A woman in her 60s went to the hospital with numbness and weakness in her legs, but doctors initially missed the real cause. She had tried to treat a stomach bacteria called H. pylori twice without success. It turned out her real problem was an autoimmune condition where her body was attacking her stomach lining, preventing her from absorbing vitamin B12. This vitamin is crucial for nerve health. When she received B12 injections, her symptoms improved dramatically. This case highlights an important lesson: when H. pylori treatments keep failing, doctors should check for autoimmune stomach problems that can lead to serious nerve damage if left untreated.

The Quick Take

  • What they studied: Why a woman’s repeated attempts to treat a stomach bacteria didn’t work, and what the real underlying problem turned out to be
  • Who participated: One woman in her 60s who had numbness in her hands and feet and difficulty walking
  • Key finding: The woman’s real problem wasn’t the H. pylori bacteria—it was her immune system attacking her stomach lining, which prevented her body from absorbing vitamin B12. This caused nerve damage in her spinal cord. B12 injections fixed the problem.
  • What it means for you: If you’ve had multiple failed attempts to treat H. pylori, ask your doctor to check for autoimmune stomach problems and vitamin B12 levels. Catching this early can prevent serious nerve damage.

The Research Details

This is a case report, which means doctors documented one patient’s medical story in detail. The woman came to the hospital with numbness and walking problems that had started two weeks earlier. Doctors ran blood tests and found her vitamin B12 was very low. They did an MRI scan of her spine and saw damage in the nerve pathways that carry sensation. They also tested her blood for special antibodies (immune system proteins) that attack stomach cells, and these tests came back positive. Finally, they looked directly at her stomach with a camera and saw it was inflamed and damaged.

This case is important because it shows how one disease can hide behind another. The woman’s doctors kept trying to treat H. pylori because she had failed treatments before, but they didn’t realize her real problem was her immune system. This teaches doctors to think more carefully when treatments don’t work—sometimes there’s a different disease causing the same symptoms.

This is a single case report, which is the lowest level of scientific evidence. It tells us one person’s story very well, but we can’t know if this happens to many people or just a few. However, the doctors did thorough testing including blood work, imaging, and direct examination of the stomach, which makes the diagnosis reliable for this one patient. The case is valuable because it points out a pattern that doctors should watch for.

What the Results Show

The patient had numbness in her hands and feet (called stocking-glove paresthesia because it affects the areas covered by socks and gloves), a red tongue, loss of deep sensation in her legs, and trouble with balance and coordination. Her blood vitamin B12 level was low. An MRI of her spine showed damage in the posterior columns—the nerve pathways that carry sensation from the body to the brain. When doctors tested her blood, they found antibodies against intrinsic factor and gastric parietal cells, which are proteins her stomach needs to absorb B12. When they looked at her stomach with a camera, they saw it was thin and inflamed (atrophic gastritis). After starting B12 injections, her symptoms improved significantly and she could walk independently again.

The case revealed an important pattern: autoimmune gastritis (where the immune system attacks the stomach) is becoming more commonly recognized in patients who have failed H. pylori eradication treatments multiple times. This suggests that some people who seem to have treatment-resistant H. pylori may actually have a different disease entirely. The doctors note that this autoimmune condition can lead to serious neurological problems if not caught and treated.

Previous research has shown that vitamin B12 deficiency can cause nerve damage, and that autoimmune gastritis is a real condition. However, this case highlights a newer understanding: autoimmune gastritis may be more common than previously thought among people with repeated H. pylori treatment failures. This suggests doctors need to expand their thinking about why treatments fail and look for autoimmune causes more often.

This is just one patient’s story, so we cannot say how common this problem is or whether it applies to other people. We don’t know the long-term outcome—whether the patient’s nerve damage fully recovered or if there were lasting effects. The case doesn’t include a comparison group of other patients with similar symptoms. Additionally, we don’t have information about how many people with failed H. pylori treatments actually have autoimmune gastritis versus other causes.

The Bottom Line

If you have failed H. pylori eradication treatments (especially multiple attempts), ask your doctor to: (1) check your vitamin B12 levels with a blood test, (2) test for antibodies against intrinsic factor and gastric parietal cells, and (3) consider a gastroscopy to examine your stomach directly. If you have numbness, tingling, or balance problems along with stomach issues, mention this to your doctor. This case suggests these symptoms may be connected. Confidence level: Moderate—this is based on one well-documented case, but the pattern makes medical sense.

People who have had repeated failed attempts to treat H. pylori should pay special attention. Anyone experiencing numbness, tingling in hands and feet, or balance problems should discuss these with their doctor, especially if they also have stomach problems. Doctors treating patients with failed H. pylori eradication should consider autoimmune gastritis as a possibility. People with known autoimmune conditions should be aware of this connection.

In this case, the patient showed improvement in walking ability relatively quickly after starting B12 injections, but nerve damage recovery can take weeks to months. Some nerve damage may be permanent if the B12 deficiency went untreated for a long time. Starting treatment early is important for the best outcome.

Want to Apply This Research?

  • Track any numbness, tingling, or balance problems weekly using a simple 1-10 scale. Also log any stomach symptoms and note when you take B12 supplements or injections. This helps you and your doctor see if symptoms are improving over time.
  • If you have failed H. pylori treatments, set a reminder to schedule blood work to check your B12 levels and get tested for autoimmune gastritis antibodies. Keep a symptom diary noting any new numbness, tingling, or walking difficulties to share with your doctor.
  • Over the long term, monitor your B12 levels regularly (as recommended by your doctor), track any neurological symptoms monthly, and maintain a log of your stomach health. If you’re on B12 supplementation, note how you’re feeling and whether symptoms are stable, improving, or worsening.

This case report describes one patient’s experience and should not be used for self-diagnosis. If you have symptoms of numbness, tingling, balance problems, or have had failed H. pylori treatments, consult with a qualified healthcare provider for proper evaluation and testing. Vitamin B12 deficiency and autoimmune gastritis require professional medical diagnosis and treatment. Do not start or stop any medications without medical supervision. This information is educational and not a substitute for professional medical advice.