Prolonged acid suppression therapy with PPIs or H2 blockers may result in serum vitamin B12 deficiency. - GreenMedInfo Summary
Effect of long-term acid suppression therapy with proton pump inhibitors or Hreceptor blockers on serum vitamin Blevels in elderly population.
Ir J Med Sci. 2020 Oct 21. Epub 2020 Oct 21. PMID: 33085017
Srinivasan Damodharan
BACKGROUND: Long-term usage of acid suppression drugs like proton pump inhibitors (PPIs) or Hreceptor blockers in the elderly population has been found to result in vitamin Bdeficiency. However, the reports are equivocal.
OBJECTIVE: To determine the serum vitamin Blevels in elderly patients under chronic acid suppression therapy.
METHODS: Patients aged above 60 years and on any of the PPIs or Hblockers for at least 6 months were recruited. Out of 77 patients recruited, 60 patients were included for the final analysis. The serum vitamin Blevels were measured using the AccuDiag™-Vitamin B12 ELISA system.
RESULTS: Out of 60 patients, pantoprazole (40%) and omeprazole (37%) were the commonly prescribed acid-suppressing drugs. Nearly 50% of the patients on prolonged acid suppression therapy were either"deficient"(less than 200 pg/ml) or"insufficient"(200 to 300 pg/ml) in serum vitamin Blevels. Neither the average serum vitamin Blevels (p = 0.994) nor the vitamin Bstatus (p = 0.226) varied significantly across the drug groups of pantoprazole, omeprazole, and ranitidine.
CONCLUSIONS: Prolonged acid suppression therapy with PPIs or Hblockers may result in serum vitamin Bdeficiency. However, there was no class (PPIs vs. Hreceptor blockers)- or drug (pantoprazole vs. omeprazole vs. ranitidine)-based differences found in the vitamin Bdeficiency caused.