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Are Acid-Suppressing Drugs Responsible For Vitamin Deficincies?

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Q. After taking Aciphex to treat serious heartburn for four years, I developed a severe vitamin B12 deficiency. I complained to my doctor about being extremely tired all the time. I needed to rest after just a simple task.

I was also diagnosed with hypothyroidism. I had to beg to have my B12 levels tested, because my doctor didn’t think it was a problem, but we found out it was.

When I contacted the manufacturer of Aciphex, the company seemed uninterested in my experience. Vitamin B12 levels drop very slowly, so the problem wouldn’t show up in just one year, but studies don’t last longer.

The companies make tons of money on acid reflux drugs and I’d like to see them take some responsibility in studying the long-term consequences of these medications.


A. Acid-suppressing drugs (PPIs) like Aciphex, Nexium, omeprazole, Prevacid, Prilosec and Protonix relieve symptoms of reflux. There is a down side, however. Stomach acid is essential for absorbing certain nutrients like calcium, vitamin B12 and even thyroid hormone (levothyroxine, Synthroid). People who take acid-suppressing drugs long term may be at increased risk for hip fractures.

Cases of vitamin B12 deficiency have been linked to acid suppressor therapy (Journal of the American Medical Directors Association, March, 2008). Symptoms of this nutritional deficiency include fatigue, confusion and memory problems, peripheral neuropathy, constipation or depression.

We are sending you a copy of our book, Best Choices From The People’s Pharmacy, with more information on treating severe heartburn and tips for discontinuing PPIs. This book is available in libraries, bookstores and online at this web site.

Getting off acid-suppressing drugs can be challenging. Acid rebound can last for months after stopping such medications.
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38 Comments

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THIS IS AMAZING. I FOUND THIS LETTER ON ACID REFLUX MEDICINE BY ACCIDENT. I'VE BEEN TAKING IT FOR 2 YEARS AND SUFFER FROM ALL THE SYMPTOMS EXCEPT DEPRESSION. IN FACT I WAS JUST IN HOSPITAL FOR 4 DAYS AND THE DIAGNOSIS WAS SEVERE CONSTIPATION, I WAS IMPACTED. IF YOU HAVE ANY OTHER INFO ON THE SUBJECT I WOULD APPRECIATE IT.
THANKS,
AH

I HAVE BEEN TAKING PRILOSEC FOR A LONG TIME. THEN I READ THIS ARTICLE. I AM ALWAYS TIRED, BUT THE DOCTORS CANNOT FIGURE WHY I AM SO TIRED ALL THE TIME. THEY KEEP CHECKING MY THYROID BUT NEVER FIND ANYTHING WRONG. I DO FEEL THAT PRILOSEC IS THE PROBLEM. I WOULD LOVE TO BE ABLE TO FIND SOMETHING TO TAKE OTHER THAN PRILOSEC.

Reading this article is like reading my own medical history! I have taken Aciphex for 10 years at least, and a few months ago my physician changed me to Nexium. I had been diagnosed with fibromyalgia in the 70s and have been taking Elavil 25 mg at night since then for sleep disturbance and chronic pain. It helped in both areas.

I controlled acid reflux for a long time with Tums or the like but eventually developed GERD and had to have numerous esophogeal dilatations and was prescribed Aciphex.

My husband of 49 years died in 2006 and during his long illness I became clinically depressed and have been taking 25 mg of Zoloft for the last 5 years. This past winter I contracted a terrible bronchitis and it took 2 months and numerous antibiotics to clear up. I didn't realize how that illness depleted me of energy and strength, and I found I tired so easily after small housekeeping chores I would have to rest.

I am 73 and I thought in good heath until this terrible fatigue took over. My annual pap smear and mamogram were due 3 weeks ago and my gynecologist ordered a vitamin D3 level which came back at 14. I am now taking 8000 units of vit.D3 daily and will have another level done in 2 months.

