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    Old 11-02-2011, 07:15 AM   #1
    Julia356
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    A warning for those that take PPI's(acid blockers)

    I wanted to warn anyone who is being treated for anemia and also taking PPI's ( acid blockers like Prilosec,Acifex,Zantac, etc.). These medications make it difficult or impossible for your body to absorb oral iron! Your stomach needs the acids to properly absorb any kind of iron ( from foods or supplements). If you are like me, and suffer from severe GERD, and cannot do without your PPI med, then you will also have to get your iron from a different route. I get IV iron infusions every 6 months or so when my Hgb and ferritin levels drop. Anyone with concerns of anemia who also takes these PPI's should discuss this with your doc!

     
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    Old 11-18-2011, 07:23 AM   #2
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    Re: A warning for those that take PPI's(acid blockers)

    I too take Prilosec for severe GERD & have for a couple of years. I specifically asked my Dr. about this, & he said I just need to worry about the absorption of my Calcium because you could wind up with osteoporosis. Now, I've read enough online over the years to know about the B-12 issue, but he dismissed it. I love my Dr. but sometimes we disagree on things, another being my thyroid issues & the meds I take for it. But that's another story.

    And...10 years ago my B-12 was 89, & the Neuro I was seeing at the time put me on B-12 shots indefinitely. I took them for a few years, then stopped. Well, a couple of years later she checked my level, the level was again low at 100, so I went back on them until about 8 months ago. She moved away, & my primary Dr. checked my level & it was 600, (3 months earlier it was 750), so he says that's fine & no need for shots anymore. I'm afraid my levels are going to continue to drop, especially now that I'm on the dose of Prilosec I am. I am supplementing with B-12 drops for now & hope it will be o.k.

    As for my iron levels, they are in range.

     
    Old 11-21-2011, 10:52 AM   #3
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    Re: A warning for those that take PPI's(acid blockers)

    You are referring to an Iron salt that needs acid in the gut to absorb the iron, but not all irons are iron salts. For example a good oral liquid iron to consult with your doc about is NovaFerrum. It is absorbed in the small intestine so you can actually take it with a PPI or an H2 antogonist. It's got 100 mg elemental iron and once a day dose so you're likely going to get what you need minus the hassle of an IV. The stuff actually has a good taste to it too. It comes in a powder and it's mixed at the pharmacy and your instructed to put it in the frig when you get home. Why deal with the IV if you don't have to - ultimately you can discuss it with you doc. If he hasn't heard of NovaFerrum you can search it on the web. One catch is that it's sold by prescription only, but it still cost about the same as an over the counter supplement only you're getting prescription strength, and if anything it's much cheaper than an IV. Your insurance may even cover it. Sorry about my grammar -- Hope his helps.

    Last edited by DaleP; 11-21-2011 at 01:28 PM.

     
    Old 11-22-2011, 09:12 PM   #4
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    Re: A warning for those that take PPI's(acid blockers)

    If you're taking a PPI regularly, a daily multivitamin such as Twinlab Daily One with iron, and a calcium citrate supplement, are a great idea, to help ensure your body is getting everything it needs.

    To the person getting IV iron, taking oral iron every day (eg Vitacost Ferrochells 45mg) would likely let your body adsorb enough iron to avoid the shots.

    Its avaliable online, about 12 bucks for a years supply - it would be well wroth a try
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    Old 11-23-2011, 10:43 AM   #5
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    Re: A warning for those that take PPI's(acid blockers)

    My apologies, but I have to respectfully disagree with jonnstar. Twinlab Daily One with iron has a carbonyl iron that is dependent on gastric acid to be absorbed. Therefore taking this supplement with a PPI is not a good idea.
    As for Ferrochel, it is an iron as ferrous bisglycinate chelate and does not contain much if any elemental iron, which is the key component that a clinician will look out for when addressing anemia.
    Iím not sure why people are so quick to recommend an OTC when anemia is a factor. Your recommending a hammer when what you need is a sledgehammer. Go to your MD and ask them of the choices youíve been suggested about. Just note that NovaFerrum has 100mg elemental iron and itís sold by prescription only so youíll have to get a script for it. All the best -

     
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    Old 12-08-2011, 06:16 AM   #6
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    Re: A warning for those that take PPI's(acid blockers)

    I have a question. I take Prilosec but I also take a women's daily multivitamin. It lists the iron as Ferrous Fumarate. Does anyone know if my Prilosec would prevent absorption of it?

