The Hidden Side Effect
Long-term PPI use caused my deficiency
James(name changed)
Age 58
“A medication I took every day was slowly robbing my body of B12.”
James's Journey
The Beginning
I'd been taking omeprazole (a proton pump inhibitor) for acid reflux for over a decade. It worked well, and I never thought twice about it. No one ever mentioned I should have my B12 levels monitored.
The Struggle
In 2019, I started noticing numbness in my feet. I assumed it was poor circulation - I have a desk job and don't exercise as much as I should. But over the next year, the numbness spread, and I started having difficulty walking. I felt unstable, particularly in the dark.
Getting Diagnosed
After referral to a neurologist, nerve conduction studies showed peripheral neuropathy. My serum B12 was 156 ng/L - borderline. But my MMA (methylmalonic acid) was significantly elevated, confirming functional B12 deficiency. The neurologist explained that PPIs reduce stomach acid, which is needed to absorb B12 from food.
Recovery
I started B12 injections immediately due to the neurological involvement. The improvement has been gradual - neurological damage takes time to heal. After 18 months, about 70% of the numbness has resolved. My balance is much better, and I can walk normally again.
Where I Am Now
I've switched from omeprazole to a H2 blocker (ranitidine) which has less impact on B12 absorption. I continue B12 injections every 8 weeks. The remaining nerve damage may be permanent, but I'm grateful the deficiency was caught before it progressed further.
Journey Timeline
2010
Started omeprazole for acid reflux
2019
Noticed numbness in feet, assumed circulation
2020
Walking became difficult, investigated by neurologist
2021
MMA test finally revealed B12 deficiency
2022
Neurological symptoms improving with treatment
2023
Switched to H2 blocker, maintaining B12 injections
Advice to Others
James's recommendations for those facing similar challenges
- Ask your doctor about B12 monitoring if you take PPIs long-term
- Omeprazole, lansoprazole, and similar drugs can all affect B12 absorption
- Metformin for diabetes can also cause B12 deficiency
- Neurological symptoms need urgent investigation
- MMA testing can reveal deficiency even when serum B12 appears normal
Important Warning
- Medication-induced deficiency is underrecognised. Long-term PPI users should be monitored.
Key Facts
Cause
Medication-induced - long-term PPI use
Time to Diagnosis
2 years
Initial B12 Level
156 ng/LLow with neurological symptoms
Current Status
Neurological symptoms 70% improved, ongoing treatment
Symptoms Experienced
Tests Performed
- Serum B12
- MMA (elevated)
- Homocysteine (elevated)
- Nerve conduction studies
Treatment
Hydroxocobalamin injections
Loading doses for neurological involvement, then every 8 weeks
What Helped
- MMA testing
- Neurologist who investigated thoroughly
- Switching medication
- Regular B12 injections
Published: 10 September 2023
Last updated: 20 January 2024
Related Stories
From Exhaustion to Recovery
Vikki, 42
“For years, I was told my symptoms were just stress and tiredness. Finding The B12 Society changed everything.”
Avoiding Irreversible Damage
Ian, 67
“At 65, I was developing dementia-like symptoms. B12 treatment reversed what doctors thought was irreversible cognitive decline.”
A Parent's Warning
Sarah (mother's account), 17
“My daughter's recreational nitrous oxide use caused devastating B12 deficiency that affected her ability to walk.”
Has this story helped you?
Consider sharing your own experience to help others on their journey.
Medical Disclaimer: This personal story is shared for informational purposes only and does not constitute medical advice. B12 deficiency affects everyone differently. Always consult a healthcare professional for diagnosis and treatment.