Omeprazole and Iron Deficiency Anemia

If you're taking omeprazole or another proton pump inhibitor to treat GERD or other stomach or esophagus problems, you may be at risk of iron deficiency. Research suggests a connection between omeprazole and anemia.

Steak is filled with iron. (Image: Anntua/iStock/GettyImages)

If you have concerns about how long-term use of omeprazole may affect your health, talk to your doctor. The following information can give you some talking points for such a discussion.

Tip

Omeprazole is a proton pump inhibitor that decreases the amount of acid your stomach makes, helping treat issues such as acid reflux and ulcers. Long-term use of proton pump inhibitors does increase your risk of developing iron-deficient anemia. Talk to your doctor about the risks and benefits of the prescription medication.

Use of Omeprazole

Omeprazole can help heal acid damage to the stomach and esophagus caused by gastroesophageal reflux disease (GERD) and other stomach or esophagus problems associated with the amount of acid your stomach creates, explains MedlinePlus.

GERD occurs when the backward flow of acid from the stomach gurgles into your throat, causing heartburn, persistent cough, sensation of a lump in your throat and difficulty swallowing. Severe GERD can disrupt your sleep and quality of life. Use of a proton-pump inhibitor (PPI) such as omeprazole can help prevent ulcers as well as cancer of the esophagus.

Omeprazole is available in prescription and nonprescription forms. The prescription form may be recommended to treat severe GERD and its complications. Nonprescription forms are available at your local drugstore to treat frequent heartburn, which is defined as occurring more than twice per week.

Side Effects of Omeprazole

You can eat a normal diet, unless otherwise directed by your doctor, while taking omeprazole. You may experience issues such as gas, constipation, nausea and diarrhea while taking the medication. Vomiting and headaches can also occur. The listed side effects of omeprazole don't mention effects on your iron levels or ability to absorb iron.

If you're on a prescription dose of omeprazole, consult with your physician if you experience the side effects regularly and they interfere with your quality of life. Take only the prescribed dose of omeprazole at the recommended times to minimize complications.

About the Mineral Iron

Iron is a micronutrient, a mineral you need in small doses for proper body function. Iron helps you produce red blood cells and deliver oxygen to tissues and cells. It helps support optimal physical growth and development.

Iron is available in two forms: Heme and nonheme. Heme forms are found in animal products, such as liver, beef and shellfish. Nonheme forms are available in plant foods such as legumes and spinach.

According to the National Institutes of Health, people in the United States usually get enough iron through a balanced diet. Some people, particularly menstruating women, those suffering from certain illnesses and people who follow a vegetarian diet, are at a risk of iron-deficient anemia.

Iron-deficient anemia can cause extreme fatigue and weakness, pale skin, shortness of breath, headache, lightheadedness and cold hands and feet. Your cognitive abilities and immune system may also suffer.

Omeprazole and Anemia

You may be concerned about use of omeprazole and your iron levels. Gastric acid produced in your stomach helps your body absorb nonheme iron from your diet, explains the National Institutes of Health. Proton pump inhibitors, such as omeprazole, reduce your production of stomach acid, having an impact on your ability to absorb iron.

Case studies show a connection between PPIs and iron-deficient anemia. One, published in Current Therapeutic Research, Clinical and Experimental in January 2017, involved a 58-year-old man with severe iron deficiency from long-term use of a proton pump inhibitor. Doctors concluded his anemia was due to malabsorption of iron caused by reduced stomach acid. His anemia didn't result from taking in too little of the mineral or from undetected bleeding.

Another case study published in a March 2018 issue of Internal Medicine showed that a 52-year-old man who took omeprazole for 25 years developed iron-deficiency anemia due to lack of absorption of the mineral. This long-term use of the medication was the attributed cause of his condition.

Case studies aren't often enough to prove a relationship, but a larger study of almost 3,000 cases published in the Journal of Internal Medicine in February 2019 confirmed that chronic use of proton pump inhibitors increases a person's risk of iron deficiency anemia. The researchers recommend that physicians consider this association between omeprazole and iron absorption when prescribing the drug to patients.

People can't correct the iron deficiency easily if they're on omeprazole. The National Institutes of Health explains that people who have iron deficiency and who take proton pump inhibitors often have less than desirable responses to iron supplementation.

Natural Ways to Control GERD

Of course, if your GERD or other esophageal or stomach acid issues are severe, proton pump inhibitors may be essential. Talk to your doctor about limiting your intake of these medications, especially if you're already at risk of iron deficiency. Also reconsider your personal treatment of mild symptoms of GERD. Think again if you always reach for a few doses of Prevacid (a type of proton pump inhibitor called lansoprazole) or Prilosec (omeprazole) whenever you suffer heartburn.

Lifestyle changes can go a long way in reducing symptoms of acid reflux. You may experience a reduction in symptoms if you limit certain foods and beverages, including carbonated drinks, caffeine, citrus fruits, fried or spicy foods, garlic and chocolate. Cut back on your total fat intake by reducing ingredients such as butter, full-fat dairy, fatty meats and oils. Eating small, frequent meals, rather than three large meals, can also help with digestion and acid production.

Always eat when upright, rather than lying down, and finish your last meal or snack at least three hours prior to bedtime. You may also raise the head of your bed with wooden blocks by about 6 to 8 inches. The Cleveland Clinic says that pillows don't work.

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