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Heartburn medicines and B-12 deficiency

Acid-controlling medications may do more than prevent heartburn. They may also interfere with vitamin B-12 absorption.

Question: Can heartburn drugs lead to vitamin B-12 deficiency?

Answer Section

Some studies have found an association between heartburn medications and increased risk of vitamin B-12 deficiency.

Medicines to treat heartburn, also called gastroesophageal reflux disease (GERD), work by suppressing stomach acid. Blocking stomach acid and other secretions may also block B-12 absorption.

Why is this important? Vitamin B-12 deficiency has potentially serious and sometimes irreversible complications if undiagnosed and untreated. These can include dementia, disorientation, neurological damage, gait disturbance and anemia.

Two common types of GERD medicines have been associated with B-12 deficiency to varying degrees:

  • H-2-receptor blockers. Examples include cimetidine, famotidine and ranitidine.
  • Proton pump inhibitors. Examples include omeprazole, esomeprazole and lansoprazole.

With either type of medication, the risk of B-12 deficiency was significantly increased when taken daily for two years or more.

If you're concerned about your vitamin B-12 level, talk with your doctor. If low B-12 is an issue, ask if a lower dose of your medicine would be effective in controlling your symptoms or whether you should take a vitamin B-12 supplement.

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