I saw my medical doctor 2 weeks ago and found I was anemic. This did not surprise me as I thought I looked pale and knew I was always tired. I had started taking vit. B12 on my own and continue with that. My medical doctor directed me to stop taking Arthrotec which I have beed taking for many years and control pain with Tylenol. That has worked quite well so far. I also take Gabapentin when the pain is intolerable but that usually doesn't happen unless I do rather hard physical labor.

I feel much more alive and have increased energy and believe that the Aciphex and Nexium were indeed decreasing my ability to absorb nutrition from my food. Another upside to all of this is decreased appetite. I don't feel hungry all the time like I did before I started the increased vitamins.

I have read pros and cons about vitamin therapy and a lot of doctors say it is a waste of money and that your body gets what it needs from food, but I feel strongly in my case the increased vitamins are helping me get my life back. Thank you for your column and advice. It is always good to know that one is not alone and others have similar problems and have found helpful remedies. I also believe in vinegar and honey as a daily tonic.

I have been taking protonix (tavanol) 10 mg/day (I cut 40 mg into 4 quarters). I have been feeling more tired than I thought I should for almost a year (especially my legs). Also my thyroid is low even though I take 5o mg of synthroid /day. Recently I have started taking Vit.D, and think it helps a little. Vit. B12 is now a serious consideration. I will talk to my Dr. about this . Thank you.

I just had my 3rd upper endoscopy as a follow up for
GERD and taking aciphex 2x daily. Also have low thyroid and take synthroid. I have all the fatique symptoms, numbing in the fingers, bronchitis pneumonia 4x in 6 years.

I questioned my md on getting off aciphex. He claims it reduces your ability to fight off bugs such as salmonella because of the reduced acid in the stomach. Other sides such as polyps in the stomach he was not worried about. The heartburn I believe is mainly due to diet and could be controlled by diet. Have a hiatus hernia as well, so he feels I should stay on the drug. Saw my life science pharmacist about low thyroid, and he explained a few things to me. Supplements are very necessary if you are staying on these drugs. I feel much less tired after religiously taking b12 and other vitamins.

Now if I don't take the aciphex before a meal I get a buildup of very salty thick saliva around the palet and it drains causing coughing with sputum. Does anyone else experience this new symptom?

I am guessing that ranitidine (Zantac), which is an acid reducer, is not in the same category?

I am a user of Aciphex and felt exhausted. My doctor diagnosed a vitamin D deficiency. I now take 1000 mg twice daily.

I am a user of PPI's for close to 13 years. And I do believe that there are many problems yet to be asociated with them. But like others, I am now finding out what side effects are now evident from talking them all these years. The B deficiency I agree with. I quit taking my Achiphex in the fall of '07 and have noticed a big change in fingernails that refused to grow over the skin line. Which I just tied in with after starting to take B 100's. Also at that time I started taking liquid acidophilus which I think really helped to get over rebounding affect. I also have lost two teeth and maybe will lose more from the acid I now believe all those years contributed. My reflux at times in the past was so bad, no PPI's helped. And I too have had polops removed during endosocopies which my GI said Aciphex was the cause of. Or I should say PPI's, as I have taken different ones over the years.

I just wanted to add to the comment that I just sent. I also have noticed since I started taking B 100's that my hair, which has been thinning for years, has seemed to stop. Coincidence? I don't think so. But time will tell. I'm 53, by the way.

I just read the post on hair thinning; I have been taking omeprazole for 4 years and my hair has got really thin. Now I'm sure it's down to the tablets. I'm only 32, and it's quite worrying. Is there anything I can take that will help? You mentioned B100's--what is that ?

I have taken Nexium for GERD for 7 years. I had so much acid that my vocal chords were swollen and my voice was very rough. The nexium resolved the problem with the stomach acid. I have been on various anti-depressants for over 10 years. Now, since Jan. I am being treated for hypothyroidism. I am taking 50 mcg of levothyroxine. This article just proves the patient is not told about these side effects. I still feel tired after 5 mos. of levothyroxine so is it possible the Nexium is cancelling out the effectiveness of the levothyroxine. The article was informative, but I don't know what to do now.

