Vitamins and Antacids are not Good Friends

[The Pard]

Anyone who is taking Antacids or PPIs to reduce stomach acidity for a prolonged period of time
would be wise to supplement their Vitamin intake with more than is taken with normal food intake.
Stomach acid is a required chemical for the conversion and absorbtion of vitamins, minerals and nutrients. B12, folic acid, calcium, iron,
and most other important elements need to be
part of your diet and supplementing your diet with
higher than normal amounts IS WISE when you are
taking anything which compromises absorbtion or
after gastric surgery which has affected your ability to absorb nature's nutients.

When the diet is restricted for any reason the available vitamins in food are also restricted.
When you are on PPI or antacids for longer than
a few days or weeks you need Vitamin and Mineral supplementation. If your Gastro didn't mention this, make sure to ask for his opinion and don't risk nerve damage or other complications.
It is too bad that the doc often has to be reminded of this.

This topic was covered on the Dr Mirkin radio
show that I heard on rebroadcast on Feb 22/03.

The Pard

[Sandi]

What exactly is nerve damage? Is it very probable that people that take PPI's for a long time could have it ?

Thanks,

Sandi

[The Pard]

Hi Sandi,

When the body is not absorbing B12 nerves can be
affected and damagged permanently.

The body has built in warnings to us, like when your arm falls asleep from lying on it. If you didn't roll over the damage could become permanent. Pins and needles are a warning.
Numbness, burning, tingling and itching are
common warnings of something going wrong. These signs need to be heeded if they persist.
If you have such signs, a visit to a neurologist
is often wise.

Diabetes, a low thyroid, shingles, a virus like
Epstein Barr, MS, etc can also be causes.

The Pard

[Sandi]

Thanks,

I think I am ok. Am taking B-12. I am glad I know the signs now.

Sandi

[daw]

This is true. One of the possible side effects of long term PPI/H2 Blocker use is Pernicious Anemia which is caused by the stomach not seceting enough intrinsic factor to ensure intestinal absorption of Vit. B12. This is due to atrophy of the glandular mucosa of the fundus of the stomach and is associated with the absence of hydrochloric acid. Intramuscular injections of Vit. B12 is the usual treatment for Pernicious Anemia.

The question is: Will taking oral suppliments of Vit. B12 while on PPIs stave off this possible future illness or only mask the problem until it get worse?

[af]

Originally posted by daw
This is true. One of the possible side effects of long term PPI/H2 Blocker use is Pernicious Anemia which is caused by the stomach not seceting enough intrinsic factor to ensure intestinal absorption of Vit. B12. This is due to atrophy of the glandular mucosa of the fundus of the stomach and is associated with the absence of hydrochloric acid. Intramuscular injections of Vit. B12 is the usual treatment for Pernicious Anemia.

The question is: Will taking oral suppliments of Vit. B12 while on PPIs stave off this possible future illness or only mask the problem until it get worse?

You can also get sublingual forms of B-12 to take, which bypasses the stomach route, but avoids an injection. Do a search on the internet and find it easily. If you think you may have B-12 deficiency, this is the way to go. However, please note that B-12 deficiency is pretty rare, even with chronic PPI usage.

[stacybrevin]

Question? I was on aciphex for 3 months for LPR and I became pregnant for the third time. I have been on zantac and I have noticed a tongue swelling with teeth marks in it. I realize it could be lack of B12. I am taking prenatal vit. I am going to get a blood test to see if I am low. Has anyone ever heard of this?

[The Pard]

Hi Stacey,

If you are taking B12 in any form it will prevent an accurate reading and may hide a low level.

Stay off the B12 supplement for a week or so and let the doc know that you were taking it before being tested.

http://www.drmirkin.com/archive/6972.html
http://www.drmirkin.com/archive/6319.html

The Pard