I am worried and I don’t know if I am worried about nothing.
In a nutshell, in 2018 hubby starts heart meds and has done so ever since. One of which is landoprazole 15mg every day. Purpose to protect his stomach from the potential harm from taking 75mg asprin to thin his blood.
A couple of weeks ago he had a blood test for B12 and Full Blood Count amongst other things. He was offered the blood test because he is becoming increasingly forgetful, irritable, unable to recall conversations and I think he is sleeping more than he usually does. (Sound familiar ?? 😂)
I checked the information leaflet for Lansoprazole and it says “… may lead to a reduced absorption of B12.” It also says “very rarely … may cause a reduction in the number of white blood cells which may decrease your resistance to infection.”
His bloods:
B12 201 ng/L (145-914 ng/L) with note that “If strong clinical features of vitamin B12 deficiency… levels up to 200 ng/L may indicate deficiency.”
Serum Folate 8.9 ug/L (<3 suggests deficiency). Total white cell count 3.71 x 10*9/L (4-10 x10*9/L).
MCV 99.3 fL (83-101 fL).
MCH pg (27-32 pg)
GP opinion carry on taking Lanzoprazole. Bloods ok and within acceptable ranges and hubby could have been fighting an infection at time of blood test which is why white blood cells low. No need to supplement with B12 or change medication. Unfortunately, his B12 and folate was not tested 5 years ago or until now so we cant compare.
My instinct is that his poor memory and sleepiness is potentially B12 deficiency and that I should just get an over counter sublingual B12 for him to take and see if he improves.
He has stoped the Lanzoprazole and is considering replacing the asprin with 100mg ginger extract with 5% gingerols which has the same effect of thinning blood but without the risks associated with asprin … but that’s another story.
Any insights please? Thank you in advance 🤗🤗🤗🤗🤗
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Wwwdot
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Any medication that suppresses stomach acid will reduce absorption of many vitamins & minerals. You're right to worry in my opinion.
That absolutely sounds like B12D & labs back that up! Yes sounds very familiar Poor hubby!
Question is how to treat. Tablets are possible. But with symptoms like that, in my nonmedical opinion and if it was my family member, i'd get IFAB tested and then pursue injections. The symptoms being the key point. Even in people with deficiency due to dietary reasons like veganism, loading doses of injections are sometimes used to quickly get levels up, before switching to tablets. You might ask doc to treat this way. Remind me to look up some references or maybe someone else will have them.
Treat folate only after starting b12 - it's within range but b12 will likely use it up. The thyroid group says it's best in the upper half of the range, though your lab doesn't give a range & neither does mine LOL.
After ruling b12 out, other possibilities are hypothyroidism and sleep apnea. Or all 3 , like me 😂
Does he snore at night?
Any thyroid labs?
Have you tested Vit D, iron/ferritin?
Has he had a bone density scan? Calcium malabsorption combined with low vit D/K2 can cause bone loss.
There may be other important vitamins/minerals to test that i'm not recalling right now, it's bedtime 😴
I'll keep my opinions on 'stomach protectors' , or whatever they call the oprazoles, to myself 😬
I would also test homocysteine. Maybe that will convince them to give injections.
Fyi high homocysteine can cause heart problems, as can hypo & hyper thyroidism. Sounds like he has atrial fibrillation? Only share as much as you want, of course
Thank you and you made me laugh … “Does he snore at night?” Yes!! We sleep in separate rooms because it is deafening and I either burst into tears or fits of giggles when he keeps me awake!
He’s a builder on the go all day so generally good bone strength, and he looks well. He’s decided to lose weight and is losing his trousers as he’s lost 6 kgs in about 11 weeks. I am pretty sure the B12 deficiency is due to the ‘stomach protector’. I will try to encourage him to go see a different GP.
You’ve had an excellent reply from jade_s .Lasoprazole is the culprit . It should only be taken for a short while. B12 injections will be of huge benefit . That’s what he needs to put him back on his feet . . Jade had given such good advice . Follow it ! Best wishes .
I've been on lansoprazole for more years than I can remember (largely because of the gastrectomy in 1959) - but that's OK for me because I've been on B12 injections for over fifty years.
If Wwwdot 's husband can get the the B12 injections he should be able to continue to take the lansoprazole if that is what is needed for his aspirin intake.
Yes Clive you are right . But so many GPs are ignorant about that . I actually know someone who was on a high dosage of Omeprazole for 12 years . B12 never tested for. Got totally numb feet . The numbness traveled up her legs . Neurologist prescribed 2 terrible spinal operations —to no avail of course . Now in wheelchair . Tragic. .
Oh my LOL. He should definitely get checked out for sleep apnea. The long term effects include increased risk of (more) heart problems, stroke, car accidents (falling asleep at the wheel). Easier said than done, i understand The weight loss may or may not reverse it.
