Omeprazole Therapy Causes Malabsorption of Cyanocobalamin (Vitamin B sub 12)

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Abstract

Objective

To evaluate protein-bound cyanocobalamin (vitamin B12) sub absorption before and after omeprazole (Prilosec) therapy in healthy male volunteers.

Design

Clinical trial in which each volunteer served as his own control.

Setting

Outpatient department of a university medical center.

Participants

Ten healthy, male volunteers 22 to 50 years old.

Intervention

Each participant had a modified Schilling test (protein-bound cyanocobalamin) and a gastric analysis, as well as measurements of serum vitamin B12, gastrin, and folate levels. Five patients were then randomly assigned to take either 20 mg or 40 mg of omeprazole daily. After 2 weeks of omeprazole therapy, these tests were repeated.

Measurements

The modified Schilling test, gastric analysis, serum gastrin level, folate level, and cyanocobalamin level.

Results

At the end of the 2-week treatment period, cyanocobalamin absorption decreased from 3.2% to 0.9% (P = 0.031) in participants receiving 20 mg of omeprazole daily. In patients taking 40 mg of omeprazole daily, cyanocobalamin absorption decreased from 3.4% to 0.4% (P < 0.05).

Conclusions

Omeprazole therapy acutely decreased cyanocobalamin absorption in a dose-dependent manner.

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