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Posts Tagged ‘acid reflux’

Which Antacids cause Vitamin B12 Deficiency?

Sunday, December 22nd, 2013



In a recent study on vitamin B12 deficiency and antacid medications, doctors from Kaiser Permanente found further evidence proving that people who take stomach acid-inhibiting drugs for GERD (acid reflux) and heartburn are more likely than others to develop significant vitamin B12 anemia over time.  Side effects include memory loss, fatigue, and nerve damage.

Antacids, Vitamin B12 Deficiency

If you suffer from gastro-esophageal reflux disease (GERD), chronic heartburn, or peptic ulcers, then you’re chances of developing vitamin B12 deficiency (aka pernicious anemia) are higher than normal, according to a California study published in JAMA.

Vitamin B12 and the stomach

In order to digest vitamin B12 from the foods you eat, your body uses digestive enzymes produced in the stomach; without these essential stomach acids, you would not be able to absorb vitamin B12 in the distal bowel – it would just pass through the digestive system untouched.

And such is the case with patients using certain antacid medications to treat chronic acid reflux, stomach ulcers, painful heartburn, and esophageal strictures. By inhibiting the production of peptic acids, you also inhibit digestion of vitamin B12, resulting in vitamin B12 malabsorption- a widespread cause of vitamin B12 deficiency, or pernicious anemia.

Likewise, elderly individuals who stop producing sufficient stomach acids as a result of old age are also at risk for vitamin B12 deficiency.

Quick note: A deficiency in stomach acids is equal to a deficiency in vitamin B12.

Which antacid medications cause B12 deficiency?

In the Kaiser study, doctors examined patients using proton-pump inhibitors (PPIs) and histamine 2 receptor antagonists (H2RAs) who also had vitamin B12 deficiency.

This doesn’t mean that you should stop taking these medications; rather, it’s important to check your vitamin B12 levels regularly if you use any of the following antacid medications long-term:

  • Omeprazole (Prilosec)
  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Cimetidine (Tagamet)
  • Famotidine (Pepcid)
  • Ranitidine (Zantac)

Quick note: If you use PPIs or H2RAs, then check your B12 levels yearly, at least.

Is vitamin B12 deficiency serious?

Untreated, vitamin B12 deficiency can lead to severe nerve damage, dementia, and increased risk for heart attack and stroke.  (Remember, pernicious anemia used to be a fatal disease until scientists learned to treat it with vitamin B12.)

However, even the earliest and middle stages of vitamin B12 deficiency can be extremely debilitating- enough to make daily functioning difficult and tiring.

Symptoms of vitamin B12 deficiency:

Listed are common signs of vitamin B12 deficiency which are often overlooked or misdiagnosed:

  • Depression
  • Extreme fatigue
  • Anxiety
  • Brain fog
  • Memory loss
  • Forgetfulness
  • Difficulty concentrating
  • Painful numbness and tingling in the hands and feet
  • Muscle spasms
  • Poor motor control
  • Gait problems, difficulty walking straight
  • Poor balance
  • Loss/increase of appetite
  • Sleep problems

Stomach Bloating from B12 Deficiency? Yes, It Happens.

How do I know if I have vitamin B12 deficiency?

Once you start noticing even the earliest symptoms of vitamin B12 deficiency, that’s a sign that your vitamin B12 levels have already dropped to a dangerous low. So, it’s important to start treating immediately.

A simple blood test may indicate if you have vitamin B12 deficiency, but it’s best not to wait for diagnosis to begin supplementing. Vitamin B12 is safe to use in any amount, so there’s no harm in taking “too much,” but there can be negative ramifications if you wait too long to begin restoring your vitamin B12 levels.

Also, the median used to determine vitamin B12 levels is too low to catch the earliest signs of vitamin B12 deficiency.

Quick note: Symptoms are a better indicator of vitamin B12 deficiency than lab tests.

Which types of vitamin B12 are best?

With vitamin B12 malabsorption, vitamin B12 pills are useless, as they pass through the stomach undigested. Instead, your doctor may prescribe vitamin B12 injections which must be inserted directly into the muscular tissue of the thigh, arm, abdomen, or buttocks.  Depending on the level of anemia, you may be required to take vitamin B12 shots monthly or bi-monthly.

