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Old 03-20-2008, 06:07 PM   #1
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Lightbulb Nexium/Malabsorption and Anemia

Hi folks--I just wanted to share my story about Nexium. I became moderately anemic with an 8.5 Hgb and Ferritin of 2. That means my body was out of iron and low on blood. I went in for a colonoscopy, endoscopy and transvaginal us. All doctors say that when a female is low on iron it is your periods. So, I went that route and had a procedure to stop that blood loss. It has taken me a year to get my Hgb to normal range on lots of daily iron and supplements. I asked my Hematologist (1 year ago) if it was malabsorption he said no. I went to my GI doc this week told him my Ferritin is 43, finally after a year and he said that is ridiculous after 1 year, and that I am having malabsorption from taking Nexium for 7 years and something else 1 yr prior to that. I am now trying a new PPI Zegerid. The thing is as you all might know, you have to have stomach acid to absorb iron. I have been out of work and home sick due to this.

I have a small hiatal hernia and mild acid reflux LOL. Nothing mild about it. I'm always sick and many things upset my stomach too. He said the problem is that PPI's don't really work on HH's and that there is one more med (if this one doesn't work) to try. Anyone know what that may be? It comes with lots of S/E's too, so I don't think I'll be trying that one. He said the next step is SX but it only lasts 2-5 yrs. I didn't even ask what particular procedure he was speaking of.

He said that I am married to iron supplements. That's better than IV iron infusions so I count myself lucky. I wanted people on here to know that there are consequences to long term use that I never realized before. If you have been on them long term I suggest that you check your Ferritin levels. It isn't a standard test you have to request it. It tells the iron stores in the bone marrow if they are being depleted. Good luck to you all. FLFLOWERGIRL

 
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Old 03-20-2008, 07:11 PM   #2
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Re: Nexium/Malabsorption and Anemia

Good evening,

I experienced something very similiar which I posted about May 29, 2007. It follows this post.

I am still taking Nexium, but only 1 a day. I take an iron tablet every other day and it seems to keep things fairly balanced. So far, anyway. Next week I am having lab work done so I will know more then.

Thank you for posting this reminder.

Ish

***************************
May 29, 2007


Hello everyone,

I have LPR and gastritis which was found during a colonoscopy and endoscopy January 2007. I had extensive blood tests at that time and my iron levels were in the mid normal range.

I was prescribed Nexium 40 mg x 2 (morning and evening). My reflux was getting better. Two weeks ago, I began to feel tired and weak and had another series of blood tests done. My iron level was very low. About one month ago, I begin having orange tan stools alternating. He ordered stool samples and those contained no undigested fat.

After researching PPIs, I found that PPIs can and do cause low iron levels in some individuals. I guess I am one of those unfortunates. I am taking Ferrous Gluconate as prescribed by my gastroenterologist.

He is rechecking for diseases such as celiac, crohn's, and other malabsorption ailments. He did the same tests in January along with biopsies and they were all negative. I am scheduled for a CT Scan this Friday to rule out more serious possibilities.

Has anyone had their iron levels take a dive while on PPIs? Have any of you had iron levels checked if extreme fatigue is an issue with you?

My thanks in advance for any replies.

Ish"

 
Old 03-20-2008, 07:46 PM   #3
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Re: Nexium/Malabsorption and Anemia

Dear All,
Wow, this is something I have found to be true! I was on PPI's for 1 year after a long bout of H pylori. I tried nexium,prevacid, prilosec,acidphex, zegrid... yep tried them all. I have a severe malabsorption problem which now remains even AFTER I went off of them. Drs. are still testing for why I am having the malabsorption and so far no answers. I have been/or am low in iron, calcium, vitamin D, magnesium ( affected my heart rhythm), potassium. If I think back it all started when I started taking the PPI's. Say what you all want but I will not go back on them unless the is a 'New" and improved version. I now only take mastic gum ( to coat stomach lining) and deglycerized licrorice for stomach problems. In my case I believePPI's reduced my stomach acid to below a normal level causing my problems.

