Vitamin B12 is a lot easier to get than people realize- if you take the following medications, you may be susceptible to severe vitamin B12 deficiency, even if you include plenty of B12-rich foods in your diet.
Vitamin B12 (cobalamin) occurs naturally in many foods that most people eat every day; lean beef, poultry, organ meats, fish, shellfish, eggs, and dairy products all contain generous amounts of vitamin B12- enough to avoid becoming deficient.
However, there are certain medications that may interfere with your ability to extract vitamin B12 from the foods you eat, eventually resulting in a severe drop in vitamin B12 levels.
What is vitamin B12, and why is it so important?
Vitamin B12 malabsorption may occur if you currently take the following pharmaceutical drugs:
Medications that cause vitamin B12 deficiency
- Cholestyramine (Cholybar®, Questran®) – used to lower high cholesterol levels in the blood.
- Cimetidine (Tagamet®) – used to treat and prevent stomach ulcers.
- Clofibrate (Atromid-S®) – impairs absorption of vitamin B12 –
- Colchicine– (ColBenemid®) – used to prevent or treat attacks of gout (also called gouty arthritis)
- Co-trimoxazole– It reduces bacteria that cause infections of the urinary tract, lungs (pneumonia), ears, and intestines.
- Demeclocycline– an antibiotic used to treat bacterial infections.
- Famotidine– a histamine blocker used to treat and prevent ulcers.
- Fluoroquinolones– antimicrobials used to kill bacteria in pneumonia, urinary tract infections, and diarrhea.
- Lansoprazole– used to prevent stomach ulcers and to treat other conditions in which the stomach produces too much acid.
- Macrolides– antibiotics used to treat a wide range of bacterial infections.
- Metformin– type 2 diabetes drug, known to cause vitamin B12 deficiency.
- Methyldopa (Aldomet®) – reduces vitamin B12 levels, leading to a vitamin B12 deficiency.
- Minocycline– antibiotic used to help treat periodontal disease, acne, and inflammatory arthritis.
- Neomycin– antibiotic, antibacterial used topically to treat skin infections, wounds, and burns. Neomycin impairs vitamin B12 absorption and has been shown to decrease vitamin B12 levels.
- Nizatidine– used to treat and prevent stomach ulcers, intestinal ulcers, and acid reflux.
- Omeprazole (Prilosec®) -used for gastroesophageal reflux disease (GERD).
- Oral contraceptives– oral contraceptives with high estrogen content leads to decreased levels of vitamin B12.
- Phenobarbital (Donnatal®, Solfoton®) -barbiturate, anticonvulsant that results in decreased levels of vitamin B6 and vitamin B12, in addition to elevated homocysteine levels. (Vitamin B12, Homocysteine, and your Heart)
- Phenytoin– an antiepileptic drug.
- Potassium chloride– used for dehydration, can be deadly in its concentrated form.
- Ranitidine (Zantac®) H2-receptor, heartburn medication used to suppress production of stomach acids that are necessary for digesting vitamin B12.
- Sulfonamides– antibiotics used to treat a wide range of bacterial infections.
- Tetracyclines (Achromycin®, Sumycin®, Tetra-C®, Tetracyn®, Tetralyn®, Tetram®, Tropicycline®) – antibiotics prescribed for acne.
- Trimethoprim– (TMP/SMX) is used to treat urinary tract infections, pneumonia, and “travelers’ diarrhea.”
- Valproic Acid (Depakene®) – anticonvulsant used for migraine headache prevention.
Symptoms of vitamin B12 deficiency
Because the decline is so gradual, people usually don’t realize that they’re not getting enough vitamin B12 until they begin experiencing the warning symptoms- which often arrive only when depletion is severe.
Warning signs of vitamin B12 deficiency include:
- Constant fatigue
- Sluggish thinking (brain fog)
- Depression
- Confusion
- Difficulty concentrating
- Memory loss
- Painful tingling, burning, and numbness in hands and feet
- Poor coordination
- Muscle twitches and spasms
- Eye problems
- Tinnitus (ear ringing)
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