Are you taking proton pump inhibitors (PPIs) for acid reflux, indigestion, or other digestive issues?
In this video we're going to look at the impact of proton pump inhibitors on vitamin B12 deficiency, how it comes about, how prevalent it is, how long you need to take PPIs in order for this to happen, and other things you should be looking at with regard to proton pump inhibitors and vitamin B12 deficiency.
Reference: www.sciencedirect.com/science....
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This video, we want to look at proton pump inhibitors (PPIs) and vitamin B12 deficiency. PPIs are a class of medications used to treat gastroesophageal reflux disease (GERD) and other conditions that involve too much stomach acid. They work by blocking the production of stomach acid, which can in some cases help relieve symptoms such as heartburn, reflux, nausea, and burning in the stomach and esophagus.
While there are some benefits to PPIs, they do come with costs. One of the costs is a reduction in the body's ability to break down and absorb certain foods and nutrients, including vitamin B12. Vitamin B12 is an essential nutrient that is important for various functions in the body, including red blood cell production, nerve function, and even DNA synthesis.
Vitamin B12 is absorbed in the small intestine, but in order for it to be absorbed, you need enough intrinsic factor. Intrinsic factor is a protein produced in the stomach that helps to bind to vitamin B12 and facilitate its absorption. PPIs reduce the amount of stomach acid, which also reduces the production of intrinsic factor. This can lead to a decrease in vitamin B12 absorption.
The amount of vitamin B12 absorption that is decreased depends on which PPI you are taking and the dose. Generally speaking, PPIs reduce the amount of hydrochloric acid by 60 to 80%.
A study published in the Journal of Gastroenterology in 2010 found that people who took PPIs for two years or more were more likely to have low levels of vitamin B12 than people who did not take PPIs. The risk for vitamin B12 deficiency was even higher in people over the age of 65.
This is likely because as we get older, we produce less hydrochloric acid and intrinsic factor. PPIs don't shut off hydrochloric acid and intrinsic factor completely, but they do reduce it by about 70%. Other acid blockers will reduce it by less than that. So in this particular study, vitamin B12 deficiency was defined as a serum vitamin B12 level of less than 100 picograms per milliliter (pg/mL). This is much lower than most lab cutoffs. And keep in mind that even having a serum B12 of less than 450 pg/mL could still be enough to cause insufficient vitamin B12 levels in your body, to where you start having manifestations, symptoms, or problems or pathologies from not enough B12, like numbness, tingling, feeling unbalanced, and things like that. So if you get to a hundred, there's a good chance that you'll be having some negative consequences, repercussions from this, probably at minimum fatigue, maybe even some memory impairment. It really depends on other factors as well.
That same study found that people who took PPIs for two years or more were more likely to have serum B12 levels at or below that 100 pg/mL cutoff, compared to people that didn't take PPIs at all. In other words, for every hundred people that took PPIs, 75 of them were going to have that 100 pg/mL or less. So they didn't necessarily say what it was like at one year or six months, three months, but it's definitely going down. As soon as you start taking them, the longer you're on it, the more potential for problems.
Some people definitely do need to take these medications for the short term and sometimes even long term. If you're taking them over the long term, you could say, "Well, I'll just supplement B12." But you're also more likely to develop something called atrophic gastritis, just meaning that your body's decreasing the production of hydrochloric acid and the intrinsic factor. So what do you do?
Well, if you're on PPIs or any type of acid blocker, definitely want to have your B12 level checked on a somewhat regular basis. You may even want to do some more advanced testing like methylmalonic acid and homocysteine levels to make sure that the intracellular B12 is high enough.
24 июл 2024
