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Study: Stomach Acid Drugs May Increase Risk of Vitamin B12 Deficiency

Authors point finger at PPIs and H2RAs (December 11)

Researchers at Kaiser Permanente in Oakland, California, have found that individuals with vitamin B12 deficiency were more likely to be receiving proton pump inhibitors (PPIs) and histamine 2 receptor antagonists (H2RAs) compared with those not diagnosed with the condition. The new findings were published in the Dec. 11 issue of JAMA.

PPIs and H2RAs are commonly used to treat stomach acid disorders, such gastroesophageal reflux disease (GERD) and peptic ulcers.

The researchers evaluated the association between vitamin B12 deficiency and the prior use of acid-suppressing medications using a case–control study within the Kaiser Permanente Northern California population. They compared 25,956 patients diagnosed with vitamin B12 deficiency between January 1997 and June 2011 with 184,199 patients without vitamin B12 deficiency.

Among those who were vitamin B12-deficient, 12.0% had been receiving PPIs for at least 2 years and 4.2% had received H2RAs for an equally long period.

By comparison, among individuals without B12 deficiency, 7.2% had been treated with PPIs for 2 or more years, and 3.2% had been treated with H2RAs long-term.

In addition, higher doses of PPIs (more than 1.5 pills per day) were more strongly associated with vitamin B12 deficiency than were lower doses (fewer than 0.75 pills per day) (P = 0.007 for interaction).

The authors concluded that clinicians should consider their findings when balancing the risks and benefits of using these medications.

Sources: JAMA; December 11, 2013; and Reuters; December 10, 2013.

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