You may find that monthly sessions of vitamin B12 shots are not enough to make you feel “normal” again. If that’s the case, then it’s helpful to take extra doses of vitamin B12 between injections.  Just make sure to use types of vitamin B12 that pass directly through the skin’s layer into the blood.

Quick note: If you can’t digest vitamin B12 in the stomach, then you have to manually insert it into your blood stream through the skin.

Also read:

Vitamin B12 Deficiency Caused by H. Pylori Infection

Gastrointestinal Surgery for Crohn’s (IBD) and B12 Warnings

Image courtesy of Stuart Miles

Does GERD cause Vitamin B12 Deficiency?

Thursday, March 7th, 2013



Gastroesophageal reflux disease (GERD) does more than just give you constant heartburn- chronic acid reflux can create a host of ailments that many people don’t link with symptoms of GERD, including vitamin B12 deficiency.

Does GERD cause Vitamin B12 Deficiency? B12 Patch

What is GERD?

Gastroesophageal reflux disease (GERD) is a digestive system disorder which prevents food from traveling through your stomach and intestines, and instead causes the food you eat, along with digestive enzymes, to seep back through the esophagus, causing irritation, heartburn, and other debilitating symptoms.

11 Surprising Symptoms of GERD

GERD and vitamin B12 deficiency

If you take GERD medications, protein pump inhibitors (PPIs), then you are at risk for vitamin B12 deficiency.

That’s because your body relies on certain digestive enzymes in order to properly extract vitamin B12 (cobalamin) from the foods you eat- meat, fish, and poultry.

As the function of GERD medications is to stop making these digestive enzymes, your body’s ability to manufacture intrinsic factor is impaired, resulting in vitamin B12 malabsorption, a condition in which vitamin B12 travels through your esophagus and the rest of your GI tract, without ever getting digested or distributed through the blood, resulting in severe vitamin B12 deficiency, or vitamin B12 anemia.

Because of GERD medications for acid reflux, vitamin B12 deficiency is often a comorbid condition of GERD, one that goes undetected for years, until depleted levels of vitamin B12 begin to manifest themselves by producing debilitating ailments, symptoms which are not always linked automatically to vitamin B12 deficiency.

Symptoms indicating vitamin B12 deficiency, which may occur as an indirect result of GERD, include:

  • Extreme fatigue
  • Depression
  • Anxiety
  • Memory loss
  • Painful tingling in the hands and feet (pins and needles)
  • Numbness
  • Muscle spasms, twitches
  • Vision problems
  • Stomachaches
  • Diarrhea

Take action

If you suffer from GERD and take PPIs or medications which reduce stomach acids, then it’s important to get your vitamin B12 levels checked frequently with a simple blood test.

If you are B12 deficient, and you wish to continue taking GERD medicines, then you will need to supplement with mega-doses of non-dietary vitamin B12, until your vitamin B12 levels get back to normal.

Your turn!

Do you have any questions or suggestions?  Please leave your comments below.

Share with your friends!

If you found this article helpful, then please share with your friends, family, and coworkers by email, Facebook, or Google+.

Like this? Read more:

25 Medications that Cause Vitamin B12 Deficiency

GERD led to B12 Deficiency- What do I eat now?

Absorbing Vitamin B12, a Metabolic Gastrointestinal Journey


Gastroesophageal reflux disease- PubMed Health

B12 deficiency: a silent epidemic with serious consequences

Image(s) courtesy of Ambro/FreeDigitalPhotos.net

11 Surprising Symptoms of GERD

Wednesday, March 6th, 2013



Gastroesophageal reflux disease (GERD) does more than just give you constant heartburn- chronic acid reflux can create a host of ailments that many people don’t link with symptoms of GERD.

11 Surprising Symptoms of GERD- B12 Patch

What is GERD?

Gastroesophageal reflux disease (GERD) is a digestive system disorder which prevents food from traveling through your stomach and intestines, and instead causes the food you eat, along with digestive enzymes, to seep back through the esophagus, causing irritation, heartburn, and other debilitating symptoms.

Think of your digestive system as a one-way street. Normally, you swallow food, it slips down your esophagus, passes through the stomach where it combines with various stomach acids, and then travels through your intestines.

There are no U-turns in a healthy gastrointestinal tract.

