Ulcer medications - proton pump inhibitors
Vitamin B12 (Cobalamin)
Symptoms of vitamin B12 deficiency are rare because it takes years to develop complications associated with long-term depletion of this nutrient. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with vitamin B12 deficiency. Low levels of this vitamin may also be associated with an increased risk of colon cancer, heart disease, brain disorders, and birth defects.
Vitamin D deficiency leads to abnormal bone formation (rickets) in children and softening of the bones (osteomalacia) in adults. Vitamin D deficiency interferes with calcium absorption, leading to deficiency of that nutrient, as well as the associated symptoms, such as increased risk of fractures, osteoporosis (bone loss), and muscle weakness. More recently, vitamin D deficiency has been linked to compromised immunity, cancer, and other chronic conditions. Because this nutrient is fat soluble, prolonged periods of deficiency are required to produce these symptoms. Speak to your doctor about testing your vitamin D levels.
The information presented here covers some of the nutrients that may be affected when you take certain medications. If you have the signs and symptoms listed, it doesn't always mean you have low levels of these nutrients. Many things affect the level of nutrients, including your medical history, diet, and lifestyle, as well as how long you have been taking the medication. Please talk with your health care provider. He or she can best address your health care needs to determine whether you are at risk for low levels of any nutrients.
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Howden CW. Vitamin B12 levels during prolonged treatment with proton pump inhibitors. J Clin Gastroenterol. 2000;30:29-33.
Mitchell SL, Rockwood K. The association between antiulcer medication and initiation of cobalamin replacement in older persons. J Clin Epidemiol. 2001;54:531-4.
Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH: LexiComp, Inc.;2001:489-491.
Ruscin JM, Page RL 2nd, Valuck RJ. Vitamin B(12) deficiency associated with histamine(2)-receptor antagonists and a proton-pump inhibitor. Ann Pharmacother. 2002;36:812-6.
van Orten-Luiten AC, Janse A, Dhonukshe-Rutten RA, Witkamp RF. The association between drugs frequently used by the elderly and vitamin D blood levels: a review of observational and experimental studies. Drugs Aging. 2014;31: 111-123.
- Last reviewed on 9/21/2014
- Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M. Editorial team.
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