Heartburn medicine may cause vitamin B12 deficiency

New study on acid-suppressing medication released


Medications taken for things like heartburn, GERD or ulcers reduce the amount of acid in the stomach.  But a new study is linking them to deficiencies in vitamin B12, too.

"It requires an acidic stomach to properly absorb vitamin B12. These medications block acid production and therefore, they're going to take the PH in the stomach up so you no longer have as much acid in your stomach and that inhibits proper absorption of vitamin B12," explained Dr. Brian Kirsh, who did not take part in the study but treats patients at Cleveland Clinic.

Kaiser Permanente researchers studied nearly 26,000 people who were vitamin B12 deficient and compared them to more than 184,000 people without B12 deficiency.

They found that among those with a new diagnosis of vitamin B12 deficiency, 12 percent were dispensed a two or more years supply of proton pump inhibitors, which are acid-reducing medications typically prescribed to treat things like heartburn or acid-reflux.

Another four percent were given a two or more years supply of histamine 2 receptor antagonists, which treat ulcers.

Researchers say the findings should not deter doctors from giving patients the medicine they need, but recommend vigilance when prescribing and using the lowest possible effective dose. Kirsh agrees.

"There needs to be a diligence in evaluating your patient saying is it time to stop? Is it time to change to something else? Do you really need this medication long-term?  Because clearly this is a long-term complication," said Kirsh. "People who get occasional heartburn or go on and off these medications are not likely to get these complications."

Complete findings for this study are available in the Journal of the American Medical Association.