takes blood thinners should seek advice from their doctor about the dosage they can supplement with vitamin E. High doses of vitamin E could increase the effect. These include: vitamin K antagonists (for example phenprocoumon such as Marcumar® or warfarin such as Coumadin®), platelet aggregation inhibitors (for example acetylsalicylic acid such as Aspirin®), new oral anticoagulants such as dabigatran (Pradaxa®) and rivaroxaban (Xarelto®).

Special basic minerals bind the stomach acid

How basic minerals work

As a rule, the stomach is well protected from its own stomach acid. If the mucous membrane is damaged, however, the acid attacks the tissue. Sometimes too much acid is produced in the stomach. Under certain circumstances, this can trigger gastritis or prevent it from healing.

Basic minerals (Carbonates) neutralize stomach acid. Drugs from the group of acid binders (antacids) also work in the same way. Probably the oldest and best known representative is sodium bicarbonate (baking soda).There are also newer preparations with calcium carbonate and various magnesium and aluminum compounds in different combinations. They are also used for heartburn. Carbonates protect the stomach lining and can help heal acid-related damage to the stomach.

Until other medicines were developed, carbonates were the main deacidifying agents for the stomach. In the meantime, however, there are more modern drugs such as proton pump inhibitors or H2 receptor antagonists. However, carbonates are useful in acute gastritis.

Dosage and recommendation for basic minerals

The following mineral compounds are used in micronutrient medicine:

  • Calcium carbonate
  • Magnesium bicarbonate or magnesium carbonate
  • Potassium bicarbonate
  • Sodium bicarbonate

The acid binding capacity is given in millivalents and should be 20 to 25 millivalents per single dose. The daily dose is usually 75 millivalents. In the case of preparations with different carbonates, the individual minerals are coordinated with one another. Overdosing can thus be ruled out. Therefore, follow the manufacturer's dosage recommendations.

Carbonates are taken either as needed (for heartburn) or after meals two to three times a day. At the same time, you should drink a lot - at least 2 liters of water or unsweetened tea (such as chamomile or lemon balm) a day.

Usually you should use carbonates not permanent be taken. However, if the doctor advises prolonged use in the case of gastritis, the preparations should be taken on an empty stomach. Otherwise the gastric acid will lose its effectiveness and digestion will be impaired.


A longer application must be accompanied by a doctor. Because the stomach can react with an increased production of gastric acid. Then the symptoms get worse. A very long application can also lead to alkalosis with weakness and weak breathing. In addition, carbonates can lower the absorption of copper in the intestine, so that a copper deficiency is possible.

Alkaline minerals: to be observed in the event of illness and medication

If carbonates (minerals) are taken in high doses over a long period of time, problems can arise in patients with chronic kidney disease. Damaged kidneys cannot adequately excrete minerals. Therefore, the doctor should regularly check the mineral balance.

Carbonates can cause drug interactions. As a result, active pharmaceutical ingredients may no longer be properly released in the digestive tract. Therefore keep an interval of two hours.

Depending on which minerals are contained in the preparation, there are further instructions for use and interactions. You can find out more in the texts on calcium, magnesium and potassium.

Alginate against heartburn and as a mucous membrane protection

How alginate works

Alginate is a multiple sugar from the cell walls of brown algae. It is used in conjunction with carbonates for gastritis. In the stomach it forms a barrier to the esophagus through a layer of foam. The stomach acid stays in the stomach, so heartburn is relieved. Alginate could also coat and protect the esophagus and possibly the stomach lining.


Flaxseeds have a very similar effect. They swell up in water. The mucus that is created in this way has a soothing effect and protects the mucous membrane from gastric enzymes. It also buffers an overly acidic stomach. Flax seeds are traditionally an important resource. So far, however, there has only been animal testing.

In addition, alginate improved the effect of common drugs in the treatment of gastritis in laboratory and animal tests: the foam formation gave the drugs a lift, which meant they stayed in the stomach longer and the active ingredients were released more slowly. In addition, the treatment of Helicobacter pylori more successful with alginate and a lower dose of medication was required.

