Micronutrient Consequences of Long Term Proton Pump Inhibitor Therapy

Gastroesophageal reflux disease management and chronic use of proton pump inhibitors

“…Hypochlorhydria is suspected of causing most of the vitamin and mineral deficiencies attributed to chronic PPI use 20. The two most significant concerns are calcium and magnesium.…”

“…Magnesium levels depend on intestinal absorption (which can be reduced by PPIs) and renal excretion 20,23. Hypomagnesemia can cause dysrhythmias, muscle cramps, paresthesia, and increased risk of osteoporosis 20.…”

“…Vitamin and micronutrient deficiencies Hypochlorhydria is suspected of causing most of the vitamin and mineral deficiencies attributed to chronic PPI use. 20 The two most significant concerns are calcium and magnesium. Other possible deficiencies include iron, vitamin B12, and vitamin C. Data from studies are conflicting, but clinician awareness is essential.…”

“…18 Hypomagnesemia Magnesium levels depend on intestinal absorption (which can be reduced by PPIs) and renal excretion. 20,23 Hypomagnesemia can cause dysrhythmias, muscle cramps, paresthesia, and increased risk of osteoporosis. 20 Potential confounding factors include impaired renal function and diuretic use, which are known causes of hypomagnesemia.…”

“…20,23 Hypomagnesemia can cause dysrhythmias, muscle cramps, paresthesia, and increased risk of osteoporosis. 20 Potential confounding factors include impaired renal function and diuretic use, which are known causes of hypomagnesemia. 23 An association between PPIs and magnesium seems to exist but evidence about the relationship to duration of therapy in retrospective studies is insufficient, and no prospective controlled studies support causation.…”