Firstly this is a post about my experience and not meant as any kind of advice.
Around six years ago I asked my GP if I could swop from warfarin to Rivaroxaban. I didn’t have any problems with warfarin itself but I was finding the regular testing to be a problem. I won’t go into that, just what was going on in my life at the time.
I guess that I’d probably been on Rivaroxaban for about a year when my GP informed me that he was prescribing Omeprazol to be take everyday whilst I was on Rivaroxaban. I accepted his reasoning and advice and have been on Omeprazol for about five years now.
Recent annual blood tests have shown me to be border line anaemic, low in B12, Folic acid and iron. I have been taking supplements to address this and also taking extra magnesium. These haven’t really improved the test results. In addition I have been finding that I tend to be more tired and not sleeping particularly well. More concerningly I seem to be suffering from anxiety and depression for no apparent reason. I’m in my seventies and have permanent AF but my life is great. Why should feel like this?
I recently read an article about long term use of PPIs and started to tick off boxes. Apparently PPIs can reduce the bodies ability to absorb B12, Iron, Folate, magnesium etc. I knew that I’d also read comments on here about PPIs and so searched for relevant posts. Perhaps I should have headed posts from Bob D and others sooner.
I stopped taking Omeprazole two weeks ago. Yes, I’ve suffered cold turkey. Heart burn and acid reflux have been rather unpleasant but I’ve stuck with it. Drunk more water, added bicarb’ once a day and resorted to Gaviscon when things got bad. But…I’m beginning to feel more human. I’m no longer so tired and motivation is returning.
On Tuesday we head off to Antarctica for the trip of a life time. I’ll be taking along some Omeprazole just incase but hopefully won’t touch the retched stuff ever again!
Written by
CloudRunner
To view profiles and participate in discussions please or .
I also had major issues with VitB12 after only being on PPIs for 12 months - I had to have injections as I was critically low and this was causing big issues with fatigue and a very, very low heart rate. I now only take them when I feel symptoms or I know I’m in for a night of it. It’s totally anecdotal but I believe taking magnesium tablets actually helps prevent indigestion for me.
I have a similar story: for many years prior to PAF I took Omeprazole for hiatus hernia.
Since AF diagnosis (Dec '22) I've been practicing deep slow breathing because it sometimes restores NSR (not always) a possible beneficial side effect of this practice may have been to strengthen my diaphragm and reduce the hiatus hernia ...
Whatever the cause, after a CT scan last summer my gastroenterologist found the hiatus hernia had considerably reduced and suggested I come off Omeprazole.
I was very happy and relieved to do this - not least because I'd heard of a possible connection between PPIs and dementia see nih.gov report:
Yes, PPIs , among many other medications change stomach acid which over time can gradually decrease your B12 and Folate levels until Insufficiency or Deficiency can occur.It can have a knock on effect on Iron levels and cause Anaemias and Vitamin D deficiency. It doesn't usually effect Magnesium.
Antacids do the same as the PPIs , so things like Bicarbonate of Soda and Gaviscon may help your acid reflux but they change the stomach acid too still making it harder to absorb B12 and Folate via the stomach from food or supplements that are digested in the stomach. This could be a reason for your continuing low results.
When you begin these medications it's good to get things like B12 , Folate , Iron/ Ferritin and Vitamin D tested each 12 months to see you levels and help prevent the deficiency from occurring. Personally, after my experiences I think they should really test these things just before you start prescriptions of medications that could decrease your B12 and Folate.
Then if you are already low they can give better guidelines on diet and supplements early on to help prevent the problem occurring.
I have Functional B12 and Folate Deficiencies, at one point I had Severe Anaemia and Vitamin D deficiency which would not respond to supplement treatment because of it. This was made worse because I also have medication I have to take.
My functional issues aren't caused by diet, and the medication was not the cause , in my case I was diagnosed with Pancreatic Enzyme Insufficiency, so I don't release enough enzymes to help me absorb many things.
Another reason you can have this is Pernicious Anaemia , which you should get tested for if you get these deficiencies as this can happen as a separate illness as we age and can be made worse by using certain medications. They test for PA antibodies and Intrinsic Factor.
Conditions like PA and Functional B12 or Folate Deficiency usually require injections or infusions for life.
Vitamin Deficiency that is only caused by Medication changing stomach acid can often be treated or prevented.
People whom are at greater risk of B12 or Folate Deficiency from using medication can usually help to prevent this issue by increasing the amount of B12 and Folate foods in their diet , and taking supplements.
But supplements that are absorbed in the stomach don't work for many people , so using liposomal sprays or sublingual supplements that melt in the mouth can usually solve the problem or prevent it.
Active or simple supplements for individual nutrients are more effective than things like multivitamins or the generic and cheap supplements prescribed by your GP.
People can then often take things like PPIs and other medications that can affect stomach acid and not develop a vitamin deficiency , especially if they maintain a nutrient rich well balanced diet and get enough B vitamins.
If you still get borderline/ deficiency results after a few months of diet changes and oral supplements your GP should offer to give you loading doses of injections and then three monthly injections until the B 12 is back in range , or an infusion for Folate or Iron.
Then you should continue oral supplements and the diet changes.
They should also recheck your B12 levels at 6 and 12 months .
If your levels are dropping again they should resume injections long term.
If you can't take Omeprazole it's important to find a prescription for something to continue to protect your stomach on many types of medication.
With some medication, ensuring you take it with food , or having a few tablespoons probiotic live natural yoghurt and honey can help to line the stomach , but that is not suitable on its own for certain people or for certain medications.
All the symptoms you are describing are common with B12 , Folate and Iron deficiency. They can also increase your cardiac symptoms.
Enjoy your holiday , and maybe get back to the mission of sorting this out in a way that works for you when you get home. Bee
The FDA recommends a three month maximum for taking PPI’s. I have mentioned this several times. Dr. Sarah Myhill, a doctor in Wales, explains the cause of acid reflux and how to fix it. PPI’s make it worse. Reflux is caused by too little stomach acid and not too much. As we age our stomach produces less acid. Take a bottle of apple cider vinegar with you and not a PPI.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Anticoagulants and PPIs
Long-term effects of Warfarin
Flecainide - long term use
Magnesium
Opportunity to be involved in an AF study