Several reviews have shown that alginate has been shown to relieve heartburn and regurgitation in humans. The effect was greater than that of acid binders (antacids), but no better than that of acid regulators (H2 blockers or proton pump inhibitors). The addition of alginate also improved the effects of drugs against heartburn, as researchers found in two reviews.

Overall, alginate can relieve heartburn. It could also have direct benefits in the treatment of gastritis. However, studies on people with gastritis are still lacking. Alginate is gentle and is therefore also suitable for sensitive people.

Dosage and recommended use of alginate

For gastritis, especially heartburn, 1,000 to a maximum of 4,000 milligrams of alginate are recommended daily. Carbonates such as sodium and calcium carbonate are important for the effect, which is why preparations always contain a combination.

It should be taken after meals or at bedtime, if necessary. Long-term use must be avoided. Otherwise there is a risk that symptoms of other diseases will be hidden. In the case of gastritis, a doctor or micronutrient expert should therefore determine the duration of intake.

Alginate: to be considered when taking medication, during pregnancy and breastfeeding

There are no known interactions with drugs, but they cannot be ruled out either. It is therefore recommended to take medication two hours apart from alginate.

As a precaution, the use of alginate during pregnancy, breastfeeding and in children under the age of twelve should be discussed with a doctor. So far, however, there have been no safety concerns from studies.

Alginates are combined in preparations with the basic minerals (carbonates). You can read about the intake of carbonates here.

Probiotics keep harmful stomach germs at bay

How probiotics work

The stomach is an environment that is hostile to bacteria due to the acid in the stomach. However, some types of bacteria can stay there and develop positive or negative effects. Bacteria that have a positive effect are called probiotics. These include, for example, lactic acid bacteria. The data show that probiotics can have a beneficial effect on infections with disease-causing bacteria. Mechanisms such as:

  • Formation of antibacterial substances that fight the stomach germ (for example bacteriocins).
  • Formation of acids and other substances that inhibit the growth of the stomach germ.
  • Displacement of pathogenic germs from the "docking points". As a result, the germs cannot colonize the stomach as strongly.
  • Reduced formation of inflammatory substances.

Chronic stomach diseases lead to a change in the composition of bacteria in the stomach and also in the intestines. An underacidification of the stomach in autoimmune gastritis also leads to the change. The consequence can be indigestion. A contribution to the development of gastric cancer is also discussed.

The effects of probiotics in treating one Helicobacter pylori infection is well studied. To what extent probiotics can help with other causes of gastritis, however, still needs to be researched. However, it can make sense to take them because probiotics help restore the bacterial balance.


When treating stomach ulcers, probiotics also seem to be useful. Animal studies to date show that probiotic bacteria like Lactobacillus rhamnosus GG, Lactobacillus gasseri OLL2716 and Lactobacillus acidophilus Can prevent gastric mucosal damage. The healing process was also accelerated.

Probiotics: dosage and recommended use

Micronutrient experts recommend consuming 10 to 20 billion bacteria (colony-forming units) daily for gastritis. Preparations are available in the form of capsules or as a powder that can be stirred into water or food such as yogurt.

In order for health-promoting effects to be felt, probiotics must be taken regularly over a longer period of time. As soon as you stop doing this, the number of probiotic bacteria in the digestive tract decreases again.

Probiotics: to be considered in case of illnesses and taking antibiotics

Some probiotic bacteria may produce histamine in the gut. Therefore, they can cause symptoms in the case of histamine intolerance. The following types of bacteria are likely to be included: Lactobacillus casei, Lactobacillus delbrueckii ssp. bulgaricus, Lactobacillus reuteri, Lactococcus lactis and Enterococcus faecium.

Very weakened patients with suppressed immune systems, people with central venous access (for example, during chemotherapy), heart valve diseases and short bowel syndrome should not be given probiotics.

Probiotics should not be taken at the same time as antibiotics, as antibiotics would kill the probiotic bacteria. In order not to impair their effect, keep an interval of two to three hours.

Medicinal plants such as chamomile and lemon balm against gastritis

Effect of medicinal plants

Certain plants have traditionally been used for gastritis. For example protect Chamomile or lemon balm the mucous membranes from oxidative stress and have an anti-inflammatory effect. This relieves the irritation of the stomach wall and esophagus. In the laboratory, plant substances from chamomile or lemon balm also have a relaxing and antispasmodic effect on the stomach muscles. Animal studies have shown that chamomile also helps relieve pain.

