B 12 deficiency - omeprazole link?: Hi- I've just... - NRAS

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B 12 deficiency - omeprazole link?

Moomin8 profile image
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Hi- I've just posted this on the pernicious anemia area on here to ask for any help or ideas - I'm not sure if it transfers to this nras area so I've copied it onto here- sorry if I've duplicated 😊

Hi

I have recently been diagnosed with rheumatoid arthritis and have been taking various drugs before and after diagnosis. A ppi(omeprazole) was prescribed to take before Naproxen (500mg twice daily) and methotrexate (10mg weekly) with 5mg folic acid 3 days later. I also have cocodamol if needed too. I try to avoid cocodamol (which gives me constipation!) and naproxen therefore ppi if I can...because I know it's best to limit their use alongside mtx. I have also had 5 steroid injections plus a week course of prednisolone since late December/January to help the widespread swelling/pain to subside asap!

My last blood test (5 weeks into mtx) revealed slight b12 deficiency -154. I actually asked for this (along with a cholesterol check!) to be tested as my symptoms were a-typical of b12 deficiency! I have been prescribed 50mg cyanocobalamin / day, orally (without actually seeing me and asking about my symptoms!) by my gp. I read the bottle which suggests an adult can take up to 3 a day and understand that these are readily bought over the counter so have decided to take more until I feel the benefit! I'd like to hear if anyone has had a similar experience and when it's best to take these i.e. : with or without food, early in the day, spaced throughout the day etc. ?

I have also read (in many reports) that omeprazole can be a reason to encourage b12 deficiency....even though my clinical nurse and my gp assure me that's not true!!!

I've also read that a low b12 and a raised folates blood test result suggests further tests should be done??

I realise I'm rambling on.....sorry

Last edited by Moomin8

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earthwitch profile image
earthwitch

I'm always surprised that doctors don't routinely test for coeliac disease when they discover people have low B12 or folate or iron stores, as coeliac disease is a prime cause of malabsorption problems. I am also often surprised when people get told they have pernicious anaemia without being seen by a haematologist. as I understand it, pernicious anaemia is a very specific disease (not all chronic low B12 is pernicious anaemia) and is diagnosed by a haematologist, not just by blood counts, but by special microscopic examination of your blood.

Interesting your comment about PPIs - the NHS patient information site also says that PPIs can cause low B12 nhs.uk/Conditions/anaemia-v...

oldtimer profile image
oldtimer

I have been fortunate in being tested exhaustively for the cause of my low blood count -this included testing for coeliac disease, iron levels, folic acid and B12 and a bone marrow. In the end they concluded that it was auto-immune - "part of the RA complex" ! and put me on high dose steroids which improved it considerably.

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