Some years ago I heard on your show about the benefits of turmeric for heartburn. One person even took mustard when the pill or powder was not available. It works swiftly and completely to assuage the heartburn. Why isn't this used more widely?

In response to Laura about the B 100's. Laura, that is a B complex of your basic B vitamins. And most are in 100 miligrams. I like the capsule form because I think it is more readily absorbed. I buy mine from Vitamin World. Also I believe Puritans Pride owns Vitamin World and is also available online. Good luck to you. I would love to hear how you do.

I started taking Omeprazol AL20s about 3 weeks ago. Lately, I have been experiencing yellow stool, weight loss, peeling skin around the nails, fatigue, and drying hair. Also seem to have a raised basal body temperature (between 36.8 & 37.2). I have hypothyroidism (take Euthyrox 75).

Told the doctor and she's given me Ercrfuryl and said I have some sort of stomach bug. Any ideas?

Hello from the UK and my apologies for not knowing what lansoprazole (Zoton) is called in the USA.
I've been taking 30mgs (high dose) of lansoprazole daily for 8 years, before that I suffered many side effects from other PPIs.

I learnt that taking a "fast tab" (quickly dissolves under the tongue) formulation first thing in the morning and ensuring I did not eat or drink anything for 40mins minimum was the best course. Capsules and tablets seemed to take far too long to work. My GORD (or GERD) is now controlled and any side effects have been greatly reduced.

I had (before lansoprazole 'Fast Tab') experienced numbness in my left fingers but with this formulation and trying to be physically active on a daily basis has also helped.

I was diagnosed with breast cancer last October at the age of 30. I had bilateral mastectomies followed by reconstruction, 4 rounds of chemotherapy which ended in March, and am now taking Tamoxifen once daily for the next 5 years which I started in April. I've been extremely tired the past several months, am deficient in iron and B12, have been taking supplements for the last 6 weeks, still not feeling any better.

Most people, including my doctors, blame the fatigue on chemo and Tamoxifen. After reading these posts, I'm thinking it might be related to Aciphex which I've been taking on and off for a few years, including the past few months. Am waiting to hear from my oncologist with latest round of blood test results to see what my vitamin levels are. Will definitely mention the Aciphex as suspect!

I also suffered with acid reflux and hiatal hernia and was on Acifhex. Finally I went the natural route by taking digestive enzymes, probiotics and eating a better diet (no sugar). Now I no longer suffer with this miserable problem. Try it, it does work. NO MORE DRUGS

I still have reflux even though I take Aciphex each morning. My specialist said it is nonacid reflux and no problem. But what comes up seems horribly caustic, and I can't neutralize the taste or feel of it in my throat and mouth. I'd love to find something that neutralizes this "nonacid" reflux. Tums worked beautifully on my acid reflux but does nothing for this other substance.

I'm sooooo glad I found this site!!! You all have the same experiences I do. I'm not crazy. I have acid reflux (prevacid 30 mg x 2 day), synthroid .175, D - deficiency, hiatal hernia - TIRED! I'm tired of getting blood work and hearing what's wrong. Glad to hear it's not just me (although, don't wish it on anyone)

I'm kind of glad I searched on the internet for this problem. I started taking ACIPHEX twice daily at 20mg 2 weeks ago and all of a sudden I started feeling exhausted, tired, fatigued. I KNEW it had to do with the medication. I still haven't spoken to my doctor about it but will when I get back from vacation. Thanks everyone!

Great stuff
I will start vitamins tomorrow. I have had acid reflux for most of my life & have managed it by selective diet.
About 10 years ago I started on zoton & recently I was found to have the whole of my stomach wall covered in polyps. The bleeding caused very low feriten iron levels
which made me very tied.

I have changed my diet even more & have reduced the bleeding but still bleed sometimes. I take iron ferro-f tablets 310mg & my energy levels have improved, but I still get tied at times so the b & d vitamins may be the answer. If anyone knows how to stop the bleeding please let me know.

My mother and sister in law were both taking Prilosec and developed vitamin D deficiencies. The doctor's said that there is no connection, but we believe otherwise.

