Proton pump inhibitor use and vitamin b12 deficiency in a lebanese population

Vitamin B12 is a crucial B vitamin. It is needed for nerve tissue health, brain function, and the production of red blood cells. Vitamin B12 deficiency is common, especially among the older population (1). The clinical manifestations and complications of vitamin B12 deficiency result from the effects of low vitamin B12 levels on the body systems, including: impaired cognition, depression, delusions, sensory loss, autonomic dysfunction, pancytopenia, macrocytosis, and cardiomyopathy. (2). Proton Pump Inhibitors are among the most commonly prescribed medications, and their use has increased in the recent years (4). Medications that reduce gastric acid may decrease vitamin B12 absorption since gastric acid plays a role in dissociation of vitamin B12 from food proteins, and the reduction of the production of intrinsic factor which impairs vitamin B12 absorption. (5). Several studies reported an association between long-term PPI use and increased risk of developing vitamin B12 deficiency (6). In our study, we performed the case-control method to evaluate the relationship between the use of PPIs and the risk of vitamin B12 deficiency, based on a sample from the Lebanese population.