Can heartburn medicines keep me from having enough vitamin B-12?
Answer From Elizabeth Rajan, M.D.
Some studies have found a link between heartburn medicines and low vitamin B-12 levels. Not having enough vitamin B-12 is called vitamin B-12 deficiency.
Medicines to treat heartburn, also called gastroesophageal reflux disease (GERD), work by blocking stomach acid. Blocking stomach acid can keep the body from taking in vitamin B-12.
Why is this important? Vitamin B-12 deficiency can cause complications if it's not treated. These can include a condition in which the blood makes too few red blood cells, called anemia, and swelling of the tongue, called glossitis. Other complications include numbness and trouble walking.
Two common types of GERD medicines have been linked to vitamin B-12 deficiency:
- H-2-receptor blockers. These include cimetidine (Tagamet HB), famotidine (Pepcid AC) and ranitidine.
- Proton pump inhibitors. These include omeprazole (Prilosec), esomeprazole (Nexium) and lansoprazole (Prevacid).
Some studies have found that taking either type of medicine daily for a year or more increases the risk of vitamin B-12 deficiency.
If you're worried about your vitamin B-12 level, talk with your healthcare professional. If your B-12 level is low, ask if a lower dose of your GERD medicine might control your symptoms. And ask if you need to take a vitamin B-12 supplement.
With
Elizabeth Rajan, M.D.
Show References
- Dinesh D, et al. Association between acid-lowering agents, metformin, and vitamin B12 among Boston-area Puerto Ricans. The Journal of Nutrition. 2023; doi:10.1016/j.tjnut.2023.05.031.
- Means RT, et al. Causes and pathophysiology of vitamin B12 and folate deficiency. https://www.uptodate.com/contents/search. Accessed May 6, 2024.
- Choudhury A, et al. Vitamin B12 deficiency and the use of proton pump inhibitors: A systematic review and meta-analysis. Expert Review of Gastroenterology & Hepatology. 2023; doi:10.1080/17474124.2023.2204229.
- Swarnakari KM, et al. The effects of proton pump inhibitors in acid hypersecretion-induced vitamin B12 deficiency: A systematic review. Cureus. 2022; doi:10.7759/cureus.31672.
- Vitamin B-12 or folate deficiency anemia. National Health Service. https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/symptoms/. Accessed May 9, 2024.
Original article: https://www.mayoclinic.org/diseases-conditions/gerd/expert-answers/heartburn-meds-and-b12/faq-20348628