Posted by: Chris Maloney | March 18, 2014

Can Horking Your Food Make You Anemic?

The connection might not be obvious to non-medical people.  Most medical personnel know that we need vitamin B12 to make nice, good looking blood. If you don’t get enough B12, your cells get big and heavy. To get enough B12, you need enough of a stomach compound called intrinsic factor.  So the question is really, does horking your food down lead to a deficiency in intrinsic factor?

What is intrinsic factor? It is what allows us to absorb vitamin B12 from our diet.  Without intrinsic factor bringing you vitamin B12, a huge number of things can happen, including dying and going insane. Studies estimate that around 6% of our elderly population is deficient, with about 20% borderline. (study here)

So what do we know about intrinsic factor?

Normally Intrinsic factor is produced in great excess by the stomach, catching all available Vitamin B12. (study here)  The bound intrinsic factor and B12 then travels through the small intestine, where it is absorbed in the farthest part of the small intestine.

If you are following so far, you’ve paid attention in college biology.  But what’s missing from the equation is something produced by the saliva, a protein called haptocorrin.  If haptocorrin from the saliva doesn’t bind with B12 going into the stomach, the B12 can be torn up by the stomach acid before the intrinsic factor ever gets a chance to bind onto it. Haptocorrin is found in human breast milk, another reason that breastfeeding is superior to formula. (study here) Not to worry, those horking in their food will find their salivary glands will increase production of haptocorrin.  Even those with a lack of saliva can make up the deficiency. (study here) So no, horking your food won’t give you anemia, it just isn’t very polite.

Once we make it to the stomach, bad things can go wrong with intrinsic factor.  For example, a small child might develop antibodies to intrinsic factor, leading to “feeding intolerance, poor growth and developmental delay” (study here). More commonly, an adult patient may develop gastritis, an inflammation of the stomach.  Whether from an infection or other causes, the intrinsic factor is not secreted  by an upset stomach and a person becomes deficient.  As people age, they may also get lower in intrinsic factor production.  Since the first signs of low intrinsic factor are fatigue and lack of energy, an older person might not catch it for quite some time.

Supplementation of B12 has been by shots in the past, but recent studies show that, generally, high oral doses are as effective as shots. (study here). Low intrinsic factor is highly associated with things like thyroid disease, leading to partial resolution in some cases until the other cause is found. (study here)

Slow your eating, chew your food, and try to enjoy the fact that intrinsic factor is likely doing all of its complex work without you even being aware of it.



  1. […] different idea: people hork their food. I’ve already written that this could lead to anemia (here).  If you have low AMY1 genetically, you already don’t have enough enzymes to break down […]

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