Here’s another reason to be cautious about acid-suppressing drugs for heartburn: They may increase the risk of a vitamin B12 deficiency.
It’s well known that proton pump inhibitors (PPIs)—such as omeprazole (Prilosec) and esomeprazole (Nexium), many sold over the counter—can interfere with the absorption of some minerals, notably calcium and iron. Now, a large study in the Journal of the American Medical Association suggests that vitamin B12 should be added to the list.
It found that people diagnosed with a B12 deficiency were significantly more likely to have taken PPIs for at least two years than their counterparts without a deficiency. The risk was greater with higher doses.
Other heartburn drugs called H-2 blockers—such as ranitidine (Zantac) and famotidine (Pepcid)—were also linked to elevated risk, though less so.
This is not a surprising finding, since reducing stomach acid can lessen absorption of vitamin B12. If untreated, a deficiency can increase the risk of nerve damage, anemia, dementia and other complications.
Our advice: If you take these drugs regularly, discuss the potential risks with your health care provider, and ask about having your vitamin B12 level measured. Use the lowest dose of the drug that works for you, and try to taper off.