Frequency of Proton Pump Inhibitor (PPI) users among B12 deficient Individuals

Abstract

Background: Vitamin B12 deficiency is a common nutritional disorder with significant neurological and hematological consequences. Proton Pump Inhibitors (PPIs), widely prescribed for acid-related gastrointestinal disorders, may impair B12 absorption by reducing gastric acid secretion. The present study aimed to determine the frequency of PPI use among B12-deficient individuals and to identify commonly used PPI types.

Methodology:  A total of 96 patients with confirmed B12 deficiency (<300 pg/ml in adults, <328 pg/ml in children) were enrolled. Data was collected via questionnaire. Statistical analysis was performed using SPSS version 25, applying chi-square  with p ≤ 0.05 considered significant.

Results: The mean age of participants was 39.96 ± 13.41 years (range: 14–71); 71.9% were female. More than half (53.1%) reported PPI use, with a marginally significant association observed in the 31–50-year age group (p = 0.054). GERD (80.4%) was the most prevalent gastrointestinal disorder. Omeprazole was the most frequently used PPI (60.8%), followed by esomeprazole (17.6%) and pantoprazole (11.8%). The majority used a standard dose of 20 mg daily, with 13.7% reporting continuous use for >1 year. Only 3.9% reported side effects, and 5.8% discontinued therapy due to intolerance. Dietary factors showed limited contribution, as 88.5% were non-vegetarian.

Conclusion: Over half of the vitamin B12-deficient individuals in this study were PPI users, with omeprazole being the predominant drug. Although most had shorter durations of exposure, the potential risk of prolonged therapy underscores the need for judicious prescribing and regular monitoring of B12 status in chronic PPI users.