Long-Term Proton Pump Inhibitor Use Tied to Nutritional Deficiencies

Published on September 29, 2016 by Sandy Liebhard

A new report published in the Harvard Health Letter warns that many medications have been liked to nutritional deficiencies. Among other things, the article notes that the long-term use of proton pump inhibitors can reduce the absorption of several important nutrients, namely vitamin B12, magnesium and calcium.

Proton pump inhibitors like Nexium, Prilosec and PrevAcid, are used by millions of people to treat GERD and other peptic disorders, and work by inhibiting the production of gastric acid. According to the Harvard Heath Letter, these drugs basically “turn off” the first stage of digestion. And while they are intended for short term use, many people use proton pump inhibitors for an extended period of time.

Calcium deficiency can increase an individual’s risk for bone fractures. In 2010, the U.S. Food & Drug Administration (FDA) warned that patients who use Nexium and other prescription proton pump inhibitors may be more likely to experience fractures of the hip, spine and wrists. The risk appeared to be greatest among individuals over age 50, and among patients receiving the highest doses for a year or more.

The following year, the FDA issued another alert regarding proton pump inhibitors and hypomagnesaemia (low serum magnesium levels). This condition can lead to muscle spasm (tetany), irregular heartbeat (arrhythmias), and convulsions (seizures). In 2014, mention of B12 deficiency as a possible side effect was added to the drugs’ labeling.

Long-Term Use and Kidney Risks

In recent years, long-term use of proton pump inhibitors has also been tied to certain serious kidney complications, including kidney failure. In April, for example, a paper that appeared in the Journal of the American Society of Nephrology reported that long-term users of proton pump inhibitors may be 96% more likely to develop kidney failure and 28% more likely to develop kidney disease compared to patients using another class of heartburn drugs called H2-blockers. Another study published in JAMA Internal Medicine in January also suggested that proton pump inhibitors might increase the risk of chronic kidney disease by as much as 50%.

Researchers writing in the April 2015 issue of CMAJ Open concluded that proton pump inhibitor use was associated with  a 3-fold increase in the odds for acute interstitial nephritis, as well as a 2.5 times higher risk of acute kidney injury.

A fourth study that appeared last month in BMC Nephrology linked the popular heartburn drugs to a 10% increase in the risk for chronic kidney disease, as well as a 76% increased chance of death.