GERD Meds Up Risk of B12 Deficiency

The original article can be found in: MedPage Today  By Cole Petrochko

Patients taking prescription anti-reflux medications had significantly higher odds of a vitamin B12 deficiency, researchers found. Among patients diagnosed with a vitamin B12deficiency, a 2 or more years’ prescription for proton pump inhibitors (OR 1.65, 95% CI 1.58-1.73) or histamine 2 receptor antagonists (OR 1.25, 95% CI 1.17-1.34) was significantly associated with risk for the deficiency, according to Douglas Corley, MD, PhD, of Kaiser Permanente in Oakland, Calif., and colleagues.

Patients who received more than 1.5 pills daily of proton pump inhibitors had significantly greater vitamin B12 deficiency than those who received doses smaller than 0.75 pills per day (P=0.007 for interaction), they wrote online in the Journal of the American Medical AssociationVitamin B12 deficiency can have a detrimental impact across cognitive function in older patients, while long-term — across years — use of proton pump inhibitors have been associated with osteoporotic fracture risks. 

The authors noted that other gastric acid suppressants can lead to malabsorption of vitamin B12, though prior research has not evaluated the impact of long-term exposure. To test this, they conducted a nested case-control study of 25,956 patients with an incident diagnoses of vitamin B12 deficiency at a single center and compared that group with 184,199 control patients who were not deficient.

Patients were all adults, were members of the Kaiser Permanente Northern California integrated healthcare system for at least 1 year, and had a diagnosis of vitamin B12 deficiency at baseline. Deficiency was defined as diagnostic coding for deficiency in the International Classification of Diseases, Ninth Revision as pernicious anemia, other vitamin B12 deficiency anemia, center-specified vitamin B12deficiency, or specific text diagnoses, as well as an abnormally low serum measure or a new and at least 6-month supply of injectable supplements.




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