Do Acid Lowering Agents Affect Absorption of Vitamin B12?

Do Acid Lowering Agents Affect Absorption of Vitamin B12?

Vitamin B12 and Acid Lowering Agents:

Vitamin B12 deficiency is common among the elderly.  The results of this recent study (Dharmarajan et al, 2008) reinforces the importance of monitoring B-12 levels in patients who are taking proton-pump inhibitors.  Vitamin B12 deficiency can result in conditions including:  anemia as well as neurological problems which can be quite severe.

“OBJECTIVE: To examine the relationship between serum vitamin B12 levels in older adults on histamine(2) receptor antagonists (H2 blockers) or proton-pump inhibitors (PPI) over 6 years. Participants: A cross-sectional sample of 659 adults, 60 to 102 years, from long-term care facilities and community ambulatory care (C) in the Bronx.”

“CONCLUSIONS: B12 status declines during prolonged PPI use in older adults, but not with prolonged H2 blocker use; supplementation with RDA amounts of B12 do not prevent this decline.This report reinforces that B12 deficiency is common in the elderly and suggests that it appears prudent to monitor periodically B12 status while on prolonged PPI use, to enable correction before complications ensue.”

Key Points:

  • Use of proton-pump inhibitors can cause vitamin B12 deficiency.  This deficiency is not corrected by supplementation with RDA amounts of Vitamin B12.
  • Antihistamines (H2 blockers) do not cause Vitamin B12 deficiencies.


  1. Dharmarajan TS, Kanagala MR, Murakonda P, Lebelt AS, Norkus EP.  Do Acid-lowering agents affect vitamin B12 status in older adults?   J Am Med Dir Assoc. 2008 Mar;9(3):162-7.
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