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April 11, 2008
Minding the Pump - proton pump inhibitors and B12 status
by
vtmnldy
on Fri 11 Apr 2008 12:56 PM CDT
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." |
B12 Status Declines during Prolonged Use of Proton-Pump Inhibitors (Acid-Lowering Agent)
The liquid B12 (Methylcobalamin) I personally use and recommend.
The Vitamin Lady writes about helping indigestion naturally
D pain, Boss - D Pain!
by
vtmnldy
on Fri 11 Apr 2008 10:32 AM CDT
The Institute for Functional Medicine, always an excellent source of information, can be reached and supported here.
Can Low Vitamin D Cause Pain?
Clearly yes. One study showed that 93% of persons 10-65 years of age who were admitted to a hospital emergency department with muscle aches and bone pain--and who had a wide variety of diagnoses, including Fibromyalgia, chronic fatigue syndrome, and depression--were deficient in vitamin D.1
A second study confirmed a strong correlation between low serum 25-hydroxyvitamin D (25[OH]D) levels in the blood and higher rates and longer duration of generalized bone and/or muscle aches and pains.2
A third study looked at chronic pain patients at a tertiary care pain clinic. They documented that those patients with serum 25-hydroxyvitamin D levels </=20 ng/mL used almost twice as much morphine, were on opioid medications almost twice as long and generally were in more pain then those with higher vitamin D levels.3
Understanding the antecedents, triggers and mediators of pain is one of the most important things a clinician can do to help their patients. The origins, manifestations and treatment of pain cuts across disciplines and organ systems. Appreciating the underlying pain processes from a functional medicine perspective allows the clinician to better treat a variety of pain disorders.
1. Holick MF. Vitamin D deficiency. N Engl J Med. Jul 19 2007;357(3):266-281.
2. Erkal MZ, Wilde J, Bilgin Y, et al. High prevalence of vitamin D deficiency, secondary hyperparathyroidism and generalized bone pain in Turkish immigrants in Germany: identification of risk factors. Osteoporos Int. 2006;17(8):1133-1140.
3. Turner MK, Hooten WM, Schmidt JE, Kerkvliet JL, Townsend CO, Bruce BK. Prevalence and Clinical Correlates of Vitamin D Inadequacy among Patients with Chronic Pain. Pain Med. Mar 11 2008.
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