Chamomile speeds healing of one Inflammation of the mucous membranes: According to a review, it reduced pain and the duration of inflammation of the oral mucosa. Also Stomach discomfort with heartburn, belching, loss of appetite and nausea could be alleviated in a first study by chamomile extract. A high-quality study for a combination of medicinal plant extracts showed similar results. These included chamomile, peppermint, caraway seeds, licorice root and lemon balm.

There are also animal experiments to protect against Stomach ulcer. For example, chamomile extract reduced gastric acid, which benefits the damaged gastric mucosa. In other animal experiments, chamomile extract soothed gastric mucosal damage caused by irritants such as alcohol or medication. Stomach protection was also observed for lemon balm extract.

Conclusion: Medicinal plants such as chamomile or lemon balm are traditional remedies for gastritis. Initial studies confirm this empirical knowledge. Consuming medicinal plants can therefore be a first step before further action is taken.


In herbal medicine, many medicinal plants and their combinations are used for gastrointestinal complaints. These include bitter candytuft, lemon balm, caraway seeds, peppermint, licorice root, angelica root and milk thistle. Animal experiments prove the effect of the combination: it increased the formation of mucus and reduced inflammatory messenger substances.

Dosage and recommendations for use of medicinal plants

Medicinal plants such as chamomile, lemon balm, caraway or peppermint tea are traditional home remedies for gastrointestinal complaints. However, attention must be paid to the quality. Many teas contain small amounts and ineffective components of the plants. Teas from the pharmacy are more suitable.

There are also micronutrient preparations with individual extracts or a combination. For example, 150 to 1,000 milligrams of chamomile extract or 50 to 150 milligrams of lemon balm extract are useful in gastritis.


For gastritis with stress as a trigger (nervous gastritis), plants with a calming effect are recommended in herbal medicine. Typical examples are valerian or lavender. Incidentally, chamomile and lemon balm also help calm you down.

Chamomile and lemon balm: to be observed during pregnancy and breastfeeding, in the event of illnesses and medication

Pregnant and breastfeeding women should not take concentrated plant extracts. No studies are available so far. The same applies to children under the age of twelve.

Chamomile tea and extract can lower blood sugar. Diabetics who take medication should monitor their blood sugar closely to avoid hypoglycaemia. This applies to antidiabetic drugs such as metformin (Diabesin®) and glibenclamide (Euglucon®) or insulin (such as Huminsulin®, Insuman® Rapid and Actrapid®).

Chamomile may affect the breakdown of drugs. Before taking it, you should check with a specialist. Blood thinners (warfarin such as Coumadin® or Marevan®) could be affected. In addition, interactions with drugs that suppress the immune system (immunosuppressants) are possible - for example azathioprine such as Azafalk® and Zytrim®).

Chamomile has slight estrogen-like effects. This could result in higher amounts of the extract (around 600 milligrams) affecting birth control pill contraception. This should also be taken into account with estrogen-dependent tumors and with cancer therapy with anti-estrogens (Tamoxifen such as Kessar® and Mandofen®). Safety cannot be guaranteed here.

Chamomile extract can increase the effects of sedative drugs and sleeping pills. Then you shouldn't do any activities that require concentration. For example, phenobarbital (Luminal®) and zolpidem (Zoldem®) are affected. The same applies to anesthetics.

Are omega-3 fatty acids useful in chronic gastritis?

How Omega-3 fatty acids work

Chronic inflammation puts a strain on the body. Omega-3 fatty acids reduce inflammation and are used in many inflammatory diseases. Accordingly, they could also have a positive effect on gastritis. Apart from the anti-inflammatory effect, omega-3 fatty acids have also shown other effects on gastritis in laboratory and animal tests: Omega-3 fatty acids reduce oxidative stress and protect the stomach cells from dying. The animals also developed cancer less frequently.

On the stomach germ Helicobacter pylori Omega-3 fatty acids also worked: they inhibited the colonization, reproduction and growth of the germ in the laboratory. Experiments with animals were also promising. In observational studies, however, the intake of omega-3 fatty acids has so far not shown any improvement in antibiotic therapy Helicobacter pylori.

