Nutritionalert :: Minding the Pump - proton pump inhibitors and B12 status

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Minding the Pump - proton pump inhibitors and B12 status

by vtmnldy on Fri 11 Apr 2008 12:56 PM CDT | Permanent Link | Cosmos

In view of the truly astonishing number of people who are taking antacids, this research is of great importance: as we know, many elderly people are being diagnosed with mental deterioration, when a B12 deficiency should be suspected.

Keywords: HEARTBURN, ACID REFLUX, STOMACH ULCER - Vitamin B12, B12 Deficiency, Proton-Pump Inhibitors, PPI, Histamine(2) Receptor Antagonists, H2 Blockers

Reference: "Do Acid-lowering agents affect vitamin B12 status in older adults?" Dharmarajan TS, Norkus EP, et al, J Am Med Dir Assoc, 2008; 9(3): 162-7. (Address: Department of Medicine, Our Lady of Mercy Medical Center, Bronx, NY, USA. E-mail: dharmarajants@yahoo.com ).

Summary: In a cross-sectional study involving 659 elderly subjects, aged 60-102 years, results indicate that prolonged use of proton-pump inhibitors (PPI) may be associated with a significant decline in serum vitamin B12 levels. Patient demographics, serum B12 levels, use and duration of use of histamine(2) receptor antagonists (H2 blockers) and PPIs, and oral vitamin B12 supplementation were assessed. Acid-lowering agents (H2 blockers and PPIs) were used by 54% of the participants, where the average duration of use was 18.2 months. No association was observed between the use of H2 blockers and serum vitamin B12 levels. On the other hand, PPI use was associated with diminished vitamin B12 levels. Additionally, oral vitamin B12 supplementation (RDA) during PPI use was observed to slow the decline in B12 status, but not prevent it. Thus, the authors of this study conclude, "B12 status declines during prolonged PPI use in older adults, b ut not with prolonged H2 blocker use; supplementation with RDA amounts of B12 do not prevent this decline. This report reinforces that B12 deficiency is common in the elderly and suggests that it appears prudent to monitor periodically B12 status while on prolonged PPI use, to enable correction before complications ensue."