Effect of long-term acid suppression therapy with proton pump inhibitors or H receptor blockers on serum vitamin B levels in elderly population.

Background: Long-term usage of acid suppression drugs like proton pump inhibitors (PPIs) or H receptor blockers in the elderly population has been found to result in vitamin B deficiency. However, the reports are equivocal.

Objective: To determine the serum vitamin B levels in elderly patients under chronic acid suppression therapy.

Methods: Patients aged above 60 years and on any of the PPIs or H blockers for at least 6 months were recruited. Out of 77 patients recruited, 60 patients were included for the final analysis. The serum vitamin B levels were measured using the AccuDiag™-Vitamin B12 ELISA system.

Results: Out of 60 patients, pantoprazole (40%) and omeprazole (37%) were the commonly prescribed acid-suppressing drugs. Nearly 50% of the patients on prolonged acid suppression therapy were either "deficient" (less than 200 pg/ml) or "insufficient" (200 to 300 pg/ml) in serum vitamin B levels. Neither the average serum vitamin B levels (p = 0.994) nor the vitamin B status (p = 0.226) varied significantly across the drug groups of pantoprazole, omeprazole, and ranitidine.

Conclusions: Prolonged acid suppression therapy with PPIs or H blockers may result in serum vitamin B deficiency. However, there was no class (PPIs vs. H receptor blockers)- or drug (pantoprazole vs. omeprazole vs. ranitidine)-based differences found in the vitamin B deficiency caused.