With GERD, however, the esophagus suddenly becomes a two-way lane, as the esophageal sphincter, which is supposed to seal the door between the stomach and the bottom of your esophagus, instead loosens, allowing food…and harmful stomach acids to travel right back up through the esophagus, causing damage to your sensitive esophageal linings and creating debilitating symptoms such as heartburn, stomach cramps, and nausea.

But that’s not all…

GERD led to B12 Deficiency- What do I eat now?

GERD symptoms

The earliest symptoms of GERD may include the usual heartburn and stomach discomfort.

But left untreated, after several years, chronic acid reflux can cause severe damage to your digestive system, as the continuous flow of acidic stomach contents and undigested food wears away at your esophagus, increasing your risk of stomach ulcers and malnutrition.

Symptoms which indicate the many stages of GERD may include:

  1. Heartburn- pain in the chest that is worsened at night, while reclining, or while bending over
  2. Nausea
  3. Sensation of having food stuck in your chest
  4. Vomiting
  5. Increased saliva, “water brash”
  6. Coughing
  7. Bitter taste in mouth, bile
  8. Sore throat
  9. Hoarseness, change in voice
  10. Difficulty swallowing food
  11. Hiccups

Your turn!

Do you have any questions or suggestions?  Please leave your comments below.

Share with your friends!

If you found this article helpful, then please share with your friends, family, and coworkers by email, Facebook, or Google+.

Like this? Read more:

Acid Reflux Medication Warning: One Big Reason to avoid PPIs

Absorbing Vitamin B12, a Metabolic Gastrointestinal Journey


Gastroesophageal reflux disease- PubMed Health
Image(s) courtesy of David Castillo Dominici/FreeDigitalPhotos.net

Proton Pump Inhibitors (PPIs) – B12 Deficiency and 5 other Health Risks

Thursday, February 2nd, 2012



Usage of proton pump inhibitors (PPIs) is linked with B12 deficiency and other adverse effects, like osteoporosis.  Your body produces stomach acids for good reason- to absorb vitamin B12 (cobalamin), iron and other essential nutrients.  While heartburn is a painful symptom of acid reflux, having too few stomach acids can also cause debilitating symptoms.


What are PPIs?

Proton pump inhibitors (PPIs) are drugs that lower the amount of stomach acid your body produces.  It’s a popular treatment for preventing acid reflux symptoms like chronic heartburn, and it’s more effective than other acid secretion inhibitors like H2 blockers (Tagamet, Zantac).  Hospitals use PPIs to prevent stomach ulcers in 40%-70% of inpatients.  Examples of proton pump inhibitors are Prilosec, Prevacid, Nexium, Aciphex, and Protonix.

The following illnesses and conditions are treated with PPIs:

  • Gastroesophageal reflux disease (GERD)
  • Barrett’s esophagus
  • Dyspepsia
  • Gastrinomas
  • Zollinger-Ellison syndrome
  • Laryngopharyngeal reflux (LPR)
  • Peptic ulcer disease (PUD)
  • Stress gastritis prevention.

The 20 Do’s and Don’ts of the GERD Diet

What are possible adverse effects of PPIs?

Severe vitamin B12 deficiency

Long-term PPI usage has been linked with nutritional malabsorption of vitamin B12 (cobalamin) and iron.  Your body needs gastric acid in order to digest vitamin B12 foods sources like beef, chicken, fish, and eggs.  Without stomach acids, vitamin B12 remains bonded to the food you eat and never enters the bloodstream, eventually resulting in vitamin B12 deficiency.  Similarly, insufficient stomach acids also result in iron deficiency.

Because stomach acid production reduces with age, senior citizens, in addition to PPI users, are advised to check their vitamin B12 levels periodically.  Other people at risk for B12 deficiency are vegans, people who suffer from autoimmune and gastrointestinal disorders and anybody who has had gastric bypass or other gastrointestinal surgery.

Gastrointestinal Surgery for Crohn’s (IBD) and B12 Warnings


Long-term PPI usage has been linked with increased risk of hip, spine, or wrist fractures resulting from severe osteoporosis.  Researchers believe that PPIs inhibit calcium absorption and bone growth.  In studies, high doses of PPIs were directly linked with osteoporosis, and that risk increased over time.