Overall, the study situation is still inconsistent: There are studies in which omega-3 fatty acids were associated with a lower risk of gastric cancer - but not with gastritis. In other studies, however, people with gastritis (atrophic gastritis) had higher blood levels of omega-3 fatty acids compared to healthy people. It is not yet clear why this is so.

So far, there is a lack of high-quality studies to assess the benefits of omega-3 fatty acids in gastritis. The body needs a certain amount of inflammatory activity in order to like germs Helicobacter pylori fend off. Omega-3 fatty acids could be useful, especially after antibiotic treatment, to allow the inflammation to subside. To confirm this, high quality studies will be needed in the future.

Dosage and recommended intake of omega-3 fatty acids

In general, 1,000 milligrams of omega-3 fatty acids per day are useful for chronic inflammation. Whether omega-3 fatty acids are suitable for your gastritis should be discussed with your doctor. When triggered by gastritis Helicobacter pylori they could interfere with therapy. Omega-3 fatty acids should then only be taken after the treatment.

Most micronutrient experts recommend preparations made from fish oil or krill oil. These preparations contain the fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA in particular has a strong anti-inflammatory effect. There is also seaweed oil for vegans and vegetarians. This mainly contains DHA.

Omega-3 supplements should be taken with food: they need fat from meals to be absorbed.

Have omega-3 fatty acids determined in the laboratory

The determination of the omega-3 fatty acids is generally useful in inflammatory diseases. A measurement could therefore be helpful in chronic gastritis. The omega-3 index is well suited. The omega-3 index is tested in the blood. The proportion of omega-3 fatty acids in the red blood cells is measured and calculated as a percentage.

If the omega-3 index is above 8 percent, the supply is very good.On the other hand, if the index is below 5 percent, you are poorly provided for.

Omega-3 fatty acids: to be considered when taking medication and illnesses

Omega-3 fatty acids have a blood-thinning effect in high doses. Therefore, from 1,000 milligrams per day they can increase the effect of blood-thinning and anticoagulant drugs. Discuss the intake with your doctor. These include, for example, coumarin derivatives (such as Marcumar®) or warfarin (Coumadin®).

Omega-3 fatty acids should not be consumed in the event of sudden liver disease, acute inflammation of the pancreas or inflammation of the gallbladder.

High doses of omega-3 fatty acids can reduce blood clotting. Before an operation, a doctor should decide whether the preparations should be discontinued. In the case of blood clotting disorders, the intake should be clarified with the doctor.

Dosages at a glance

Recommendation per day for chronic gastritis



Vitamin B12

500 micrograms (µg)

Vitamin B6

1 to 2 milligrams (mg)

Folic acid

200 to 400 micrograms

vitamin C

200 milligrams

Vitamin E.

20 to 40 milligrams



Basic minerals (carbonates)

75 millival (mval)


Other substances


1,000 to 4,000 milligrams


10 to 20 billion (1 to 20 x 109)

Colony Forming Units (CFU)

Chamomile extract

150 to 1,000 milligrams

Melissa extract

50 to 150 milligrams

Omega-3 fatty acids

1,000 milligrams (according to medical advice)



Useful blood tests for chronic gastritis


Normal values

Vitamin B12 (measured as holotranscobalamin in serum)

over 54 picomoles per liter (pmol / l)

Folic acid

over 5.9 micrograms per liter (µg / l) or
over 13.3 nanomoles per liter (nmol / l)

Omega-3 index

5 to 8 percent (%)


Support of drugs with micronutrients

Avoid nutrient deficiencies when taking H2 blockers

Long-term use of H2 blockers can lead to a deficiency in certain vitamins and minerals. These include the active ingredients cimetidine (such as cimetidine acris® or CimLich®) or famotidine (for example Famotidin-CT or Famotidin STADA®).

Vitamin B12 and folic acid, vitamin D and zinc are affected. The possible consequences: anemia, gastrointestinal disorders, susceptibility to infections and fatigue. Some of the side effects can be eliminated with the help of micronutrient medicine:

  • Vitamin B12 and folic acid counteract anemia.
  • Zinc protects the stomach lining.
  • Vitamin D is important for a healthy immune system.

