Can heartburn drugs lead to vitamin B-12 deficiency?

Answer From Michael F. Picco, M.D.

Some studies have found an association between heartburn medications and increased risk of vitamin B-12 deficiency.

Medicines to treat heartburn, also called gastroesophageal reflux disease (GERD), work by suppressing stomach acid. Blocking stomach acid and other secretions may also block B-12 absorption.

Why is this important? Vitamin B-12 deficiency has potentially serious and sometimes irreversible complications if undiagnosed and untreated. These can include dementia, disorientation, neurological damage, gait disturbance and anemia.

Two common types of GERD medicines have been associated with B-12 deficiency to varying degrees:

  • H-2-receptor blockers. Examples include cimetidine, famotidine and ranitidine.
  • Proton pump inhibitors. Examples include omeprazole, esomeprazole and lansoprazole.

With either type of medication, the risk of B-12 deficiency was significantly increased when taken daily for two years or more.

If you're concerned about your vitamin B-12 level, talk with your doctor. If low B-12 is an issue, ask if a lower dose of your medicine would be effective in controlling your symptoms or whether you should take a vitamin B-12 supplement.

Get the latest health information from Mayo Clinic’s experts.

Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Aug. 05, 2020 See more Expert Answers