The attorneys at Parker Waichman are investigating lawsuits on behalf of people who take antacids known as proton pump inhibitors (PPIs), and are suffering from adverse neurological effects due to a potential vitamin B deficiency.
Study results published in the December 11, 2013 issue of JAMA: The Journal of the American Medical Association revealed that long-term PPI use can lead to vitamin B12 deficiency in some people. For their study, the researchers compared the occurrence of B12 deficiency in patients taking PPIs and histamine 2 receptor antagonists (H2RAs)
PPIs, which work by inhibiting specific enzymes, reduce gastric acid levels and include:
- Nexium (esomeprazole)
- Protonix (Pantoprazole)
- Prilosec (omeprazole)
- Prevacid (lansoprazole)
- Vimovo (Naproxen/Esomeprazole)
H2RAs inhibit the action of stomach histamine cells, which also reduce gastric acid production, and include:
- Axid (Nizatidine)
- Pepcid (famotidine)
- Tagamet (cimetindine)
- Zantac (ranitidine)
Although the two classes of medications behave in different ways, they both work to reduce gastric acid, are available in prescription and over-the-counter (OTC) formulations, and are generally known as antacids, according to Adverse Events.
PPIs are prescribed for the treatment of gastroesophageal reflux disease (GERD), dyspepsia, erosive esophagitis, Zollinger-Ellison syndrome, and peptic ulcer disease (PUD). Vimovo is also approved to treat the symptoms of osteoarthritis, rheumatoid arthritis (RA), and ankylosing spondylitis. H2RAs are used to treat active duodenal ulcers, stomach ulcers, Zollinger-Ellison syndrome, endoscopically diagnosed esophagitis, and GERD-related heartburn.
In 2012, 14.9 million people in the United States were prescribed 157 million PPI prescriptions, according to Medical News Today.
Vitamin B12 Deficiency Side Effects Include Neurological Damage, Dementia
Vitamin B12 helps to keep the nervous system—the brain, nerves, and the spinal cord—healthy, according to Medical News Today. If a vitamin B12 deficiency is “Left untreated, vitamin B12 deficiency can lead to dementia, neurologic damage, anemia and other complications, which may be irreversible,” the researchers wrote.
Vitamin B12 deficiency can also lead to gastrointestinal adverse reactions and, according to the U.S. National Institutes of Health (NIH), fatigue and weakness, constipation, and anemia. The U.S. Centers for Disease Control and Prevention (CDC) lists an array of side effects tied to vitamin B12 deficiency, including:
- Asthenia (weakness)
- Gait abnormalities
- Vision loss
- Syncope (fainting)
- Neural tube and developmental defects in the developing babies of women who are vitamin B12 deficient during pregnancy
Prior research has also linked PPIs to the serious diarrhea-causing bacteria, Clostridium difficile (C. difficile), according to a recent ReutersHealth report.
Kaiser Permanente Study Ties PPIs to Vitamin B Deficiency
Because PPIs suppress gastric acid production, the drugs might also cause malabsorption of vitamin B12 because it is the body’s stomach acids that help the body to absorb vitamin B12.
For their study, the researchers used records from the Kaiser Permanente Northern California database, comparing patients diagnosed with vitamin B12 deficiency (25,956) to people who were not vitamin B12 deficient (184,199) and discovered that a minimum of two years of PPI or H2RA treatment led to increased vitamin B12 deficiencies. Higher PPI or H2RA doses were tied to increased deficiency and long term PPI use led to a 1.65 times increased risk of becoming vitamin B deficient.
The effects were stronger in women and in younger people, according to the Medical News Today report.