Vitamin B12, or cobalamin, is a powerhouse nutrient our bodies cannot produce. It is fundamental for maintaining healthy nerve cells, producing DNA, and forming red blood cells. Since we rely entirely on diet or supplements to meet our needs, deficiencies are surprisingly common, and a leading Indian neurologist has pinpointed two everyday medications as silent contributors to this growing health concern.
The Hidden Culprits: Common Drugs Depleting Your B12
Dr. Sudhir Kumar, a prominent neurologist, has highlighted a critical but often overlooked side effect of two widely prescribed drug classes. These medications can interfere with the body's ability to absorb vitamin B12, leading to a gradual and potentially severe deficiency if left unchecked.
The first is Metformin, a first-line medication for managing type 2 diabetes and often used for PCOS. Dr. Kumar explains that Metformin can reduce the absorption of vitamin B12 in the small intestine. This risk escalates with long-term use or higher doses of the drug. Millions of Indians rely on Metformin, making this a significant public health consideration.
The second group is Proton Pump Inhibitors (PPIs), which include drugs like omeprazole and pantoprazole used to treat acidity, reflux, and ulcers. These work by reducing stomach acid secretion. "The B12 found in food is not released, and again so there is less absorption of B12," Dr. Kumar stated in a YouTube video. Less stomach acid means the vitamin isn't properly liberated from food for absorption.
Who is Most at Risk?
The neurologist clearly identifies the high-risk groups. Individuals taking Metformin or PPIs for more than two years face a higher risk. Furthermore, older adults, especially those over 60, are particularly vulnerable. Global surveys indicate that about 6% of adults over 60 are B12 deficient, with nearly 20% having borderline levels.
Diet plays a crucial role. Those following a strict vegetarian or vegan diet are at increased risk because primary natural sources of B12 are animal-based—meat, eggs, and dairy. This combination of medication use and dietary habits makes the deficiency far more prevalent in developing countries like India.
Recognizing the Warning Signs
Vitamin B12 deficiency can creep in silently. Dr. Kumar advises watching for key symptoms, especially if you are on these medications. Early signs include unexplained fatigue, tingling or numbness in hands and feet (pins and needles), poor balance, and pale skin.
Other symptoms can be diverse and affect multiple systems:
- Cognitive changes like forgetfulness, memory problems, or confusion
- Psychiatric disturbances and irritability
- A sore mouth or tongue ulcers
- Vision problems
- Nausea, vomiting, diarrhea, or loss of appetite
- Unintended weight loss
If ignored, prolonged deficiency can lead to severe and sometimes irreversible neurological damage.
How to Protect Yourself: Prevention is Key
Dr. Kumar emphasizes that the solution is not to stop these effective medications but to adopt a proactive monitoring strategy. His primary recommendation is straightforward: Get a vitamin B12 blood test every one to two years if you are on long-term Metformin or PPI therapy. This should be done under your doctor's guidance.
"If any of these symptoms occur, the B12 level should be tested. Even if someone is totally normal, at least once in one to two years, the B12 levels can be tested. And once you test it, it can be easily treated," he reassured. Treatment typically involves B12 supplements or injections, which are highly effective.
The bottom line, according to Dr. Kumar, is that while Metformin and PPIs are safe and essential for managing chronic conditions, awareness of their potential side effect on B12 levels is crucial. Regular monitoring, coupled with a discussion with your healthcare provider, can prevent deficiency and its serious consequences. Do not alter your medication without consulting your doctor.