 
Old 03-20-2008, 10:19 PM   #4
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Re: Nexium/Malabsorption and Anemia

Ish,

Quote:
Has anyone had their iron levels take a dive while on PPIs? Have any of you had iron levels checked if extreme fatigue is an issue with you?
Many thanks for bringing this to our attention. I didn't know that the PPIs can have this effect on some people. Good to know what to watch for, should we start showing some symptoms of iron deficiency. Can that result in anemia? Just wondering...

flowergirl

 
Old 03-21-2008, 09:22 AM   #5
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Re: Nexium/Malabsorption and Anemia

I haven't been on here for awhile. Thought I would give my two cents. I think ppis do a number on you for sure. I have been sick ever since my edg in Jan. and they started me out on 2 prilosec in am then pm. I am now on protonix, which worked for awhile but now is not working, which I belive is because ins. com. switched me to the generic. This is my end esults , two weeks ago I was dignosed s having celiac spru!! I have lost 25 pounds since jan. I started the gluten free diet and am not experiencing the nausea i had among other things, but my stomach bloats terrible after i eat anything at all. I am still learning about the celiacs disease , don't know if the acid in my throat is part of that all or the Lpr thing. I go from one way of thinking to the other. I get depressed really easy and am overwhelmed at this point. I take it one day at a time. I am not going to take a protonix today and see what happens. I go back to the ent monday. I am praying for things to settle down so I can enjoy my first gluten free Easter Dinner..lol which I am stressed about cooking a larger meal gluten free ..
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Old 03-21-2008, 06:37 PM   #6
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Re: Nexium/Malabsorption and Anemia

Dear Jancie,
So sorry to hear about this. I definitely feel PPI's added/ caused my malabsorption problem. Have you been tested for H pylori?? If not please make them test you. My issues started with the diagnosis of h pylori (which was resistant to antibiotics, so took 3 rounds of antibiotics). I do not have the bloating but had the reflux. I stayed on PPI's til my esophagus and stomach had healed then weaned off ( about 1 year). I feel much better off them now. I take mastic gum every morning and deglycerized licrorice for stomach pains, acid problems. It seems to work for me, that and really watch my diet. No late eating, no spice, no grease,ect. I have not been officially diagnosed with celiac/crohn's but am following the gluten free diet to help "heal" my small bowel ( found flattened villa,erosions). Check out the local celiac groups and sites on line- they have a lot of info which is really helpful. Good luck to you and Happy Easter.

 
Old 03-21-2008, 07:07 PM   #7
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Re: Nexium/Malabsorption and Anemia

Ish--Thank you so much for your post. It's interesting to hear how others have been diagnosed and what was prescribed. You were right, your post is very similar to mine. Too bad they don't inform you at the time of writing the script. My first doc did say to try and take the Nexium every other day, now I know why. I have never been on it 2X daily (just the odd couple of bad days), although I feel like I need it many times. Now ~everything~ seems to bother me. I feel that when you take 2X daily you are in the danger zone for sure.

I would like to ask how much iron your doctor prescribed for you now as a maintenance dose? That is one great concern of mine along with the malabsorption of iron. I know that taking in too much iron can cause iron overload and organs to store too much causing more serious problems. Long term use of iron is scary to me, i.e., CA feeds off iron. I was on 350 mgs for the last year and now down to 150mgs and not storing much, hence, a 43 Ferritin. The GI doc didn't tell me how much to take, just that I am married to it. That will be my next question to him, I forgot to ask. I was shocked at what he was telling me. You said that you take yours every other day which makes more sense to me and is safer that way as long as you are getting enough. I also like the idea of not having to take it everyday.

Today I went to have a total abdomen CT to rule out other things because my liver enzymes are borderline, that is up for me. He said all is fine but I wanted an explanation because I thought that it was from too much iron all year. We shall see.

Thank you once again for posting. Please do keep us informed of your new lab results. FLFLOWERGIRL

 
Old 03-21-2008, 07:40 PM   #8
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Re: Nexium/Malabsorption and Anemia

flowergirl2day--Yes PPI's can do this from long term usage. I was on them 8 years before I had any problem that I knew of. It begins to happen years before you know something is going on.

It is hard to detect because the body makes adjustments for it. The Ferritin knows when to release from the iron stores. The final stage of lowered iron stores is ANEMIA. This can take literally years to happen and you don't notice it at all for a long time because it is a slow and gradual process. I began to eat ice that was my first sign, not even tired or sick at all, not dizzy nothing. I suggest getting an annual Ferritin test for a baseline to go on before this ~might~ happen. Then you can see if it is going down for ANY reasons.

Janice--Thank for adding your two cents! You are very fortunate that you have been able to figure out your reason for malabsorption. Sorry that you have that DX but now hopefully you are on the road to recovery. Best wishes for you and your family with your gluten free Easter!

tired47--You are so lucky not to be on PPI's. I would love this but there is no way I can go off. Also, my Mom has been DX'd with BE and I'm afraid of that too. Hers was silent she knew nothing of it. Then she was DX'd with BE, gastritis and H-Pylori after a small bleed resulting in lowered Hgb, but nothing serious.

Did you have a small bowel biopsy and blood test for Celiac? I'm gald that you have found something that works for you other than PPI's. Good luck to you. FLFLOWERGIRL

 
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