Ranitidine tabs 150mg twice daily advice pls...

[scorpiojo]

Hi all, was diagnosed in Nov with a hiatus hernia and prescribed Ranitidine and the lady that did the Camera etc said this was an older tab looked it up and said it wasn't too bad re B12.... It seems ok, softer number 2s maybe a coincidence... But I really don't want to get this wrong and disrupt any jab benefit... I had low Folate, ferritin, b12 and Vit D... Any thoughts or alternative's suggested would arm me when I see gastro for full low down in Jan... Cheers Jo x

[helvella]

Ann Pharmacother. 1992 Oct;26(10):1283-6.

Effect of histamine H2-receptor antagonists on vitamin B12 absorption.

Force RW1, Nahata MC.

Author information

1College of Pharmacy, Ohio State University, Columbus 43210.

Abstract

OBJECTIVE:

To discuss the potential of histamine H2-receptor antagonists (H2RAs) to cause malabsorption of vitamin B12 (cyanocobalamin).

DATA SOURCES:

Pertinent literature was identified via a MEDLINE search. Journals and references cited in published articles also were used as data sources.

STUDY SELECTION:

Studies evaluating the effect of H2RAs on vitamin B12 absorption were reviewed.

DATA SYNTHESIS:

H2RAs decrease acid secretion by the gastric parietal cells. Gastric acid and pepsin produced by these cells are required for the cleavage of vitamin B12 from dietary sources. Intrinsic factor (IF), also produced by gastric parietal cells, is required for vitamin B12 absorption from the gastrointestinal tract. Although H2RAs have not conclusively been shown to decrease IF secretion, studies have demonstrated a significant reduction in food-bound vitamin B12 absorption secondary to decreased acid secretion in patients taking these drugs.

CONCLUSIONS:

H2RAs have the potential to cause vitamin B12 deficiency. This may be important in patients with inadequate stores of vitamin B12 (e.g., poor diet), particularly those receiving H2RA therapy continuously for more than two years. Healthcare providers should be aware of this potential adverse effect.

PMID: 1358279

[PubMed - indexed for MEDLINE]

[scorpiojo in reply to helvella]

I don't know what the alternative is tho, as I bought Betaine and tried the vinegar and it didn't help? Thanks for this I will screen shot and show it.... X

[helvella in reply to scorpiojo]

Sorry but I am not clear what issues you are suffering! Yes - I know hiatal hernia. For example, reflux overnight - sometimes a touch of apple cider vinegar just before bed can help. (Assuming you were taking it in some other way!)

I am not aware of any interaction between ranitidine and B12 that has been injected.

[scorpiojo in reply to helvella]

Your 1st post points out it can stop b12 absorption so I am concerned about that... The lady who did the camera down the throat prescribed Ranitidine and thought it didn't affect b12... I'll talk to the gastro guy in Jan... The item you shared is good info... I did try the vinegar and Betaine tabs but they didn't help... I'm wondering if I can't get around this heartburny thing unless I take a tab that compromises my b12... Maybe I'll have to counteract it by more jabs... Thanks for info Jo

[scorpiojo in reply to helvella]

Sorry maybe I wasn't clear I have jabs from gp for b12 and top up myself with jabs if I feel tired etc... I had a count of 93 on my Blue Horizon blood test and PA in my close family so b12 is a issue, but being given Ranitidine for heartburn or acid because I have this Hiatus hernia has helped, I just want to know if I'm causing a b12 problem again... I had been on laziprazole once... I do know not to have that again... So just trying to get the best tab if possible for the heartburn hernia thing that wont harm the t3 I'm on or b12... Thanks again

[Foggyme Administrator]

Hi Scorpiojo. Just thought I'd mention that The Ranitidine patient information leaflet carries the following warning:

Take special care with Ranitidine Tablets

Speak to your doctor before taking Ranitidine Tablets if:

you have stomach cancer

kidney problems. You may need different dose of Ranitidine Tablets

you have had stomach ulcer and you are taking non-steriodal anti-inflammatory medicines (NSAID) such as aspirin or ibuprofen

you have rare condition called acute porphyria

you are over 65 years old

you have lung disease

you are diabetic

you have any problems with you immune system

The last one was particularly relevant to me (I have undifferentiated connective tissue disease - an autoimmune condition). Within 7 days of starting these tablets, most of my symptoms were exacerbated - most disturbing, I lost the ability to move my legs on several occasions. And I felt very ill indeed.

