Proton pump inhibitors and B12 deficiency: What to do now

We can now add vitamin B12 deficiency to the growing list of risks of long term use of the proton pump inhibitors (PPIs). The New York Times had an article outlining the evidence that prolonged use of both proton pump inhibitors (PPIs) like Prilosec, Protonix, Prevacid and others, as well as the less potent H2 blockers like Zantac and Pepcid, can lead to vitamin B12 deficiency.  This is in addition to previously documented concerns about reduced calcium absorption that can lead to osteoporosis, increased risk of pneumonia and increased risk of Clostridium difficile colitis. It seems simple to ask patients to just stop their PPIs, but it’s not that easy. It can be hard to stop using a PPI due to rebound hyperacidity, a phenomenon where after using a PPI for as little as 2 months upon stopping the stomach produces more stomach acid than prior to using the drugs.  This tends to result in a big flare-up in the symptoms of heartburn or dyspepsia that prompted use of the drugs in the first place. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Family Physicians Tags: Meds GI Medications Source Type: blogs