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Old 07-24-2006, 06:03 AM   #1
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Brad53 HB User
Proton Pump Inhibitors (Prevacid, Nexium, etc) cause B-12 deficiencies

Hi all

I just wanted to share this information. I have learned that B-12 is broken down in the stomach, by acids, then absorbed by the small intestine. The PPIs drastically reduce the acid in your stomach (dose dependant I would think).

Just do a search on "PPIs and B-12 deficiencies". I just happened to see this board section for the first time. Well I guess I have seen it before, but had no reason to study Anemia. Now I do, but what is so frustrating is that I have had many blood tests in the past, but have never had my B-12 directly tested.

The test results for me was high MCV (mean corpuscular volume) and MCH (mean corpuscular hemoglobin). Last fall I got these results. It was a quack that I went to, but he had the nerve to order some sophisticated blood testing. I didn't go back to him, but showed the results to my cardiologist. The test showed that I had a chronic, active Epstein Barr virus infection. He referred me to an infectious disease doctor, who diagnosed me with chronic fatigue and arthralgia (joint pain).

I had a heart attack and stroke in the summer of 2003. All the heart meds that I started caused extreme fatigue for me. Now, I doubt that these meds actually were causing all the fatigue that I had. It has been very confusing. No one mentioned that the abnormal MCV and MCH could be a sign of a B-12 dificiency. I searched the net and found out. I was told 2 weeks ago by a Physicians Assistant that I had a B-12 deficiency, due to new blood test results the same as last fall (high MCV and MCH).

I have been taking prilosec for almost 7 years due to ulcers in my small intestines and erosions in my stomach and esophagus. They are supposedly cured, but when I have tried to stop this PPI, I get extreme ulcer pain. So I have been taking lots of B-12 and folic acid since 2003 per my cardiologist. So that is why I thought that I couldn't have a B-12 deficiency. But I didn't know about the affects of PPIs on the breaking down of B-12 (or not breaking it down).

I have had all the symptoms that you guys have had from pernicious anemia. I have really been taking lots of good B-12 supplements lately and the symptoms have improved. I take them with an acidic drink, like orange juice or coke. It has really helped. I may also have problems with the intrinsic factor as one of you have mentioned. I don't know, but I am seeing my PCP today and want my serum B-12 tested.

Believe it or not, the high MCV and MCH is also associated with leukemia. I also have abnormally low gammaglobulin Igg and Iga, which is also associated with leukemia. I am seeing a rheumotoligist thats ays I have RA or just arthritis. He is doing more blood work to check for leukemia or Hodgkin's disease.

So sorry about this long post on the medical history of my life, lol. It has just been so confusing. I have learned that you must accept responsibility for your own health. The docs have a hard time putting all these things together. These boards and the net are great for learning and sharing what you have learned.

Now for the big QUESTION! Do B-12 shots hurt bad???
Thanks so much for reading. I plan to get a B-12 shot today.

Good health and happiness to all

Brad

 
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Old 07-24-2006, 10:13 AM   #2
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Re: Proton Pump Inhibitors (Prevacid, Nexium, etc) cause B-12 deficiencies

Hi Brad

I have a monthly B12 shot, and no it does not hurt. But I guess it's all relative.

My Doctor gives me mine in my upper arm, but also told me some patients request it in the buttocks. I don't think it matters as long as it is a muscular area.
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Old 07-24-2006, 12:14 PM   #3
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Brad53 HB User
Re: Proton Pump Inhibitors (Prevacid, Nexium, etc) cause B-12 deficiencies

Thanks....I think women have a higher threshold to pain than men. I am a big chicken when it comes to needles, lol.

 
Old 07-24-2006, 02:39 PM   #4
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Re: Proton Pump Inhibitors (Prevacid, Nexium, etc) cause B-12 deficiencies

Hey, it did hurt! I also saw my B-12 test level. It was around 300. Still in the low normal range. Seems like the high end of the range was over 900...I was peering over the doc's shoulder at the test results.

Last edited by Brad53; 07-24-2006 at 02:39 PM.

 
Old 07-25-2006, 04:14 AM   #5
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Re: Proton Pump Inhibitors (Prevacid, Nexium, etc) cause B-12 deficiencies

Hey Brad

Sorry it hurt! After awhile I guess you get used to it... I've been *****ed with needles so many times now it's second nature for me and I don't feel it anymore lol.

Hopefully next time won't be so bad! There is an alternative to the shots though. You could try a sublingual B12. This is a tablet that you place under your tongue and this is where your body absorbs it. So you still bypass having you absorb it in your stomach/small intestines, but you also will get to bypass getting stuck with a needle! And, most people have just as good results with the sublingual as they do with the direct injection.

Again, everyone is different though, so always keep that in mind!

What type of B12 is your doc using? Methylcobalamin is the preferred type as it is more readily used by your body.

300 is deficient according to new medical literature. The low end of the range is 500... although some doctors still do not follow this.

I was at 83 when tested in february and I was tested again June 16 (5 injections later) and was up to approx 603...

Anyway, I'm rambling now... I hope you feel better soon.

Oh, and one question, did your doctor tell you how long you will have to be supplementing B12? I would think you will have to continue supplementing as long as you are taking the PPI's.
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Last edited by Angela22F; 07-25-2006 at 04:21 AM.

 
Old 08-09-2006, 06:30 PM   #6
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Re: Proton Pump Inhibitors (Prevacid, Nexium, etc) cause B-12 deficiencies

I found out about the link between the PPI's and B12 deficiencies recently too. I have esopahgitis and reflux and have been taking Prilosec for almost 8 years every day. I went through an endoscopy and a colonoscopy last year to see if there was activ ebleeding from ulcers,etc. Thnakfully,I had no bleeding and just a couple of polyps. I have been taking Ferrous Gluconate for the past year and I'm still anemic. I'm a nurse and I had been reading about this connection not too long ago. I have an appointment with my rheumatologist next week(I have RA) and I'm going to ask him if he'll test me for Pernicious Anemia.It will be interesting if itcomes back that I do!

 
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