Assessment of vitamin B12 tissue stores in elderly proton pump inhibitor users

Abstract

Background: Adults over the age of 65 years are more prone to gastroesophageal reflux and, as such, are commonly prescribed proton pump inhibitors (PPIs). PPIs inhibit gastric acid secretion which can have adverse effects on vitamin B12 absorption. This quasi-experimental study was conducted to determine whether chronic use (≥1 year) of proton pump inhibitors (PPIs) results in decreased vitamin B12 in adults aged 68–94 years, as indicated by increased urinary methylmalonic acid (uM-MA). Methods: Fifteen men and women who had been using PPIs daily for a minimum of one year were recruited. Fifteen subjects not using PPIs were age (±3 years) and gender matched to the subjects taking PPIs. Tissue stores of vitamin B12 were determined using uM-MA. Results: The majority of subjects in this study resided in assisted care living facilities (55.66%) and the remaining subjects (43.33%) were free living. There were no significant differences in uM-MA levels between those using PPIs (Mdn = 1.1 μg uM-MA/mg creatinine), and those not using PPIs (Mdn = 1.1 μg uM-MA/mg creatinine) (p = 0.75). Conclusion: Chronic use of PPIs did not alter vitamin B12 in healthy individuals aged 68–94 years. Larger studies are indicated to validate these findings.

Keywords

• urinary methylmalonic acid
• vitamin b12 deficiency
• elderly
• proton pump inhibitors