Association of Vitamin B12 deficiency with long-term PPIs use: A cohort study

Mumtaz, Hassan; Ghafoor, Bushra; Saghir, Hina; Tariq, Mariam; Dahar, Kashmala; Ali, Syed; Waheed, Syeda Tahira; Ahad, Syed Abdul

doi:10.1016/j.amsu.2022.104762

Cited by 19 publications

(7 citation statements)

References 25 publications

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“…Long-term PPI use has been linked to the emergence of vitamin B12 insufficiency, according to a single-center cohort study. 90 Moreover, an observational study showed that PPI users had a greater prevalence of vitamin B12 deficiency. 91 The use of PPIs is also linked to a rise of vitamin B12 deficiency, according to a meta-analysis of four case-control studies and one prospective cohort study.…”

Section: Adverse Effects-associated With Long-term Ppi Therapymentioning

confidence: 99%

Adverse Effects Associated with Long-Term Use of Proton Pump Inhibitors

Maideen¹

2023

Chonnam Med J

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Proton Pump Inhibitors are used widely to manage many gastric acid-related conditions such as gastroesophageal disease, gastritis, esophagitis, Barrett’s esophagus, Zollinger-Ellison syndrome, peptic ulcer disease, nonsteroidal anti-inflammatory drug-associated ulcers, and Helicobacter pylori eradication, around the globe. This review article focuses on adverse effects associated with the long-term use of proton pump inhibitors. Various observational studies, clinical trials, and meta-analyses have established the adverse effects associated with the long-term use of proton pump inhibitors including renal disorders (acute interstitial nephritis, acute kidney injury, chronic kidney disease, and end-stage renal disease), cardiovascular risks (major adverse cardiovascular events, myocardial infarction, stent thrombosis, and stroke), fractures, infections ( Clostridium difficile infection, community-acquired pneumonia, and Coronavirus disease 2019), micronutrient deficiencies (hypomagnesemia, anemia, vitamin B12 deficiency, hypocalcemia, hypokalemia), hypergastrinemia, cancers (gastric cancer, pancreatic cancer, colorectal cancer, hepatic cancer), hepatic encephalopathy, and dementia. Clinicians including prescribers and pharmacists should be aware of the adverse effects of taking proton pump inhibitors for an extended period of time. In addition, the patients taking proton pump inhibitors for long-term should be monitored for the listed adverse effects. The American Gastroenterological association recommends a few non-pharmacological measures and the use of histamine 2 blockers to lessen gastrointestinal symptoms of gastroesophageal reflex disease and the utilization of proton pump inhibitors treatment if there is a definitive indication. Additionally, the American Gastroenterological association’s Best Practice Advice statements emphasize deprescribing when there is no clear indication for proton pump inhibitors therapy.

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Section: Adverse Effects-associated With Long-term Ppi Therapymentioning

confidence: 99%

Adverse Effects Associated with Long-Term Use of Proton Pump Inhibitors

Maideen¹

2023

Chonnam Med J

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“…Zaobserwowano dodatkowo, że ta tendencja dotyczy głównie mężczyzn w wieku 18 i 40 lat i jest bardziej nasilona podczas stosowania omeprazolu w porównaniu z pantoprazolem. 37 W tym przeglądzie stwierdzono natomiast, że pacjenci stosujący IPP przez ponad 2 lata charakteryzują się 65 % większym ryzykiem niedoboru witaminy B12. 38 Z kolei w obszernej analizie przekrojowej, obejmującej prawie 26 tys.…”

Section: Ipp a Witamina B12unclassified

Do the benefits outweigh the risks? Potential dangers associated with long-term therapy of proton pump inhibitors

