Medications and Nutrients: When depletions occur


Vitamin B12 Depletion

As a clinical nutritionist, I see clients who usually take a long list of medications. Some of these medications might interfere with the nutrients needed for homeostasis. Proton-pump inhibitors are one of the most prescribed medications worldwide, and they work by suppressing the acid released in the stomach necessary for digestion. They are designed to treat acid reflux and other gastrointestinal disorders.


We might not think about it daily, but why is stomach acid essential in the first place? Stomach acid, also known as gastric acid, is a digestive fluid formed in the stomach. It chemically breaks down the food we ingest. It is composed of hydrochloric acid (HCl), potassium chloride (KCl), and sodium chloride (NaCl). Stomach acid is responsible for breaking down proteins in the stomach and triggering the release of enzymes that further break down food in the small intestine. Stomach acid also protects against pathogens that can cause infection.


If you are taking a PPI medication, it is vital to be aware of the potential risks of dysbiosis. Dysbiosis has been linked to various health problems, including inflammatory bowel disease, obesity, and type 2 diabetes. Recent research has linked PPIs to a significant increase in gut dysbiosis or an imbalance of gut bacteria (Bruno et al., 2019).


Dysbiosis has been linked to several severe health conditions, including inflammation, immune system disorders, and cancer. If you are taking a PPI medication, it is crucial to be aware of the potential risks of dysbiosis.

Talk to your doctor about whether a PPI may suit you and how long the intervention should last. If you are currently taking a PPI, work with a qualified healthcare practitioner such as a clinical nutritionist to ensure that your gut health is being monitored.


Aside from dysbiosis, PPIs deplete certain nutrients in the body. One of the nutrients that are affected by PPIs is vitamin B12. Vitamin B12 is a water-soluble vitamin that is involved in many essential processes in the body, including DNA synthesis, red blood cell formation, and nervous system function. Ensuring adequate amounts of vitamin B12 are replenished in individuals taking PPIs is extremely important.


References:


Bruno, G., Zaccari, P., Rocco, G., Scalese, G., Panetta, C., Porowska, B., Pontone, S., & Severi, C. (2019). Proton pump inhibitors and dysbiosis: Current knowledge and aspects to be clarified. World Journal of Gastroenterology, 25(22), 2706–2719. https://doi.org/10.3748/wjg.v25.i22.2706


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