Neither the pharmacist, gastrologist, neurologist, or endocrinologist had heard of this type of reaction - though the 'with care' warning is clear in the patient information leaflet - and must be there for a reason.

Sorry, but I can't remember if you also have any autoimmune conditions (and don't have time to check right now) but thought it worth mentioning, just in case.

So...if you start to go downhill...and sincerely hope that you don't...could be down to the new meds...😖😀.

In terms of reducing B12 absorption...shouldn't be a problem as you're injecting B12 so this will 'bypass' the absorption problems usually associated with PPI's and H2 receptor antagonists.

However...if you have low stomach acid (most people with PA have low acid - which can equally cause acid reflux) ranitidine will reduce this further and may exacerbate any gastric acid issues you have.

Just wondering - has anybody suggested having your hernia surgically repaired?

Just hope that you find something that works for you...😀

P.s. Just read your previous reply about the T3 issue - no idea - thyroid forum a good place to ask that one.

Also - have you tried SAUKRAUT for your gastric acid issues - many here say it works wonders. Also, people seems to have very good results with Symprove - but it's quite expensive - some start with that and then move on to BioKult.

And fbirder's trick with the lime juice before meals seems to work well for low acid people (low acid can be equally responsible for reflux in people with PA).

Just some late night last though before bed ramblings 😀😀💤💤

[scorpiojo in reply to Foggyme]

Thanks for this Foggyme... The repair could be a thing if I pushed I guess... I think they'll try tablets 1st... Thanks re injection info I'll carry on knowing it won't cancel out the b12then... The t3 I've placed similar ? on there re Ranitidine and t3 as it both these things I want to protect... I'll look at the Symprove etc... 😁 I'll also carry on looking out for side effects... X

[Gambit62 Administrator]

as helvella has pointed out ranitidine affects absorption of ingested B12, ie from food.

Like helvella, I'm unaware of anything that indicates it would affect B12 once it is in the blood - ie it shouldn't affect your B12 levels if you are getting your B12 from injections

[scorpiojo in reply to Gambit62]

Thanks for the help... I'll carry on and I know GP is going to for life every 3moths with his jab... So I just need to see re the t3 ... I'll get answers on the other board I'm sure... Thanks you guys... And happy new year x

[scorpiojo]

Medneg, I think it's worth noting which of these acid blockers etc is the worst evil... I'm left thinking that I can't do nothing at all, it's too painful.... However, if it's the case that because I've known what it affects then I can try and get around things a different way.... I'd been on Lanziprazole for years, and have probably caused lots of stripping of vitamins by taking it... Had I taken more notice I'd have been more proactive in getting vits down me in another way... From the b12 side it seems as long as I'm getting the jabs Ranitidine isn't canceling the jabs out... Not sure about the Vit d or ferritin and Folate... Maybe someone can comment on which of these drugs (Ranitidine Lanziprazole etc etc) is the least stripping while helping the hernia acid thing... Or ways to take Ranitidine and get the vid d ferritin and folate needed despite the drug... I don't see me coming off Ranitidine type drugs, as I've tried the vinegar thing so need to fit it/Ranitidine in... Hope you can work it out too... Don't just dismiss it, try other things and check for more comments x

[scorpiojo]

The 1st reply seems to say it's not the best tablet for us to take... If there is anything other than Betaine or vinegar, which I tried and didn't help, I'm guessing I'll have to take the best of these stripping drugs:(( Good thing about here is that people will update if anything better comes along.... My Vit D was 15 so you were very low... I will take top ups and have blood tests to keep on top of what Ranitidine strips... Fingers crossed we all feel better in 2017 x

[scorpiojo]

I believe that has the same B12 stripping side effect... My aim is to find the least stripping tablet for acid, as I don't need any more B 12 stripped from my system 😊 Thanks for reply