Abstract
Background
Long-term usage of acid suppression drugs like proton pump inhibitors (PPIs) or H2 receptor blockers in the elderly population has been found to result in vitamin B12 deficiency. However, the reports are equivocal.
Objective
To determine the serum vitamin B12 levels in elderly patients under chronic acid suppression therapy.
Methods
Patients aged above 60 years and on any of the PPIs or H2 blockers for at least 6 months were recruited. Out of 77 patients recruited, 60 patients were included for the final analysis. The serum vitamin B12 levels were measured using the AccuDiag™-Vitamin B12 ELISA system.
Results
Out of 60 patients, pantoprazole (40%) and omeprazole (37%) were the commonly prescribed acid-suppressing drugs. Nearly 50% of the patients on prolonged acid suppression therapy were either “deficient” (less than 200 pg/ml) or “insufficient” (200 to 300 pg/ml) in serum vitamin B12 levels. Neither the average serum vitamin B12 levels (p = 0.994) nor the vitamin B12 status (p = 0.226) varied significantly across the drug groups of pantoprazole, omeprazole, and ranitidine.
Conclusions
Prolonged acid suppression therapy with PPIs or H2 blockers may result in serum vitamin B12 deficiency. However, there was no class (PPIs vs. H2 receptor blockers)- or drug (pantoprazole vs. omeprazole vs. ranitidine)-based differences found in the vitamin B12 deficiency caused.
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Acknowledgments
We express our sincere gratitude to Dr. C. Vislatchi and Mrs. K. Gunasundari (Department of Biochemistry, SVMCH & RC, Puducherry, India) for helping us in the laboratory works. We are also thankful to Indian Council of Medical Research (ICMR) for approving this study under the ICMR-STS (Short Term Studentship) Program 2019 [Reference ID: 2019-04748] and supporting this project with a studentship stipend (http://14.139.60.56:84/Result/STS-2019_Reports_Result.pdf).
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Srinivasan Damodharan: investigation (lead), data curation, writing—review and editing. Gerard Marshall Raj: conceptualization, methodology, investigation (equal), formal analysis, supervision, visualization, writing—original draft preparation. Sakthibalan Murugesan: investigation (supporting), resources, supervision. Karthikeyan Dakshinamoorthy: resources, supervision. Muraliswaran Perumal: resources, supervision.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institute Ethics Committee (Human Studies) of the Sri Venkateshwaraa Medical College Hospital and Research Centre (SVMCH & RC), Puducherry, India (SVMCH/IEC/2019-Feb/14).
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Damodharan, S., Raj, G.M., Sakthibalan, M. et al. Effect of long-term acid suppression therapy with proton pump inhibitors or H2 receptor blockers on serum vitamin B12 levels in elderly population. Ir J Med Sci 190, 1213–1217 (2021). https://doi.org/10.1007/s11845-020-02399-w
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DOI: https://doi.org/10.1007/s11845-020-02399-w