Does the drug I'm taking lead to vitamin B12 depletion?

[Rod Grundy]

Hi John,

Thanks for posting such an interesting question; hopefully I will be able to decide the bragging rights between the two Doctors you spoke to.

Essentially the first Doctor you spoke to, the retired GP is correct. Proton Pump Inhibitors such as Omeprazole can potentially cause a deficiency in vitamin B12. The mechanism behind this is that a PPI reduce the production of acid in the stomach, which is required to release vitamin B12 from the food you eat. However in reality the likelihood of a PPI actually causing a vitamin B12 deficiency is extremely slim; in most cases as most people consume more than enough vitamin B12 in their diet from meat, fish and dairy products - potentially vegans are at greater risk.

In my personal experience I have never come across a patient, vegan or otherwise, who has had a vitamin B12 deficiency that was attributed to taking a PPI; and PPI's are some of the most commonly prescribed medications. So I do not think your health is at risk from talking Omeprazole and your other medication Amlodipine long term.

If you are worried that you may be suffering from a vitamin B12 deficiency please speak to your GP as it can be potentially serious and if untreated can lead to anaemia - it is easily diagnosed by a simple blood test and in most cases treated very simply. However I am sure when you spoke to your GP regarding your concerns about PPI and B12 depletion, he asked you questions to assess whether you might be suffering from it. For your information I have added a list of symptoms of Vitamin B12 deficiency and anaemia to the end of this e-mail.

Best wishes,

Rod.



Symptoms of vitamin B12 deficiency

• a pale yellow tinge to your skin
  a sore and red tongue (glossitis)
  mouth ulcers
  pins and needles (paraesthesia)
  changes in the way that you walk and move around
  disturbed vision
  irritability
  depression
  changes in the way you think, feel and behave
  a decline in your mental abilities, such as memory, understanding and judgement (dementia)

Anaemia symptoms

• extreme tiredness (fatigue)
  lack of energy (lethargy)
  breathlessness
  feeling faint
  headaches
  pale skin
  noticeable heartbeats (palpitations)
  hearing sounds coming from inside their body, rather than from an outside source (tinnitus)
  loss of appetite and weight loss
  Vitamin B12 deficiency