Chronic use of proton pump inhibitors and vitamin B12 deficiency: Current evidence and recommendations

Abstract

Proton pump inhibitors (PPIs) are among the most widely used drugs in the world. Representing the first choice of treatment for various disorders that affect the digestive system, these drugs are also among the most sought after for self-medication, since they are over-the-counter. The massive and prolonged use of PPIs ended up bringing to light adverse reactions that were eventually serious and often avoidable if they were used rationally. One of the main concerns about the chronic use of these drugs concerns their potential to cause vitamin B12 deficiency in chronic users, with damage ranging from megaloblastic anemia to severe neuropsychiatric disorders. Numerous studies have already addressed the topic without reaching a consensus. Currently, several indications postively relate the use of PPIs with vitamin B12 deficiency, and many others show the absence of a significant relationship. In general, the evidence is considered weak, and the recommendation among prescribers is that no action regarding serum monitoring or routine VB12 supplementation is necessary in patients on chronic use of proton pump inhibitors.

DOI:https://doi.org/10.56238/sevened2023.006-108