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By Dr. James Howenstine, MD.
November 8, 2006

Bursa are spaces with a small amount of lubricating fluid that contain tendon sheaths and tendons which are attached to muscles and bones. When the fine connective tissue sheaths become irritated by excessive use, trauma or other causes an inflammatory reaction may occur resulting in painful swelling of the bursal space(bursitis). The conventional medical management for bursitis usually consists of an injection of a potent cortisone substance into the bursal space which often resolves the pain. If the needle is directed in several slightly different angulations it is often possible to create multiple holes in the tendon sheath which relieves the pressure and often results in complete resolution of the pain. I was always delighted that a painful problem had been eliminated but was ignorant of the fact that a more serious health issue had been overlooked.

Dr. I.S. Klemes reported in 1957 that injection of 1000 mcg. of Vitamin B12 daily for several consecutive days would always eliminate the pain of bursitis. Dr. Jonathan Wright has confirmed the effectiveness of B12 injections for bursitis in hundreds of patients. He learned that giving 2000 mcg. of B12 daily until the pain disappeared was more effective than the lower dosage initiated by Dr. Klemes. Vitamin B12 does not relieve pain but does appear to reverse inflammation in persons with bursitis. Pain relief usually begins in two or three days after the initial injection. Complete elimination of pain may require up to 2 weeks. Vitamin B12 by injection solves bursitis but B12 taken by supplement or in food is of no value in resolving bursitis proving that B12 absorption is flawed. Patients who are not studied to learn why they have bursitis are likely to experience a new episode of bursitis when their Vitamin B 12 levels becomes depleted after these injections.

Dr. Wright advises that bursitis is nearly always a sign that the stomach is not producing enough hydrochloric acid and intrinsic factor which is needed to absorb B12. Because B12 injections bypass normal gastric absorption by going directly into the blood stream they are able to resolve bursitis even though there is flawed B12 absorption. He strongly recommends that all persons with bursitis have a gastric analysis. In his experience 95 % of these patients have exhibited reduced quantities of acid[1] or no acid at all. Patients with no or low production of hydrochloric acid are routinely found to have diminished amounts of essential amino acids and low levels of nearly all minerals.

The parietal cells in the lining of the stomach normally produce hydrochloric acid and intrinsic factor which allow Vitamin B12 to be absorbed from the small intestine. Hydrochloric acid is also responsible for activating pepsin that digests and breaks down proteins into aminoacids and peptides. In addition hydrochloric acid also breaks up the organic matrix that binds many minerals found in food(iron in meat and spinach etc.) thus freeing these minerals for absorption. When minerals (zinc, manganese, cobalt, copper, magnesium, chromium, calcium, vanadium, boron, selenium, molybdenum etc.) are poorly absorbed chemical reactions in the body slow down or fail to occur because minerals perform key functions in the proper function of enzymes.

Essential amino acids can not be manufactured by the human body so they must appear in and be absorbed from food. When both essential amino acids and minerals are deficient it is common for patients to lack energy. The essential amino acids are also needed for construction of most of the neurotransmitters that control brain functions.

Mental health conditions like depression can be caused by inability to construct sufficient neurotransmitters resulting from failure to produce enough hydrochloric acid to ensure absorption of essential amino acids. Getting started on a SSRI drug for depression is the wrong course of action if you are really suffering from failure to absorb amino acids. Persons with impaired stomach absorption often have low levels of essential minerals as well. These patients may also have diminished quantities of folic acid.

Therapy for this problem of failing gastric absorption can be accomplished with hydrochloric acid /pepsin capsules and injections of B12 and folic acid. With this therapy complete recovery may take many months even years. A more rapid resolution of the problem can be brought about by intravenous amino acids and minerals. In Dr. Wright’s experience most persons with mental health problems have low or absent levels of essential amino acids. Therapy for stomach acid lack can lead to disappearance of fatigue, depression, insomnia and lack of energy.

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Persons with bursitis can have their pain resolve with a series of daily injections of 2000 mcg. of Vitamin B12.They are best managed by obtaining a gastric analysis because failure to produce adequate hydrochloric acid and pepsin often leads to significant health problems (depression, insomnia, fatigue, anemia, impaired enzyme function, confusion).


1, Wright, Jonathan Nutrition & Healing Vol 12, Issue 4, May 2005 pg.7

© 2006 Dr. James Howenstine - All Rights Reserved

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Dr. James A. Howenstine is a board certified specialist in internal medicine who spent 34 years caring for office and hospital patients. After 4 years of personal study he became convinced that natural products are safer, more effective, and less expensive than pharmaceutical drugs.

This research led to the publication of his book A Physicians Guide To Natural Health Products That Work. Information about these products and his book can be obtained from and at and phone 1-800-416-2806 U.S. Dr. Howenstine can be reached by mail at Dr. James Howenstine, C/O Remarsa USA SB 37, P.O. Box 25292, Miami, Fl. 33102-5292.










Essential amino acids can not be manufactured by the human body so they must appear in and be absorbed from food. When both essential amino acids and minerals are deficient it is common for patients to lack energy.