Apollo doctor warns: Two common medicines that affect vitamin B12 absorption in the body

Vitamin B12 deficiency is often associated with poor diet or absorption issues, but according to a recent video shared by Dr. Sudhir Kumar, MD, a senior neurologist at Apollo Hospitals in Hyderabad, certain commonly prescribed medications can also play a significant role. Speaking through his YouTube channel, Dr. Kumar explained that two types of medicines — metformin and proton pump inhibitors (PPIs) — can interfere with the body’s ability to absorb vitamin B12, potentially leading to deficiency over time.

Metformin and Its Impact on B12 Absorption

Dr. Kumar highlighted that metformin, a widely used drug for managing diabetes and also prescribed in cases of polycystic ovary syndrome (PCOS) and metabolic disorders, is one of the key culprits. He explained that metformin can reduce vitamin B12 absorption in the small intestine. This interference, if prolonged, can result in a gradual decrease in B12 levels in the body.

He advised that individuals who are on long-term metformin therapy should remain aware of possible signs of vitamin deficiency. These may include fatigue, numbness, tingling sensations, or even cognitive changes such as forgetfulness and mood disturbances. Regular testing of B12 levels is recommended at least once every one to two years, especially for those taking the drug for extended periods.

PPIs and the Role of Stomach Acid
The second class of drugs Dr. Kumar referred to are proton pump inhibitors (PPIs), commonly prescribed for acidity and peptic ulcers. Medications such as omeprazole, pantoprazole, rabeprazole, and esomeprazole are widely used for gastric conditions. Dr. Kumar explained that while PPIs are effective in reducing stomach acid, this decrease in gastric acid secretion affects how vitamin B12 is released from food, resulting in lower absorption levels.

He noted that individuals who depend on these medications for chronic acidity or digestive issues could unknowingly become deficient in B12. This is because the stomach acid required to extract B12 from dietary sources becomes significantly reduced during long-term use of PPIs.

Dr. Kumar emphasised that those taking metformin or PPIs should not stop their medication without consulting a doctor. Instead, he recommended regular monitoring of B12 levels and prompt testing if symptoms of deficiency appear. Early detection, he added, allows for easy correction through supplementation or dietary adjustments.