| Title | Vitamin b12 deficiency in hypersecretors during long-term acid suppression with proton-pump inhibitors. | | Author(s) | Hirschowitz BI, Worthington J, Mohnen J | | Institution | Division of Gastroenterology & Hepatology, University of Alabama School of Medicine, Birmingham, AL 35294, USA. | | Source | Aliment Pharmacol Ther 2008 Feb 27. | | Abstract | Background: Proton pump inhibitors (PPI) may cause B12 malabsorption, but measuring serum B12 alone may underestimate the prevalence. However, B12 deficiency elevates methylmalonic acid and homocysteine, both additional markers of B12 deficiency.
Aims: To determine the true prevalence of B12 deficiency and whether acid suppression by PPI caused it.
Methods: Sixty-one acid hypersecretors (BAO > 15 mmol/h), 46 with gastrinoma (ZE) and fifteen without (pseudo-ZE), were treated with lansoprazole to determine its long-term (up to 18 yr) pharmacological and clinical efficacy and safety, particularly in affecting B12.
Results: Of 61 patients, six (10 %) had low serum B12. Additional tests uncovered B12 deficiency in 13(31%) of the 41 still-available patients, despite normal serum B12. B12 replacement reduced elevated homocysteine and methylmalonic acid, supporting the diagnosis. Also, measuring both basal and stimulated gastric secretion, we found acid suppression was neither prolonged nor profound enough to explain the B12 deficiency.
Conclusions: 1.) B12 deficiency was more frequent (29%) than detected by measuring only serum B12. 2.) There was not enough acid suppression to explain this deficiency. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 18315582 |
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