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Acid-Reflux Drugs & Lower Levels of Vitamin B-12

Study found risk of deficiency rose with longer use, higher doses

WebMD News from HealthDay

By Serena Gordon

HealthDay Reporter

TUESDAY, Dec. 10, 2013 (HealthDay News) -- People who take certain acid-reflux medications might have an increased risk of vitamin B-12 deficiency, according to new research.

Taking proton pump inhibitors (PPIs) to ease the symptoms of excess stomach acid for more than two years was linked to a 65 percent increase in the risk of vitamin B-12 deficiency. Commonly used PPI brands include Prilosec, Nexium and Prevacid.

Researchers also found that using acid-suppressing drugs called histamine-2 receptor antagonists -- also known as H2 blockers -- for two years was associated with a 25 percent increase in the risk of B-12 deficiency. Common brands include Tagamet, Pepcid and Zantac.

"This study raises the question of whether or not people who are on long-term acid suppression need to be tested for vitamin B-12 deficiency," said study author Dr. Douglas Corley, a research scientist and gastroenterologist at Kaiser Permanente's division of research in Oakland, Calif.

Corley said, however, that these findings should be confirmed by another study. "It's hard to make a general clinical recommendation based on one study, even if it is a large study," he said.

Vitamin B-12 is an important nutrient that helps keep blood and nerve cells healthy, according to the U.S. Office of Dietary Supplements (ODS). It can be found naturally in meat, fish, poultry, eggs, milk and other dairy products. According to the ODS, between 1.5 percent and 15 percent of Americans are deficient in B-12.

Although most people get enough B-12 from their diet, some have trouble absorbing the vitamin efficiently. A deficiency of B-12 can cause tiredness, weakness, constipation and a loss of appetite. A more serious deficiency can cause balance problems, memory difficulties and nerve problems, such as numbness and tingling in the hands or feet.

Stomach acid is helpful in the absorption of B-12, Corley said, so it makes sense that taking medications that reduce the amount of stomach acid would decrease vitamin B-12 absorption.

More than 150 million prescriptions were written for PPIs in 2012, according to background information included in the study. Both types of medications also are available in lower doses over the counter.

Corley and his colleagues reviewed data on nearly 26,000 people who had been diagnosed with a vitamin B-12 deficiency and compared them to almost 185,000 people who didn't have a deficiency.

While 12 percent of people with a vitamin B-12 deficiency had taken PPIs for more than two years, 7.2 percent of those without a deficiency had taken the medications long-term.

Of those with a deficiency, 4.2 percent took an H2 blocker for two years or longer, while 3.2 percent of those without a deficiency took the drugs for two years or more.

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