I was reminded of this topic when more than a few clients came in who had been on drugs long term caused vitamin deficiencies.
Two common types of drugs lower absorption of vitamin B12.
The first drug family that decreases absorption of Vitamin B12 are heartburn drugs, also known as PPI’s such as Nexium and Prilosec, prescribed to lower acid reflux, also known as GERD.
PPI’s lower absorption of stomach acids, which can help and eliminate GERD, but also interfere with the digestive processes that extract vitamin B12 from protein.
The second type of drug that lowers absorption of B12 is metformin, a diabetes drug that lowers insulin resistance and helps control blood glucose levels.
The exact mechanism for the lowered absorption is not clear but it is thought that metformin changes intestinal motility, which affects absorption of B12.
What should you do if you are on one or both of these drugs?
Ask your physician to have your vitamin B12 levels measured on your next blood draw and monitor them on a semi-annual basis. Chronically low levels of B12 can lead to cognitive decline and dementia, nerve damage and anemia.
If you have a low levels consider taking a B12 supplement and having your diet assessed to maximize B12 in foods.
Since PPI’s were designed to take on a short-term basis consider changing your diet and/or lifestyle to help eliminate GERD in other ways. Stomach acids protect our health and shutting them down can harm our health in other ways.
Metformin has many positive side effects for diabetics, so monitoring and maximizing B12 is the safest way to go.
Having your diet and medications assessed by an RD or health-care professional who knows about drug/nutrient interactions may be wise so you are not doing unnecessary damage. Taking care of your health and happiness many times requires you to be your own gatekeeper and take charge of how prescribed things can be affecting you in unknown ways.