Increased Vitamin B<sub>12</sub> Requirement Associated with Chronic Acid Suppression Therapy

Force, Rex W.; Meeker, Angela D; Cady, Paul S.; Culbertson, Vaughn L.; Force, Wendy S; Kelley, Craig M

doi:10.1345/aph.1c037

Cited by 45 publications

(41 citation statements)

References 12 publications

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“…The mechanism of the reduced vitamin B 12 levels in these patients may have been primarily related to sustained achlorhydria producing a reduction in acid-mediated extraction of protein-bound cobalamin [45,46]. In past studies, investigators have reported slight reductions in median serum vitamin B 12 levels; however, the patients enrolled were predominantly elderly and/or those with Zollinger-Ellison syndrome who received high-dose PPI therapy.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Proton Pump Inhibitor Use in Children: A Retrospective Review of Safety

Tolia

Boyer

2007

Dig Dis Sci

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The objective of this work was to assess the efficacy of continuous proton pump inhibitor (PPI) therapy in children and to evaluate changes in biochemical, endoscopic, and histologic parameters during such treatment. A retrospective review of children receiving PPI therapy continuously for 1 year or more with baseline and follow-up esophageal and gastric biopsies on treatment was conducted to assess type, frequency, and duration of PPI dosing, symptom relief, gastrin levels, histologic findings, and adverse events. A total of 113 children (59 male, median age 4.5 years) were identified. Of these, 31% (35/113) were neurologically impaired. The median treatment duration was 35.2 months. Elevated serum gastrin levels occurred in 73% of children with no statistically significant differences in gastrin level by PPI type, dose, and dosing frequency or treatment duration. Adverse events were reported by 12% of children: diarrhea (5%) and constipation (4%) were the most frequent. Long-term PPI therapy appears to be effective, safe and well tolerated in children despite some biochemical, endoscopic, and histologic changes.

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Section: Discussionmentioning

confidence: 99%

Long-Term Proton Pump Inhibitor Use in Children: A Retrospective Review of Safety

Tolia

Boyer

2007

Dig Dis Sci

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“…Two older case control studies which also deal with this subject are included in Table 1 [22,41]. In a case control study in 2004 (Table 1)[22] in a geriatric population(≥65 years) the usage of H2R/PPIs and a number of other variables were compared in 53 patients with vitamin B12 deficiency to 212 controls (matched for age, gender, multivitamin use, frequency of Helicobacter pylori infection).…”

Section: Long-term Use Of Ppis and Effects On Vitamin B12(vb12) Amentioning

confidence: 99%

Association of Long-Term Proton Pump Inhibitor Therapy with Bone Fractures and Effects on Absorption of Calcium, Vitamin B12, Iron, and Magnesium

Ito

Jensen

2010

Curr Gastroenterol Rep

271

211

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Proton pump inhibitors (PPI) are now one of the most widely used classes of drugs. PPIs have proven to have a very favorable safety profile and it is unusual for a patient to stop these drugs because of side effects. However, increasing numbers of patients are chronically taking PPIs for gastroesophageal reflux disease and a number of other common persistent conditions, therefore the long-term potential adverse effects are receiving increasing attention. One area that is receiving much attention and generally has been poorly studied, is the long-term effects of chronic acid suppression on the absorption of vitamins and nutrients. This area has received increased attention because of the reported potential adverse effect of chronic PPI treatment leading to an increased occurrence of bone fractures. This has led to an increased examination of the effects of PPIs on calcium absorption/metabolism as well as numerous cohort, case control and prospective studies of their ability to affect bone density and cause bone fractures. In this article these studies are systematically examined, as well as the studies of the effects of chronic PPI usage on VB12, iron and magnesium absorption. In general the studies in each of thee areas have led to differing conclusions, but when examined systematically, a number of the studies are showing consistent results that support the conclusion that long-term adverse effects on these processes can have important clinical implications.

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“…Defi nitions of vitamin B 12 defi ciency and use of acid suppression were limited in this analysis. Other retrospective series have linked acid suppression use with greater cobalamin supplementation by primary care physicians [ 29 ]. Additional data on this topic are limited to case reports and physiologic experiments [ 24 ].…”

Section: Cobalamin Malabsorptionmentioning

confidence: 99%

Potential adverse effects of proton pump inhibitors

Coté¹,

Howden

2008

Curr Gastroenterol Rep

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Proton pump inhibitors (PPIs) have revolutionized the management of gastroesophageal reflux disease and peptic ulcer disease over the past two decades. Among the most commonly prescribed agents worldwide, PPIs' overall safety profile is unquestionable. However, emerging evidence indicates that PPI therapy, particularly with long-term and/or high-dose administration, is associated with several potential adverse effects, including enteric infections (eg, Clostridium difficile), community-acquired pneumonia, and hip fracture, all of which have received much attention recently. We review the current data on these and other potential consequences of PPI therapy. More judicious use of PPIs (eg, administering them in no more than the minimum effective dose to older adult patients) may help to further limit the impact of some of these possible adverse effects.

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Increased Vitamin B₁₂ Requirement Associated with Chronic Acid Suppression Therapy

Abstract: Initiation of vitamin B(12) supplementation was associated with chronic gastric acid suppression therapy.

Cited by 45 publications

References 12 publications

Long-Term Proton Pump Inhibitor Use in Children: A Retrospective Review of Safety

Long-Term Proton Pump Inhibitor Use in Children: A Retrospective Review of Safety

Association of Long-Term Proton Pump Inhibitor Therapy with Bone Fractures and Effects on Absorption of Calcium, Vitamin B12, Iron, and Magnesium

Potential adverse effects of proton pump inhibitors

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Increased Vitamin B12 Requirement Associated with Chronic Acid Suppression Therapy

Abstract: Initiation of vitamin B(12) supplementation was associated with chronic gastric acid suppression therapy.

Cited by 45 publications

References 12 publications

Long-Term Proton Pump Inhibitor Use in Children: A Retrospective Review of Safety

Long-Term Proton Pump Inhibitor Use in Children: A Retrospective Review of Safety

Association of Long-Term Proton Pump Inhibitor Therapy with Bone Fractures and Effects on Absorption of Calcium, Vitamin B12, Iron, and Magnesium

Potential adverse effects of proton pump inhibitors

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Product

Resources

About

Increased Vitamin B₁₂ Requirement Associated with Chronic Acid Suppression Therapy