After a Esoghagogastroduodenoscopy gastritis & erosion was found in my stomach. Prilosec for 3 months was prescribed. Thank goodness I found lots of info about problems arising from taking this med.

I have had H. pylori and after research know that this is linked to my problem. When I had my 2 wk after procedure appointment with my Dr. he interrupted my time to take a personal call on his cell. When I tried to ask probing questions like: Why do I need an acid reducer when I only have heartburn every 2 to 3 months, Are there foods that aggravate this condition... he told me to stop complaining, stop eating fat (We never spoke of my diet) and as he was walking out of the exam room he said to get on with my life.

After all this he told his caller he would meet at 3 so I guess he was in a hurry. Thank God for technology so patients can go on line to get info their Doctors have no time for.

I've been on PPI for 5 years and will need to continue. Was on Ergocalciferol for 9 months, with no improvement on D levels; thus dr determined it was not being absorbed.

What is the best calcium supplement for me to take and what is the best way for me to get the necessary D? Thank you.

I have been taking aciphex for about 1 1/2 years now. Just today I was diagnosed with a vitamin D deficiency. I have also been very bloated and have had major hair loss. I am also taking other medications for blood pressure, but I had not experienced the vitamin D deficiency or the hair loss until after I began taking aciphex. Before taking aciphex, I was taking nexium, but my insurance stopped paying for it.

Have been on Zoton for 10 years for acid problems. Recently feeling sore joints and extremely tired asked Doc if tablets could be causing this? However she said no!! Since then been told I have osteoarthritis! Could the tablets have contributed to this? Have tried so many vitamins etc which don't agree with my stomach, calcium etc?

Has anyone any ideas what would be best to take without upsetting stomach? Does anyone else think tablets could be cause? Trying to cut back on Zoton to see if it helps but feel so angry they were probably causing other problems!

I took Zoton (Acid reduction)for about 10 years because of acid reflux, I was only 40 when I started getting Osteoarthritis in my fingers, none of my family have had this so it was very unexpected. The condition continued to get worse and doctors said there was nothing I could do. I actually stopped drinking alcohol 3 years ago and the acid stopped immediately so I stopped taking the Zoton. My fingers have stopped hurting now and are not getting any worse.

I also read today of this happening to someone else. I think there is a direct link between the Zoton and my Osteoarthritis. Has this happened to anyone else and is there any research being done into this problem?

I've just found your comment after reading another and replaying to that. Yes I have had the same issue with ZOTON and have osteoarthritis. I found that by stopping drinking alcohol my acid problem stopped completely. That wont cure my now damaged fingers at such an early age. Looks to me like proper research wasn't done before they released this drug on the market.

I find this very interesting as I have been taking aciphex for over 5 years. I too developed a severe B12 deficiency. I am taking B12 shots at home every other week. I was told that there is good acid in your stomach that helps the body produce B12 but when you cut out of the acid but taking these acid reducers your body has nothing to work with to make B12.
I hate the idea of the pain I would go through if I stopped this medicine so its a catch 22.

I have a b12 count of 294 and have been taking a prescription drug for acid reflex for 11 years. My doctor now, 2 months ago, put me on b12 1000 mg once a day but because acid reducers will not let the b12 be absorbed will that be the same for the b12 vitamins I am taking. Should I, therefore, be on b12 injections instead of the vitamins? Or will the b12 vitamins work for me?

My new doc started me on prilosec 20mg once a day. After 3 months I now have a vitamin d deficiency... Now my doc wants to give me vitamin d pills. Every time I go she is pumping me with more drugs.. She has me on 5 diff things for blood pressure cholesterol and you name it. Every time she prescribes something she says "its up to you".

I'm 33 yrs old!! My old doc had me on 2 pills 1 for cholesterol and 1 for blood pressure and everything was fine. Is she covering side effects with more drugs? Why should taking medicines be up to me? It feels like I don't need them and shes just trying to pump me with more crap.

