Proton pump inhibitors are medications prescribed to reduce stomach acid in patients with gastroesophageal reflux disease and peptic ulcers. Despite the well-known safety profile of proton pump inhibitors, increased risks of infection and nutritional deficiencies need to be reviewed in further depth, according to "The American Journal of Medicine." It is believed by these researchers that the higher risk of infection and nutritional deficiencies attributed to long-term proton pump inhibitor therapies can play an integral part in developing colon and gastric cancers as well as osteoporosis. As always, it is imperative to discuss options for supplementation with the prescribing physician before attempting to self-medicate.
Calcium Deficiency
The role of proton pump inhibitors have been the subject of considerable research as of late. According to the "Journal of the American Medical Association," the longer a patient uses a proton pump inhibitor for stomach concerns, the higher the risk for bone fractures due to deficiencies in calcium needed for strong bones. These increased risks were seen in clinical research studies of hip fractures among patients taking proton pump inhibitors versus otherwise healthy individuals with hip fractures. As it turns out, the deficiencies in calcium and subsequent predisposition this causes for osteoporosis drastically increases likelihood that they would have hip fractures. Additionally, the longer a patient uses proton pump inhibitors paired with higher dosages of the medication, the higher frequency they had of hip fractures and overall calcium deficiency.
Vitamin B-12 Deficiency
Vitamin B-12 is an essential vitamin needed for metabolic processes, building red blood cells, and general brain functions. Proton pump inhibitors work by altering the acid balance in the stomach, pepsin production, and negatively affect the absorption of vitamin B-12 leading to a deficiency. "The American Journal of Medicine" suggests that while the vitamin B-12 deficiency is a known nutritional side effect from taking proton pump inhibitors, the long-term effects are not well established. Some researchers believe that vitamin B-12 deficiency plays an integrative role in cancer. Larger, randomized clinical trials need to be conducted before evidence is considered conclusive.
Iron Deficiency
Iron is a mineral stored in cells and assists with many tasks in bodily function. Iron deficiencies are referred to commonly as anemia, and are mostly seen in patients who have had stomach surgeries or those with malnutrition or following a vegan diet. Such deficiencies can result in poor movement, motor skill development, weakness, have also been reported as a direct nutritional effect from taking proton pump inhibitors. Researchers believe that the mechanisms by which the proton pump inhibitor works effectively also cause hypersecretion of stomach acids, especially over long periods of time. According to Louisiana Drug Utilization Review Education, this research presents evidence that a portion of the population taking proton pump inhibitors have significant iron deficiency. This same population did not response to iron supplementation as absorption rates seemed permanently altered, even after cessation of the medication. As with all clinical trial research, larger more randomized clinical trials are necessary and underway to determine the potential effects this deficiency may cause and the long-term safety of proton pump inhibitors in general.
References
- "The American Journal of Medicine"; Long-Term Safety Concerns with Proton Pump Inhibitors
- "Journal of the American Medical Association"; Long-Term Proton Pump Inhibitor Therapy and Risk of Hip Fracture
- Louisiana Drug Utilization Review Education: Clinical Considerations for Proton Pump Inhibitor Use