It should be noted that osteoporosis is also a vitamin B12 deficiency side effect from PPIs, as vitamin B12 benefits include sustained bone mass.

Increased chances of intestinal infection

Long-term and short-term PPI usage can lead to clostridium difficile infection (diarrhea), according to scientific studies published by the Archives of Internal Medicine.

Gut Bugs:Winning the Bacteria Battle

Community-acquired pneumonia

If you stay at a hospital and are given proton pump inhibitors, your chances of acquiring pneumonia during your visit is increased by 30%, according to studies. While the use of PPIs for preventing stress-related ulcers is a valuable life-saving procedure, a significant amount of hospital patients who receive PPIs are not at risk for suffering from ulcers.

Rebound acid hypersecretion

If you try to wean off proton pump inhibitors, you’re likely to experience severe withdrawal effects, including sudden overproduction of stomach acids- hypergastrinemia. For this reason, PPI users become dependent on the heartburn drugs, and may suffer from adverse effects such as diarrhea, stomach tumors, and neoplasia.  Dependence on PPIs happens quickly, as early as one month into prescription.

Heart disease

Studies have linked PPI usage with decreased effectiveness of clopidogrel (Plavix), a medication prescribed for heart disease.  Also, decreased vitamin B12 is linked with increased risk for heart disease and stroke through elevated levels of homocysteine.

12 Healthy Heart Habits, Including Vitamin B12 Supplements

Please tell us…

Have you been diagnosed with GERD, or one of the other illnesses treated with PPIs?  If so, have you noticed vitamin B12 deficiency symptoms like chronic fatigue, “pins and needles” in hands and feet, memory loss, and anxiety?

As always, we welcome your comments, inquiries, and suggestions!

Read more about vitamin B12 deficiency and your gut:

Leaky Gut Syndrome Symptoms and Causes

Absorbing Vitamin B12, a Metabolic Gastrointestinal Journey

5 Ways to Prevent Diverticulosis-Diverticulitis Gastro Illness


Proton Pump Inhibitor Use Linked to Clostridium Difficile Infection

Proton Pump Inhibitors Should Have Black-box Warnings, Group Tell FDA

Long-term Proton Pump Inhibitor Therapy and Risk of Hip Fracture- JAMA

Gastroesophageal Reflux Disease- NEJM

Acid Blockers Linked to Pneumonia Risk

The 20 Do’s and Don’ts of the GERD Diet

Friday, July 1st, 2011



Avoid acid reflux and heartburn…for good! Follow this GERD diet.

The 20 Do’s and Don’ts of the GERD Diet- B12 patch

Most people get heartburn occasionally, but if  you experience acid reflux frequently, then you might be suffering from GERD (Gastroesophageal Reflux Disease).

GERD is caused when the lower “gate” (sphincter) of the lower esophagus relaxes, thereby creating a regular flow of stomach acids through the esophageal tubes.

GERD has the potential to cause serious damage to your esophageal lining, vocal chords, lung tissues, and throat, in addition to creating ulcers.

How is GERD different from heartburn?

GERD is the clinical disease of chronic acid reflux, and heartburn is one of its symptoms.

The symptoms of GERD include:

  • Heartburn- burning, painful sensation behind the chest, and feeling of a “bubble” behind the breastbone
  • Partial vomiting of sour bile into mouth
  • Throat pain while swallowing
  • Asthma-like symptoms, including coughing, wheezing, and sore throat

Here are 20 Do’s and Don’t for managing GERD:

1- DO…Take vitamin B12 supplements.

Vitamin B12 deficiency is a common complication with GERD patients who take antacid medication.

A normal amount of stomach acids is healthy and beneficial for digesting foods, and your body cannot absorb vitamin B12 without them.

If you take prescription heartburn medication, then you run the risk of developing B12 deficiency, which can lead to anemia, chronic fatigue, memory loss, and a host of other harmful symptoms.

B12 Deficiency: Don’t Ignore the Symptoms.

2- DON’T… Eat chocolate.

Chocolate is chock-full of ingredients that disagree with acid reflux- it’s highly caffeinated, contains theobromine, a bitter alkaloid, and it’s high in fat.  If you must have your chocolate fix, opt for lower-fat dark chocolate- at least you’ll be getting some antioxidants.

3- DO…Follow a low-fat diet.

