What supplements should I take while on PPI?

Until evidence-based guidelines become available, it seems prudent to advise patients on chronic PPI therapy to consume a well-rounded diet rich in natural B complex, iron, calcium and magnesium.

Should you take magnesium with PPI?

Treatment of hypomagnesemia generally requires magnesium supplements. Treatment in patients taking a PPI and who have hypomagnesemia may also require stopping the PPI.

Do proton pump inhibitors cause B12 deficiency?

The use of PPIs for two or more years was associated with increased odds of vitamin B12 deficiency (odds ratio 1.7; 95\% CI, 1.6–1.7). Among patients taking PPIs for at least 2 years, higher daily doses were associated with higher odds of vitamin B12 deficiency (see TABLE).

How much magnesium should I take for PPI?

Suggested supplementation of magnesium is 250 to 400 mg/day. Second is vitamin B12 rated as a moderate depletion. Monitoring of vitamin B12 is recommended, and some people may need a supplement.

Does omeprazole stop B12 absorption?

Omeprazole interferes with the absorption of vitamin B12 from food (though not from supplements) in some but not all studies. A true deficiency state, resulting in vitamin B12-deficiency anemia, has only been reported in one case.

Can omeprazole cause B12 deficiency?

Summary: The chronic use of proton pump inhibitors such as omeprazole (Prilosec) is fairly common in medical practice especially for gastroesophageal reflux disease (GERD) or in patients at increased risk of peptic ulcer disease (PUD), but has been associated with causing vitamin B12 deficiency.

What nutrients do PPIs deplete?

PPIs have been associated with an increased risk of vitamin and mineral deficiencies impacting vitamin B12, vitamin C, calcium, iron and magnesium metabolism.

How do PPI affect magnesium?

PPIs may decrease intestinal magnesium (Mg) absorption by interfering with both active [transient receptor potential melastatin (TRPM) protein channels] and passive (paracellular pores) absorption [6, 7].

Does PPI cause low magnesium?

Hypomagnesemia has recently been recognized as a side effect of PPIs. Low magnesium levels may cause symptoms from several systems, some of which being potentially serious, such as tetany, seizures and arrhythmias. It seems that PPIs affect the gastrointestinal absorption of magnesium.

How long does it take to restore magnesium levels?

Chronic magnesium deficiency is often associated with normal serum magnesium despite deficiency in cells and in bone; the response to oral supplementation is slow and may take up to 40 weeks to reach a steady state.

Does omeprazole block magnesium?

The PPIs may inhibit active magnesium (Mg) absorption by interfering with transcellular transient receptor potential melastatin-6 and -7 (TRPM 6 and 7) channels. More recent cell culture studies have suggested concomitant inhibition of passive Mg absorption by omeprazole.