WOLANIN

ZIELONKA

DENGLER

et al. 2023

J Educ Health Sport

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Introduction:Proton pump inhibitors (PPIs) are one of the most popular and also one of the most commonly prescribed medications worldwide. In many conditions associated with excessive secretion of hydrochloric acid in the stomach, they are the first-line treatment. When they are used in a balanced manner in strict indications, they have a high level of efficacy and a favorable safety profile. The low rate of side effects refers mainly to their short-term use. With the over-the-counter availability of PPIs, increasing dangerous trend of their abuse has provided new evidence suggesting the presence of numerous, more serious side effects of long-term PPI therapy. Purpose:The purpose of this review is to summarize current reports regarding the potential risks and causal relationship of adverse effects occurring as a consequence of long-term use of proton pump inhibitors. Material and methods:This literature review based on the available scientific literature, published between 2015 and 2023 in the Pubmed database, searched using the terms, listed under "keywords”. Conclusion:PPIs are relatively safe drugs. However, they are not completely free of side effects. There are a lot of reports suggesting a potential connection between their long-term use and the development of complications, such as: various infections, decreased absorption of nutrients, kidney disease, liver disease, pancreatic disease, musculoskeletal disease, nervous system disease, cardiovascular disease, dementia, hypergastrinemia and even cancer. However, some of them are fraught with errors, and another often provide contradictory results. More precisely designed studies are needed to draw clear conclusions, especially in view of the ever-increasing abuse of PPIs worldwide. It is worth noting that patients with strictly defined indications for long-term PPI therapy, may benefit significantly outweighing the potential dangers.

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“…Hyperhomocysteinemia and dementia are associated with VitB12 de ciency [12] . The potential reasons for VitB12 de ciency include malnutrition; malabsorption; genetic changes in the way that VitB12 is transported in the blood, cellular uptake, or metabolic route [13] ; autoimmune diseases or pernicious anemia [9] ; and some medications such as proton pump inhibitors [14] and metformin [15] .…”

Section: Introductionmentioning

confidence: 99%

Effect of metformin on vitamin B12 and homocysteine levels among Sudanese with type 2 diabetes mellitus

Al-Ghaili,

tayrab

2024

Preprint

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Background: Metformin is the first-line treatment for type 2 diabetes mellitus (T2DM), and hyperglycemia. When taken in high doses or for an extended period, metformin may decrease vitamin B12 (VitB12) level and may increase homocysteine (Hcy) level. There has been no research conducted in Sudan to determine whether metformin has an impact on VitB12 and Hcy levels in individuals withT2DM. The aim of this research is to investigate the effect of metformin on VitB12 and Hcy levels among Sudanese with T2DM. Methods: This cross-sectional study included 98 Sudanese with T2DM who had been taking metformin for at least a year. Data analysis was carried out using SPSS V-26. Results: This study found that 1 patient (1%) had a VitB12 deficiency (< 180 pg/mL), 52 (53.1%) subjects had a normal VitB12 level (180 - 900 pg/mL), and 45 (45.9%) subjects had VitB12 ≥ 900 pg/mL. One patient (2.9%) had an Hcy deficiency (< 3µmol/l) and 34 (97.1%) subjects had a normal Hcy level (3–15 µmol/L). The study showed a, significant negative correlation between VitB12 and vitamin supplements (P = 0.003) and metformin combined with insulin (P = 0.000). Although that belongs to the subgroup that took vitamin supplements, there was a significant positive correlation between VitB12 and metformin alone (P = 0.006) and a significant negative association with metformin combined with insulin (P = 0.000). In the subgroup that did not take vitamin supplements, there was a significant positive correlation between VitB12 and FBS (P = 0.001). There was an insignificant correlation between VitB12 and the metformin dose and use duration. The correlation between VitB12 and Hcy levels was insignificant in the entire group and in both subgroups. The correlation between Hcy levels and metformin use duration was significantly negative (P = 0.015), but the correlation between Hcy levels and metformin dose was insignificant. Conclusions: In Sudanese with T2DM and under metformin treatment, serum VitB12 level was positively and significantly correlated with DM duration and (FBS), was significantly and negatively correlated with vitamin supplements. On the conversely, serum homocysteine (Hcy) levels significantly decreased with metformin use duration.

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Association of Vitamin B12 deficiency with long-term PPIs use: A cohort study

Cited by 19 publications

References 25 publications

Adverse Effects Associated with Long-Term Use of Proton Pump Inhibitors

Adverse Effects Associated with Long-Term Use of Proton Pump Inhibitors

Do the benefits outweigh the risks? Potential dangers associated with long-term therapy of proton pump inhibitors

Effect of metformin on vitamin B12 and homocysteine levels among Sudanese with type 2 diabetes mellitus

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