Fatty foods slow down digestion, increasing your chances of suffering a gastrointestinal backlash.  Follow a light diet, and you’ll feel lighter, too.

4- DON’T…Eat fried foods. Oily foods are at the top of the no-no list if you have GERD, and fried foods are the oiliest of the oiliest.  Save yourself from the pain, and experiment with roasted potatoes, eggplant, carrots, zucchini, or kohlrabi.  Roasting brings out the natural flavor, and requires less oil.

5- DO…Avoid caffeine.

A small cup of coffee every morning is fine, even if you get chronic heartburn, but a tall mug of latte every three hours is pushing it.

6- DON’T…Eat starchy carbohydrates.

Starchy, high-sugar vegetables are difficult for your body to digest, resulting in large amounts of undigested carbs.  Carbohydrates that sit in your stomach end up contributing to excess stomach acids, a sure-fire way to cause acid reflux.

7- DO…Eat sauerkraut.

Aged, fermented foods like pickles, kimchee, and sauerkraut have a stabilizing effect on the tummy, according to many health experts, when eaten in moderate amounts.

8- DON’T…Consume alcohol.

Although alcohol is not an acidic substance, it does have a loosening effect on the esophagus’s lower valve that controls gastric acid flow.

9- DO…Take probiotics supplements.

Probiotics promote healthy bacteria, a veritable army against heartburn, diarrhea, and many other stomach problems.

Probiotics are a main ingredient in yogurt and kefir, but if you can’t handle dairy products, then opt for probiotic supplements and tonics.

Natural Treatments for the Symptoms of Crohn’s Disease

10- DON’T…Indulge in fatty dairy products.

Sour cream, soft cheeses, ice cream, and whole milk these all contribute to GERD symptoms.  Opt for the lower fat versions, if dairy is what you crave.

11- DO…Exercise portion control.

When dining out, ask for a to-go container as soon as the food reaches your table.  You’ll be less tempted to overindulge if you divide your meal in half before you start eating, and save the rest for later.

12- DON’T…Drink acidic fruit juice.

Orange juice, grapefruit juice, lemonade, and tomato juice just add fuel to the fire.  Also, avoid tomato-based sauces, as their acidic content aggravates heartburn symptoms.

13- DO…Keep a food diary.

Let’s face it- not everybody can keep a mental log of everything he ate this past week, let alone since breakfast.  Keeping track of your eating habits in a food journal is the only way to manage your heartburn triggers.

14- DON’T…Drink bubbly drinks.

Remember the volcano science projects you used to do as a kid- the one where you put baking soda inside a papier-mâché “volcano,” poured in a solution of vinegar and red food food coloring? Well, imagine that in your stomach…

15- DO…Avoid processed foods.

Overly processed, refined foods lack the fiber needed to travel through your digestive system efficiently.  Choose whole foods- brown rice instead of white, whole sugar instead of white, and you’ll also get more vitamins, to boot.

16- DON’T…Eat fatty meats.

Stay away from fatty beefsteaks, beef jerky, and pork.  Leaner meats like ground turkey breast, skinless chicken, and trimmed beef chuck are healthier for the heart, less likely to cause heartburn, and higher in vitamin B12.

17- DO…Drink apple cider.

Apple cider is a natural alternative that balances stomach fluids, even if you have GERD.

Drink a few tablespoons of organic apple cider added to an 8-ounce glass of water, every day after meals.

Gut Bugs:Winning the Bacteria Battle

18- DON’T…Fall asleep after a meal.

Your body needs time and energy to process a meal.  While physical activity is excellent for pushing food through your system, lying on the couch has the opposite effect.  Sit down for dinner early, and make a habit of going out for a neighborhood stroll afterwards.

19- DO…Exercise regularly.

Light aerobic exercise increases your metabolism, ensuring that your food digests quicker and more efficiently, as opposed to sitting around in your stomach collecting acids

20- DON’T…Sleep on your right side.

Use the force of gravity to your advantage.  If nighttime heartburn is an issue, then sleep on your left side, and your stomach acids will stay where they belong.


7 Foods That Cause Acid Reflux

Gastroesophageal Reflux Disease (GERD)

What Is GERD? Pain, Symptoms, Causes, Remedies, and More


Natural Remedies for Acid Reflux & GERD

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