B-12 and Antacids: A Dysfunctional Pairing
By: Dr. Michelle Stanton
Antacids like Tums, Prevacid, Prilosec (prescription and over-the-counter), are one of the top prescribed drugs in America. Many people experience symptoms like heartburn (roughly 25% experience it on a weekly basis) and an uncomfortable fullness after eating. Sometimes people will put up with this for months or even years, maybe even with the consistent use of these drugs. So, what’s the deal if it is just causing “a little discomfort”?
The vitamin B12 requires stomach acid (hydrochloric acid – “HCl”) for its absorption. This is a beautiful design by the body, since the highest sources of B12 are meats, and protein also requires HCl for it’s digestion. When B12 isn’t consumed in appropriate amounts and/or is not absorbed properly, a person can develop a deficiency with a range of symptoms. A B12 deficiency can present with mild symptoms like fatigue or tingling in the fingers and toes, while more severe deficiencies can lead to anemia, neurological dysfunction, or permanent nerve conduction problems.
Infants are also affected by a B12 deficiency, either from the use of recommended antacids or nursing from a mother who is B12 deficient. Symptoms in infants may be increased irritability, abnormal reflexes, trouble feeding, and in extreme cases delayed brain growth and developmental delays or disabilities.
It is important that a patient who is taking antacids on the recommendation of their doctor be reevaluated often to determine the effectiveness of the drug. Moreover, it’s imperative that the cause of the heartburn be carefully investigated. Very rarely is too much stomach acid actually the problem. In fact, a person will make less stomach acid as they age.
Causes of heartburn include (but aren’t limited to) low levels of stomach acid, SIBO (small-intestinal bacterial overgrowth), parasites, H. Pylori, hiatal hernia, or a subluxation causing decreased nerve innervation to the digestion organs. Identifying and addressing the underlying cause is the first step to truly healing. With this resolve, often times there is no need for the acid-blocking drug, and therefore vitamin B12 levels are protected. Contact the doctors at Prairie Sage to see how we can help you preserve your B12 levels AND address the cause of your heartburn!
https://www.annualreviews.org/doi/pdf/10.1146/annurev.nutr.24.012003.132440
https://health.clevelandclinic.org/long-term-antacid-use-linked-to-b12-deficiency/
https://onlinelibrary.wiley.com/doi/full/10.1111/imj.12697
https://www.drugs.com/pro/prilosec.html#s-43685-7