Study Ties Use of Common Heartburn and Ulcer Medication to Deficiency of Vitamin B12

A new study links commonly prescribed heartburn and ulcer medications to an increased risk of vitamin B12 deficiency that further elevates the risk of dementia and other medical complications.

The study, reported in the Journal of the American Medical Association, claims that long term use of commonly prescribed heartburn medications is associated with deficiency of vitamin B12. And if left untreated this deficiency elevates the risk of anemia, nerve damage, dementia and other serious medical complication, some which cannot be reversed. This is the first large population based study that associates vitamin B12 deficiency with acid suppressing medications.

The stomach acids help in the absorption of vitamin B12, and if these acids are suppressed, health threatening vitamin deficiency occurs. To proceed with the study, the researchers examined the electronic health records of almost 25,956 adult Kasier Permanente patients. These participants were diagnosed with vitamin B12 deficiency in Northern California between 1997 and 2011. They were later compared with 184,199 patients who didn't suffer from the deficiency in the same time period.

"Patients who took PPI medications for more than two years had a 65 percent increase in their risk of B12 deficiency," said Douglas A. Corley, MD, PhD, a gastroenterologist and research scientist with the Kaiser Permanente Division of Research. "Higher doses also were associated with an increased risk, compared with lower doses. Kaiser Permanente's electronic health records allowed us to look at what happens in the real world for these commonly used medications."

Though PPIs and a similar class of medication known as histamine 2 receptor agonists (H2RAs)are given by physicians, a few of them are easily accessible over the counter.

The researchers noticed that among the 25,956 patients who suffered from B12 deficiency, nearly 12 percent used PPS for almost two years compared to 7.2 percent in the control group. The impact of the daily dosage of H2Ra was less significant.

"This research raises the question of whether people who are taking acid-depressing medications long term should be screened for vitamin B12 deficiency," Dr. Corley said. "It's a relatively simple blood test, and vitamin supplements are an effective way of managing the vitamin deficiency, if it is found."

The study reports that in 2012, nearly 15 million people had taken 157 prescriptions for protein pump inhibitors- a class of anti acid medication.