I recently changed docs because insurance changed. Old doc had me on 2 pills for years now new one has me on 5 and wants me to take a 6th!! The doc is like 28yrs old.. Is she pumping me with crap for the pill company kick backs??

thanks everyone, I appreciate this info. My brother is normally upbeat and has been depressed recently. For years now, he has been taking an acid reducer, varying kinds. We are wondering in this recent depression may be linked to continued us and based upon your site. It seems so. Thanks again. I pray for speedy recovery for you all!

AH: My friend recommended ""Ground Flax Seed Meal" and have been using it regularly. No more constipation. I add 3 Tablespoons of the Ground Flax Seed to my cereal every day. In fact, I use milk, Yogurt,and some type of fruit, cereal, ground cinnamon and the ground flax seed meal.

I had been taking Aciphex for about 2 1/2 years and was just diagnosed with vitamin B and vitamin D deficiencies. Both deficiencies are quite severe. My insurance company recently conducted a wellness event that I participated in because I had been feeling so poorly. After getting the blood work results back, I researched the cause for the B deficiency and learned about its link with long term use of Aciphex as well as all ppi drugs.

I immediately stopped taking the drug. When I spoke with my physician he didn't believe there was a link (which I begged to differ with him). However, he felt that my symptoms indicated that I could also have a vitamin D deficiency. I am now receiving monthly vitamin B-12 injections and taking a weekly mega-dose of vitamin D. I am positive that Aciphex was the cause of the problem. Although I am not a physician (I'm a Library Director so research is my game) I firmly believe that the extended use of Aciphex created an issue with my small intestines ability to absorb nutrients.

Does anyone else have Vertigo, after 6yrs of Zoton Fast Tab. I have tried to stop the Zoton; but just about anything I eat or drink cause me to bring up acid (I have Hietus Hernia).

Any suggestions what to take? Also I am going to arrange a blood test with my doctor.

I am back on Zoton and have been for the past 10 months following moving to France from the UK. My troublesome knees are getting unbearable and I am having trouble walking. I am only 42.

I found it was wheat that was causing my acid problems, even the slightest trace would leave me feeling sick and acidic for a couple of days. Even a morsel of breaded ham would do it! Zoton completely eliminated the symptoms. My doctor prescribed me other generic Lansoprasole meds but they made my symptoms much worse, to the point where I was bringing up blood.

When I gave up wheat I lost two stones in a mater of a few months, now I am back on them I am steadily gaining weight again because, I thought, I am eating wheat. Maybe it is to do with the Zoton? My wife is a vegetarian (so I don't eat much meat) and we have a very healthy diet, eat lots of fresh fruit and veg and rarely have anything fried.

Most worrying for me are the bouts of depression I seem to have been suffering for the last 3-4 months and the very rapid deterioration in my knees. I am going to go Zoton and wheat free again to see what if any difference it makes. I know I will loose weight again but I am curious to see if my mood and my knees improve.

This is very educational..I have been taking prilosec for 8 years now I have barrett's esophagus from prolonged acid reflux I just ate Tums for a couple years before I had and endoscopy. Now I have to have endoscopy every 2 years to make sure the precancerous cells are not turning cancerous. I also have noticed thinning hair.

My newest issue is with my 2 fingers on my left hand, I am told it's a compressed nerve in my elbow. I was sent for blood work and very vitamin d deficient and b deficient. So I am now taking vitamin d 2x a week and b6 every day. I had no idea that all of these symptoms are connected to not enough acid. so the medicine that stop my acid reflux is depleting my body of vitamins. ugh... I am going to get b 100 vitamins and do more research. Thanks everyone...

My husband has been taking Aciphex for several years. A year ago, he was diagnosed with a deficiency in iron. He was anemic and given iron intravenously. Yesterday, when visiting with his doctor, it was determined from his blood tests that, once again, my husband was deficient in iron, making him very tired. His doctor told us that taking an iron pill will not be absorbed by the body, due to the Aciphex. My husband is scheduled for 4 visits to intravenously replace the iron. It's a catch 22, as my husband has Barretts and cannot go off Aciphex.

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