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Popular heartburn drugs could rob you of this crucial vitamin

Kathleen Blanchard's picture

Results of an analysis finds a link between low levels of vitamin B12 and popular antacid medications. Drugs used to treat heartburn that are heavily marketed and readily available were linked to lower levels of vitamin B12 in a Kaiser Permanente study. The medications that are popular for treating gastric reflux have also been linked to other side effects that are still being scrutinized.

What are the GERD drugs?

Examples of the medications include Nexium, Prisolec, Prevacid, Zantac and Tagamet. Some of the medications reduce stomach acid by blocking histamine in the body (H2 blockers). Others work by inhibiting the stomach mechanism that produces stomach acid (PPIs or proton pump inhibitors).

In their analysis that is published in the Journal of the American Medical Association (JAMA), researchers found using the drugs for 2 years or more was associated with vitamin B12 deficiency.

The importance of the study is that vitamin B12 is vital for neurological function. Lower levels has also been linked to dementia.

Past studies link dangers of antacids

In May, 2010 five separate studies linked the GERD medications to potential health problems. The medications are generally considered safe, but the concern is they are often overused.

An accompanying editorial to the past studies stated 53 to 60 percent of heartburn drugs are prescribed inappropriately.

Chronic illnesses, taking aspirin and other blood thinners puts patients at risk for ulcers. The medications are useful for hospitalized patients, especially in the ICU who are prone to develop ulcers.

Among the findings were:

  • Higher risk of fracture from antacids for postmenopausal women
  • Recurrence of C. difficile infection from taking the drugs
  • There has also been a previous suggestion that the drugs could lower vitamin B12 levels.

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The new study

Jameson R. Lam, M.P.H., of Kaiser Permanente, Oakland, Calif., and colleague found 25,956 patients who had new diagnoses of vitamin B12 deficiency.

The odds of vitamin B12 deficiency were high among those taking anti-reflux medications. for two or more years and the association was stronger for people taking higher doses.

Vitamin B12 deficiency was also more strongly linked to women and children taking antacids long-term.

"We cannot completely exclude residual confounding [factors besides the drugs] as an explanation for these findings, but, at minimum, the use of these medications identifies a population at higher risk of B12 deficiency, independent of additional risk factors,” the authors concluded.

“These findings do not recommend against acid suppression for persons with clear indications for treatment, but clinicians should exercise appropriate vigilance when prescribing these medications and use the lowest possible effective dose. These findings should inform discussions contrasting the known benefits with the possible risks of using these medications.”

Foods that fight heartburn

Some foods can help fight heartburn naturally and include:

  • Ginger
  • High fiber foods like oatmeal and beans
  • Parsley
  • Rice
  • Oatmeal
  • Green leafy vegetables
  • Low fat meats like fish, turkey and chicken

If you have been taking acid reducing drugs for an extended period of time, speak with your doctor. Other strategies to reduce stomach acid include weight loss, sleeping with the head of your bed elevated, smoking cessation, avoiding coffee and spicy foods and taking antacids only when symptoms occur.

JAMA: doi:10.1001/jama.2013.280490

Image: Wikimedia Commons