Proton pump inhibitor use and vitamin B12 deficiency: a problem in the future

Au, Minnie (2013) Proton pump inhibitor use and vitamin B12 deficiency: a problem in the future. Medical Student Journal of Australia, 5 (1). pp. 10-15.

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Background: Proton pump inhibitors (PPIs) are commonly prescribed in the clinical setting and are known to have a safe side effect profile and high efficacy. Recent literature reviews showed a positive correlation between their long term use and adverse effects such as fractures, pneumonia and enteric infections. However these studies have inconclusive findings on PPI use leading to vitamin B12 deficiency.

Aim: To determine whether there is an association between PPI use and vitamin B12 deficiency.

Method: A systematic review was conducted using PubMed, Embase and the Cochrane Library for records between 1988-2012. Reference lists of review articles were scanned to identify studies not found in the database search.

Results: Studies meeting inclusion criteria consisted of two clinical trials, 13 observational studies, two case reports and seven review articles. The clinical trials suggested that vitamin B12 absorption is impaired during PPI therapy. Observational studies showed a reduction in serum vitamin B12 levels in participants on long term PPI therapy. Whether this led to vitamin B12 deficiency with a significant clinical impact remains unanswered.

Conclusion: Certain groups of the population were at risk of developing vitamin B12 deficiency whilst on long term PPI therapy; this included the elderly, individuals with Zollinger Ellison syndrome, those on concurrent metformin and slow metabolisers of PPIs. Serum vitamin B12 levels should be monitored to minimise the haematological, gastrointestinal and neuropsychiatric manifestations of vitamin B12 deficiency.

Item ID: 39463
Item Type: Article (Research - C1)
ISSN: 1837-4956
Keywords: proton pump inhibitors, vitamin B12 deficiency
Date Deposited: 28 Oct 2015 01:22
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110307 Gastroenterology and Hepatology @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1101 Medical Biochemistry and Metabolomics > 110103 Medical Biochemistry: Inorganic Elements and Compounds @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920105 Digestive System Disorders @ 50%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920411 Nutrition @ 50%
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