List of medications to avoid?

[Myoldcat]

Hi all, hope we're all getting our natural Vitamin D on this sunny Sunday☀️?

I understand there are some medications that can badly affect us B12 deficients - certain antibiotics for instance.

Is there a definitive list available? I've searched this forum but can't find anything. I'd really like to have a reference list if possible, to avoid taking anything that will undo all my hard won improvement.

Many thanks.

[Wheat]

hello, I found this:

' Medications That Lower Vitamin B12 Concentrations Copyright EBM Consult

Interacting Medication Proposed Mechanism

Colchicine

Impairs or inhibits the receptors located in the terminal ileum of the small intestine for which vitamin B12/intrinsic factor complexes would bind to for absorption.

Chloramphenicol

Most likely due to an inhibition within the bone marrow due to chloramphenicol's ability to cause bone marrow suppression thus depriving the red bloods cells from utilizing the available B12.

Ethanol

Impairs absorption from the intestine possibly due to affects on the pancreas. May affect the pancreas' ability to secrete proteases necessary to release vitamin B12 from R-binders within the duodenum.

Antagonists (H2RA)

Histamine 2 Receptor Increasing the gastric pH (i.e., making the gastric pH more alkaline) can impair the activation of pepsin that is necessary for freeing vitamin B12 bound to protein within the ingested food so that it can then bind to an R-binder. When the pH is high pepsinogen is not as effectively converted to pepsin for this process to take place.

Metformin

The mechanisms may be multifactorial and include: an effect on intestinal motility, bacterial overgrowth, and/or alterations in calcium-dependent uptake of the vitamin B12/intrinsie factor complex within the terminal ileum of the small intestine. Proton Pump

Inhibitors (PPI)

Increasing the gastric pH (i.e., making the gastric pH more alkaline) can impair the activation of pepsin that is necessary for freeing vitamin B12 bound to protein within the ingested food so that it can then bind to an R-binder. When the pH is high pepsinogen is not as effectively converted to pepsin for this process to take place.

E B M CONSULT'

Also Nitrous Oxide. Associated with surgery, dentistry.

Others on this forum may know more.

Best wishes, x

[Myoldcat in reply to Wheat]

Thanks Wheat, very helpful.

[Regenallotment in reply to Wheat]

This is so helpful! Thanks for posting 🙏

[Pa234aw]

Trimethoprim, a common antibiotic for urinary and other infections, attacks folate which has a bearing on B12. It’s listed on some NHS VB12 deficiency/PA documentation.

[Myoldcat in reply to Pa234aw]

Thank you, that is very useful to know.

[Cherylclaire Forum Support]

I found a few, years ago now, and kept a copy of two of them:

Drugs.com : "Vitamin B12 (cyanocobalamin) Drug Interactions" list 27 interactions.

University of Maryland Medical Center : " Drugs That Deplete: Vitamin B12 (Cobalamin)" umm.edu/health

I have personally had reactions to antibiotics ( Metronidazole, Doxycycline) - both caused vertigo and headache. Also Trimethoprim seems to have had a bad effect on others here.

[Myoldcat in reply to Cherylclaire]

Thanks for this Cherylclaire. I had a bad reaction to Nitrofurantoin, and wanted to be prepared if i need to take any thing in the future, especially antibiotics.

[Cherylclaire Forum Support in reply to Myoldcat]

There are likely to be more up to date lists now available.

Worth letting GP know if you have a bad reaction to any drug - it might help others with B12 deficiency in future. Still hopeful !

[Myoldcat in reply to Cherylclaire]

GP education is part of our job! 😄

[Cherylclaire Forum Support in reply to Myoldcat]

Every day's a school day !