Study: Vitamin B12 deficiency due to acid blockers



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Acid blockers may cause vitamin deficiency
11.12.2013

Medications such as omeprazole and pantoprazole are prescribed to prevent gastric and duodenal ulcers, for example, or to treat reflux disease. The so-called "proton pump inhibitors" (or "acid blockers") are actually supposed to protect the stomach by suppressing the formation of stomach acid. Apparently there is also a flip side to the coin, because scientists have now found that the drugs cause a vitamin B12 deficiency and could even lead to psychosis and dementia.

Use for stomach ulcers or heartburn Whether omeprazole, pantoprazole or lansoprazole: so-called "proton pump inhibitors" are among the top-selling drugs worldwide and are used for the treatment or prophylaxis of gastric and duodenal ulcers or for heartburn. The medicines are actually considered to be "gastric protectors" because they ensure that a certain enzyme in the parietal cells of the stomach (proton-potassium pump) is inhibited and thereby the formation of stomach acid is suppressed.

Concentration disorders and anemia due to vitamin B12 deficiency However, US scientists have now found that in the long run the drugs may do more harm than they help. Because if they are taken over a longer period of time, they can apparently lead to a lack of vitamin B12, which manifests itself in, among other things, problems with concentration, anemia and severe exhaustion, and there is also evidence of an increased risk of dementia and psychosis.

US researchers investigate causes of vitamin deficiency The research team led by Jameson Lam and Douglas Corley from the "Kaiser Permanente Division of Research" in Oakland had investigated in a current study what could cause a deficiency in vitamin B12 - which is the first Line is found in animal foods such as meat, fish, eggs or dairy products and is involved in the breakdown of fatty acids and blood formation, among other things. The researchers came to the conclusion that twelve percent of the more than 25,000 patients whose vitamin B12 levels were too low regularly took “gastric protectors” - it was evident that the risk of a vitamin deficiency was the higher the more the more patients took of the drug: "Those who took the medication for more than two years increased their risk of vitamin B12 deficiency by 65 percent," said Douglas Corley in the report on the study in the "Journal of the American Medical Association" ( JAMA).

Prescription boom in proton pump inhibitors On the other hand, patients who took antihistamines (also histamine receptor blockers) such as ranitidine, famotidine or cimetidine for the treatment of allergies or gastric mucosal inflammation showed a lower risk of vitamin B12 deficiency. But compared to proton pump inhibitors, the proportion of these stomach drugs is low and has also been declining for years. The proton pump inhibitors, on the other hand, are experiencing a veritable prescription boom, which is viewed with skepticism by the US researchers: “Although the reflux disease has increased in the industrialized nations, it has certainly not been four-fold in the past ten years to increase this continuous increase in the prescription to explain."

Prescription of medication should be checked carefully for every patient "The use of previous and current gastric acid inhibitors could be significantly associated with the presence of a vitamin B12 deficiency. These findings should be considered when weighing the risks and benefits of using these drugs, ”the authors recommend.

So taking omeprazole, pantoprazole and similar medicines may be helpful in some cases - but with regard to the possible side effects, you should look carefully at each individual patient and not be prescribed automatically for every heartburn, acid regurgitation or other clinical pictures.

According to the AOK Scientific Institute (WIdO), almost 3 billion daily doses of these funds were recorded in 2012 in Germany alone. “Proton pump inhibitor prescriptions have increased four-fold in the past 10 years. […] In the absence of other therapeutic concepts, proton pump inhibitors are presumably also used for the very common irritable stomach syndrome, although there is almost no scientific evidence for this indication, ”says Joachim Rössner in the Pharmaceutical Ordinance Report 2013. (nr)

Image: Sigrid Rossmann / pixelio.de

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