Study: Long-Term Use of Antacids Can Interfere with Vitamin B12 Absorption

by Dorian Martin Patient Advocate

My 88-year-old father continually wakes up in the middle of the night with heartburn and takes a swig (or two) of the liquid antacid that he keeps by the side of the bed. I swear, I don't think it's my cooking. He'll have discomfort on the days we bring in from local restaurants. I've never really worried about his antacid use, but a new study has found that some types of this medication can mess with a critical vitamin that our body needs.

Researchers out of Kaiser Permanente looked at the association between use of proton pump inhibitors (such as Prilosec, Prevacid and Nexium) as well as histamine 2 receptor antagonists (such as Tagamet and Zantac) and deficiencies in vitamin B12. The study involved 25,956 patients who had been diagnosed with a deficiency of vitamin B12 between January 1997 and June 2011 as well as 184,199 patients who did not have this vitamin deficiency. The researchers' analysis of the data found that people who used gastric acid inhibitors for at least two years were 65 percent more likely to have a vitamin B12 deficiency.

The researchers don't believe that people should stop taking this medication should stop. Instead, they recommend that people who use this type of medication a lot should talk with their physician about getting screened for vitamin B12 deficiency.

Why is vitamin B12 so important? MedlinePlus points out that the body needs this vitamin to make red blood cells. Additionally, this vitamin is important in maintaining the body's metabolism and the central nervous system. Untreated deficiency of vitamin B12 may increase your risk of developing nerve damage, dementia, heart palpitations, depression and anemia. Additionally, low levels of this vitamin can lead to loss of balance, dandruff, numbness, tingling in the arms and legs, weakness, menstrual problems, weak pulse, sore tongue, red tongue, paleness, nervousness, difficulty swallowing and fatigue.

So how does vitamin B12 get into the body? The body absorbs this vitamin with the assistance of a special protein, intrinsic factor, which is released by the stomach cells. And that's part of the problem with proton pump inhibitors since they shut down the cells in the stomach that are responsible for making this stomach protein as well as the acid used in digestion. The body stores vitamin B12 in the liver and can keep it there for years. Vitamin B12 is considered a water-soluble since it dissolves in water.
After the body uses this vitamin, leftover amounts are flushed out of the body through urination.

However, some people have difficulty with this vitamin. For instance, many people who are older than 50 years of age lose their ability to absorb this vitamin from food. Additionally, people who have digestive disorders such as celiac disease or Crohn's disease may experience difficultly with absorption. People who have weight-loss surgery and other types of gastrointestinal surgeries lose the ability to absorb this vitamin. And people who eat a vegetarian or vegan diet can be at risk of developing this deficiency unless they eat foods that have been fortified with vitamin B12 or take B12 supplements.

So what is the recommended daily allowance for vitamin 12? Adults who are over the age of 14 should get 2.4 micrograms daily, except for pregnant women (2.6 micrograms) and lactating women (2.8 micrograms). Children between the ages of 9-13 should get 1.8 micrograms while those between the ages of 4-8 years of age should get 1.2 micrograms. For younger children, the RDAs are as follows: 0-6 months, 400 nanograms; 6-12 months, 500 nanograms and 1-3 years, 900 nanograms.

All of this brings me to the best sources of vitamin B12, which you may want to eat if you use antacids a lot. The George Mateljan Foundation points to three excellent sources of this vitamin -- calf's liver, sardines and salmon. Very good sources include lamb, shrimp and scallops. Good sources of vitamin B12 include halibut, grass-fed beef, yogurt, cod, milk from grass-fed cows, and eggs from pasture-raised chickens. You also can get supplemental vitamin B12 through multivitamins as well as a prescription form.

Primary Sources for This Sharepost:

Colliver, V. (2013). Popular antacids increase risk of B12 deficiency. Houston Chronicle.

George Mateljan Foundation. (ND). Vitamin B12.

Lam, J. R., et al. (2013). Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA.

MedlinePlus. (2013). Vitamin B12.

Dorian Martin
Meet Our Writer
Dorian Martin

Dorian Martin writes about various topics for HealthCentral, including Alzheimer’s disease, diet/exercise, menopause and lung cancer. Dorian is a health and caregiving advocate living in College Station, TX. She has a Ph.D. in educational human resource development. Dorian also founded I Start Wondering, which encourages people to embrace a life-long learning approach to aging. She teaches Sheng Zhen Gong, a form of Qigong. Follow Dorian on Twitter, Facebook or Instagram at @doriannmartin.