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antacids and vitamin b12

Long-term antacid use depletes B12

What's happening

Stomach acid is required to release B12 from food proteins. Long-term PPI use (>2 years) increases B12 deficiency risk by 65%. Can cause anemia, neuropathy, cognitive decline. Sublingual B12 bypasses this issue.

Recommendation

Monitor B12 levels if on long-term PPIs. Consider sublingual or injection B12.

Timing

Use sublingual B12 which doesn't require stomach acid

Sources

  • — JAMA
  • — PMID: 24327038
  • — PMID: 19996585

Frequently Asked Questions

Can I take antacids and vitamin b12 together?

Long-term antacid use depletes B12. Monitor B12 levels if on long-term PPIs. Consider sublingual or injection B12.

How should I time antacids and vitamin b12?

Use sublingual B12 which doesn't require stomach acid

Is this interaction dangerous?

This interaction is rated “Warning” by Formulate. Stomach acid is required to release B12 from food proteins. Long-term PPI use (>2 years) increases B12 deficiency risk by 65%. Can cause anemia, neuropathy, cognitive decline. Sublingual B12 bypasses this issue.

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Medical disclaimer. This page is for educational purposes only and does not replace advice from a qualified healthcare provider.