     
    Old 12-14-2011, 01:37 PM   #7
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    Re: A warning for those that take PPI's(acid blockers)

    Ferrous Fumarate is an iron salt and will not be absorbed in to your system while you're taking a PPI, Prilosec. You need hydrochloric acid in the gut for an iron slat to be absorbed and that obviously is not going to happen while on a PPI. Are you anemic or are you just looking for a daily vitamin? If just a daily vitamin an iron, or a daily multivitamin, a good iron to take is one that has a Polysaccharide Iron Complex. It bypasses the gut and gets absorbed in the small intestine. If your concerned, go to your doctor and get your blood tested. At the very least you can have some peace of mind.
    - all the best

     
    Old 12-14-2011, 03:56 PM   #8
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    Re: A warning for those that take PPI's(acid blockers)

    All iron is adsorbed in the small intestine, not the stomach.

    Your multi should give you adequate iron, even with the prilosec.... if in doubt, take it with a glass of orange juice.
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    Old 12-15-2011, 02:15 PM   #9
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    Re: A warning for those that take PPI's(acid blockers)

    SG, please do not listen to Jonnstar, or to anyone on this board, and go ask your Doctor.
    There is a clear difference between Ferrous Sulfate, Ferrous Gluconate, Ferrous Fumarate, and Polysaccharide Iron Complex. Jonnstar's statement is partly true, but not hardly. Iron salts are an ionized form of iron and are extremly currosive to the mucosal lining where as other available irons that do not ionize and can be taken with a PPI. Iron salts are contraindicated with PPI's - this is a medical fact. Just go to a Nexium and/or Prilosic PI and it will tell you this. Jonnstarr is making recommendations to patients with IDA (Iron Deficient Anemia) that if they choose to listen they can place themselves at a much higher risk of getting worse.
    SG, please ask your doctor about taking iron salts and PPI's. An MD will read the PI and see that it is contraindicated and recommend an alternative iron, much like a Polysaccharide Iron Complex that does not ionize and is much less stressful to the GI tract. And it is well tolerated with a PPI.
    Ultimatly don't take any heed to what anyone tells you on this board, but let a licensed professional inform you what you should do. Anemia is a serious condition, and if not properly treated could lead to serious consequences. Best to you -

    Last edited by DaleP; 12-16-2011 at 06:40 AM.

     
    Old 12-30-2011, 11:18 PM   #10
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    Re: A warning for those that take PPI's(acid blockers)

    Quote:
    Originally Posted by DaleP View Post
    Ferrous Fumarate is an iron salt and will not be absorbed in to your system while you're taking a PPI, Prilosec. You need hydrochloric acid in the gut for an iron slat to be absorbed and that obviously is not going to happen while on a PPI. Are you anemic or are you just looking for a daily vitamin? If just a daily vitamin an iron, or a daily multivitamin, a good iron to take is one that has a Polysaccharide Iron Complex. It bypasses the gut and gets absorbed in the small intestine. If your concerned, go to your doctor and get your blood tested. At the very least you can have some peace of mind.
    - all the best
    I am anemic. I also take Ferrous Sulfate by precription. Does the Prilosec prevent Ferrous Sulfate form of iron from being absorbed as well?

     
    Old 01-04-2012, 12:21 PM   #11
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    Post Re: A warning for those that take PPI's(acid blockers)

    The following is straight out of the package insert for Prilosec:

    7.2 Drugs for Which Gastric pH Can Affect Bioavailability
    Because of its profound and long lasting inhibition of gastric acid secretion, it is theoretically possible that omeprazole may interfere with absorption of drugs where gastric pH is an important determinant of their bioavailability (e.g., ketoconazole, ampicillin esters, and iron salts).

    ** Ferrous Sulfate is an iron salt and it will interfere with absorption while on a PPI, Proton Pump Inhibitor, i.e. Prilosec. I encourage you to go to your doctor and ask him to consider an iron with Polysaccharide Iron Complex that is not an iron salt. NovaFerrum is an example and it works well with PPI's. I'm surprised your doctor wrote you a prescription for Ferrous Sulfate knowing you were on Prilosec. Print out the package insert for Prilosec and show it to him......Keep us posted --

    Last edited by DaleP; 01-04-2012 at 12:33 PM.

     
    Old 01-20-2012, 11:40 PM   #12
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    Re: A warning for those that take PPI's(acid blockers)

    Thanks for the info on NovaFerrum. I am on 80 mg a day Prilosec for Barrett's esophagus, and am dealing with anemia. This sounds like a good choice. I had an integrative medicine doc when I lived up north that had me on something called Hematin Plus from a natural supplement store. It did a good job, but I went off it when I moved to FL. My current doc is not into integrative medicine, so I doubt he would go with that. I will mention NovaFerrum to him.

     
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