The males in his family, including cousins have a tendency to loud snoring and his father had sleep apnea which was scary when he used to come stay with us!🤪
Don’t get me wrong, he is y sleepy or falling asleep, it’s just that when he goes to sleep he sleeps very deeply and for hours longer than me - up to 9 hours and he takes longer to wake up fully sometimes - like he’s hungover (but he isn’t).
It’s difficult because I feel he thinks I am making a fuss so I am not the only one injecting B12! I must confess I do feel as if I am seeing B12 deficiency everywhere. 🤗🤗🤗
When i went in for my sleep test, i had no daytime sleepiness or stopping breathing any of the other typical things except snoring like a freight train 😂
They found i had nearly 40 hypopneas an hour, which is reduced airflow, and it was causing me to wake up 40 x an hour with oxygen saturation down to 93%. The doc said my body was very responsive to the hypopneas by waking me before they became full blown apneas (total stopping of breathing), and it did this by constantly releasing adrenaline 😳 I too would wake up feeling hungover. I sleep soooo much better with my cpap
Cpap stands for continuous positive airway pressure & refers to the machine that we use to keep our airways open at night. It's connected to a mask that you wear over your nose/mouth at night, and it blows air at your prescribed pressure, allowing the airway to stay open. No more sleep apnea. People find it a bit fiddly or even annoying, but you get used to it. And when you start feeling better & refreshed, it's absolutely worth it!
yes this happened to me, I was on lansoprazole for 15 years and ended up like your husband thinking I had dementia or some kind of degenerative disease, through desperation I researched and was bought back from the edge with b12 injections and coming off lansaprazole , my doctor was not interested at all in the association, I had to dig deep and use my intuition , having coeliac disease also my kindly doctor prescribes me b12 to self inject, but you can now pay to have them at beauty salons ect….it is on the leaflet side effects and is real but you may not get very far so my advice would be to get the injections However you can.
Hi how did you come off the Lanzoprazole after being on it so long . What did you use instead and how did you wean as I know acid reflux can be really bad if you try to come off .
I had fundoplication surgery, it was a long process to get it and a bumpy ride recovering but it cured my acid reflux so I no longer need any ppi’s , antacids ect
I believe that what was an intermittent B12 deficiency turned into PA because I began taking Omeprazol. I also believe that PPIs are possibly harmful drugs, particularly for older people. It is widely recognised that, whilst having some protective effect on the stomach, they can damage the stomach lining and impair it's ability to process B12. I think it would be wise to pursue the B12 route and find a way of injecting, if only to see it it improves your husband's health.
Thank you, what a nightmare this is. 😭 The GP who is head of the practice said there is no association of B12 deficiency and using Lansoprazole even though it says so on the leaflet AND on the NHS website.
That’s all 4 family members now with low B12 - looks like my kids have inherited my PA genes.
I will print off the NICE guidelines and send him back with the leaflet and see what happens.
Tanyanarialucia, may I be nosey and ask did you go through painful reversing symptoms? Has the damage been permanent?
Thank you all. I was really hoping that this was all in my head. I am so grateful but also really upset too 🤗🤗🤗🤗
ask away, i needed all the help and research I could get to make myself better, it’s been a long road for me as I had undiagnosed coeliac disease hence being on ppi’s for 15 years to suppress constant reflux, no one looked into the cause untill I was so poorly and in hospital, I had fundoplication surgery to stop the reflux and stopped taking ppi’s…. It’s taken a long time but with regular b12 injections and all the supplements a coeliac needs I’m now functioning well and working full time which is a very different story from how I was… so yes it is reversible!
That sounds like a tough road you walked and thank you for sharing the wisdom acquired. Good to know that you are in a better place. Thank you again 🤗🤗🤗
If you check the entry for aspirin in the British National Formulary, you can see that in many cases the preferred treatment is not aspirin. Rather, nowadays, often a Direct Acting Oral Anticoagulant (DOAC - formerly NOAC for "novel"). Things like Apixaban.
That is, it is worth reading further and considering whether aspirin is the most appropriate medicine. If not, then that might remove any justification for lanzoprazole being prescribed.
Not that I know enough about the relative merits of the various options and the balance of decisions.
I am still reeling from the situation and your information is so helpful.
I am thinking of alternatives to Asprin so I will look it up. Hubby has stopped the Lansoprazole for now and takes the Asprin with his meal for the time being but that’s a holding position.
Ideal is to get away from Asprin, I will look into Apixaban and I am also looking at ginger extract.
I'm sure you know that there are other possible thinners as well as ginger, such as natural vit E, turmeric, garlic, magnesium. Worth looking into, depending on husband's diagnosis of course, but he needs B12. Cheers
What sort of heart condition is your hubby suffering from ? I was advised to stop my aspirin and suffered heart failure ! I take 2 aspirin and clopidogrel to thin my blood plus lansoprazole to protect my stomach - or destroy it depending on how you look at it !