Micronutrient experts recommend paying attention to the supply of micronutrients when taking H2 blockers. The following dosages are useful:

  • Vitamin B12: 20 to 100 micrograms
  • Folic acid: 400 micrograms
  • Vitamin D: 1,000 to 2,000 international units (or depending on your level)
  • Zinc: 10 to 20 milligrams

Proton pump inhibitors: make sure there is an adequate supply of nutrients

Acid blockers (proton pump inhibitors) slow down acid production. This includes, for example, Pantoprazole (for example Rifun® and Pantozol®). If the medication is taken for a long time, certain micronutrients may be deficient. This is because there isn't enough stomach acid to absorb it. Vitamin B12, calcium, magnesium as well as iron and vitamin C are affected.

Micronutrient experts therefore recommend a micronutrient preparation for long-term use of acid blockers in order to avoid a deficiency. The following dosages are useful:

  • Vitamin B12: 250 micrograms
  • Calcium: up to 1,000 milligrams
  • Magnesium: 100 to 300 milligrams
  • Vitamin C: 100 to 1,000 milligrams

Probiotics: improve antibiotic effects and alleviate side effects

Probiotics can counteract the effectiveness of antibiotics Helicobacter pylori improve by up to 50 percent. This is the result of a review article with 30 partly high-quality studies. In addition, probiotics resulted in fewer antibiotic side effects. These included diarrhea, nausea, vomiting, and epigastric pain.

The researchers suggest adding probiotics to antibiotic therapy at one Helicobacter pylori-Infection use. However, they also say that more studies are needed to find the optimally effective bacterial species and dosages. Probiotics are probably not all equally useful: the effect depends on the bacterial strain. Above all, lactobacilli (such as Lactobacillus salivarius), Bifidobacteria (such as Bifidobacterium longum) and Saccharomyces boulardii to be helpful.

To promote the regeneration of the intestinal flora after antibiotic treatment, micronutrient experts recommend a dose of 10 to 20 x 109 Colony Forming Units (CFU).

Dosages at a glance


Recommendation per day when taking H2 blockers

Vitamin B12

20 to 100 micrograms (µg)

Folic acid

400 micrograms

Vitamin D

1,000 to 2,000 International Units (IU); or depending on the mirror


10 to 20 milligrams (mg)


Recommendation per day when taking acid blockers

Vitamin B12

250 micrograms (µg)

vitamin C

100 to 1,000 milligrams (mg)


up to 1,000 milligrams


100 to 300 milligrams


Recommendation per day when taking antibiotics


10 to 20 billion (1 to 20 x 109)

Colony Forming Units (CFU)


Gastritis is an inflammation of the lining of the stomach. Chronic gastritis usually has only mild symptoms or no symptoms at all. However, the risk of secondary diseases can increase. These include stomach ulcers, stomach bleeding, and cancer. In addition to regular alcohol and nicotine consumption, the cause of chronic gastritis is often the germ in the stomach Helicobacter pylori.

A problematic nutrient is vitamin B12, because gastritis leads to a reduced intake. The risk of a deficiency increases. Micronutrient experts therefore recommend taking vitamin B12 for chronic gastritis.

Micronutrient medicine can also help to subside gastritis and protect it from damage to the gastric mucosa. Vitamin C and E reduce oxidative stress. Oxidative stress occurs more frequently with inflammation and leads to further tissue destruction and pain. Basic minerals (acid binders) neutralize excess stomach acid. They help to subside the symptoms. In addition, the combination of alginate with the basic minerals (carbonates) forms a barrier to the esophagus. This prevents heartburn from gastritis. The intake of probiotics can especially contribute to antibiotic therapy Helicobacter pylori-Make infections more effective and reduce the side effects. Medicinal plants such as chamomile or lemon balm protect and soothe the mucous membranes and could alleviate gastritis symptoms. Whether omega-3 fatty acids also reduce inflammation has not yet been conclusively clarified.

Medicines used for gastritis can lead to a deficiency in certain vitamins and minerals. These include vitamin B12, vitamin C and D, folic acid, calcium, magnesium and zinc. Therefore, care should be taken to ensure adequate supply.