Calcium Supplements May Protect Nexium Users from B12 Deficiency

Published on August 5, 2016 by Sandy Liebhard

B12 deficiency can occur among long-term users of Nexium and other acid-blocking medications. Now a new study suggests that calcium supplements could reduce the risk for this serious complication.

Proton Pump Inhibitors and B12 Deficiency

Nexium and other proton pump inhibitors work by reducing the amount of gastric acid produced in the stomach. However, this acid plays a vital role in the absorption of B12, a vitamin that helps keep blood and nerve cells healthy. People deficient in B12 may experience tiredness, weakness, constipation and a loss of appetite. A more severe B12 deficiency may result in balance problems, memory issues and nerve problems, such as numbness and tingling in the hands or feet.

The labeling for Nexium and other prescription proton pump inhibitors already mentions B12 deficiency as a possible side effect. That information was added to the labels’  “Warnings and Precautions” section in December 2014. A year earlier, a study published in the Journal of the American Medical Association suggested that using proton pump inhibitors for two years or more was associated with a 65% increase in the risk of B12 deficiency.

Now research published in the May 2016 issue of the Journal of Nutrition Health and Aging suggests that calcium supplementation may provide some protection to patients who use heartburn medications over a long period of time. The study drew data from inpatients discharged from the Quebecois Geriatric Assessment Unit from January 2008 through March 2012. All of the study subjects were being treated with an acid-reducer, including proton pump inhibitors, at the time of admission. Just over 41% were suffering from B12 deficiency.

An analysis of the data indicated that patients taking proton pump inhibitors without concomitant calcium supplements were more likely to have vitamin B12 deficiency than those taking the drugs in combination with calcium. The authors of the study concluded that calcium supplements reduce the vitamin B12 malabsorption effect of gastric acid reducer, and suggested that future research should consider calcium supplement co-administration to be a confounding variable in regards to B12 malabsorption.

Other Risks Associated With Long-Term Nexium Use

B12 deficiency is not the only  side effect potentially associated with Nexium and other proton pump inhibitors. The drugs’ labels also include cautions regarding the possibility of low magnesium levels and certain bone fractures, especially with long-term use. Recent studies have also suggested that the extended use of proton pump inhibitors might also increase a patient’s risk for chronic kidney disease, renal failure, dementia and heart attacks.