Yes indeed ginger ect can help thin the blood but will it be enough to stop further heart problems ? It's too late once it has occured. I wouldn't advise anyone with a heart condition to stop medication without getting advice from a cardiologist first.
Indeed lansoprazole is not good long term but you have to weigh up the pro's and con's of takinging the wretched things - the heart is not something to mess with and medical advice needs to be sought before any changes are made. I now suffer with a B12 deficiency and self inject.
I would mention the lansoprazole to your hubbys Gp, insist on further B12 testing and voice your concern's.
Thank you and happy to hear you are still with us despite a horrible experience.
He had two stents fitted and was diagnosed with heart disease - it’s more likely genetic makeup as he doesn’t smoke or drink excessively- just works very hard in a physical job.
GP is clueless as insists all is fine and no Lansoprazole/B12 connection. I just don’t need another health battle but life is what it is.
Two stents ! So your hubby has a serious heart problem which should not be messed with when it comes to his medication without seeking mediacal advice.
There is lots of info in regard to lansoprazole and B12 deficiency. Most Drs seem clueless and many of us have to battle to be heard.
We have to weigh up what is best of the ailments ( non of which are very good ) a heart attack or stroke because he has stopped the aspirin or to treat the B12 deficiency - I chose the latter.
Yes it was a serious situation but he is and always has been very physically active. I am concerned at the large range of medication he’s been on for 5 years with no blood tests, reviews or check ups. You wouldn’t do that to a car and not expect problems!!
It is a balancing act, I know, and the choice of the lesser of two evils but I find it hard to come to terms with the complete lack of understanding by GPs of what they are dishing out is not without consequences that need to be addressed.
I can feel a rant coming on … will bow out gracefully! 🤗🤗
Hi I’ve PA now and interestingly was on Aspirin and Lansoprazole after cardiac surgery 21/2 years ago. Aspirin did not suit my stomach ended up with microscopic colitis after too. I was put on Apixaban blood thinner , kinder to stomach. I would get your husband to really emphasise to his GP about how badly it’s effecting his stomach . I actually had blood loss through bowel so pretty bad. You don’t want to get like this. Aspirin does not suit everyone. Try to get them to swap to a Noac blood thinner if you can .You don’t need to be in Lanzoprolole either then.
It is good to know that you found a workable alternative.
I actually don’t think he needs to be on the Lansoprazole as it was prescribed at the same time as he started Asprin - as a “just in case”. I have asked him to stop the Lansoprazole which he has done for 4 days now and to take the Asprin with a meal and there do not seem to be any obvious issues with that for the time being.
I will look into Noac blood thinners. Thank you for taking the time to share. 🤗🤗🤗
Hi, I can agree with many of previous responses. I was on ppi's/lanz. for 8+ years to protect my gut from possible S.Es. of diclofenac (nsad). Also on 2 monthly B12 because of neuropathy etc. I became very jittery / anxious while on Lanz. (do Google side effects of Lanz) and GP wasn't to interested. I am sure I had developed achlorhydria or hypochlorhydria due to ppi. I think my gut had ceased absorbing essential minerals.I stopped the Lanz and now take a multmineral/multivitamin every day. Jittery/lack of confidence problems started to disappear within a week. I have now added a live yoghurt to my diet hoping it enhances mineral absorption.
hi there. Can’t comment on the lanzoprasol but I was on Omeprazole for over 10 years non stop and had a few issues and now better for it. Re Vitamin B12 and Folic acid deficiency. My B12 was down to 139 don’t know how long it had been an issue but over the last 2 years, unintentional weight loss. Excessive tiredness. Loss of appetite, anxiety and stress, lack of motivation. I’ve just had my 4th loading injection out of 6 and o have a lot more energy and motivation. 2 more this week and then 1 every 3 months. Taking 1 folic acid tablet a day.
I would ask Gpfor a course and if no, why not, maybe he can take a supplement or there is an option to get injections through a clinic. Worth researching. He’ll feel so much better.
GP opinion is unchanged. Ie bloods are fine. B12 levels are fine. Keep taking Lansoprazole.
After your posts, I sent bloods to the PA consultant I saw and he said the opposite. The presence of neurological symptoms combined with low B12 of concern, also looking at iron and vitamin D etc.
Hubby is booked in for further blood tests and B12 loading doses 3rd week of July. AND he’s forgiven me 😂😂😂
Thank you all for giving me the support and courage to act on my convictions.
I will give you an update in due course. As always you guys are priceless 🤗🤗🤗🤗🤗
Remember, and tell him, it can get worse before it gets better. Oh and in my case i had to sleep / nap like crazy, also a known effect. So if he suddenly can't keep his eyes open after lunch (more than usual LOL), then it's not a bad sign
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Poor hubby! 
The weight loss may or may not reverse it. 
B12/folate
Low B12 *Update after seeing unhelpful GP*
First post - B12 & leg cramps
Low B12 with 'normal' MCV/MCH
