Methylmalonic Acid Levels in Non-Elderly Adult Chronic PPI Users

The use of proton pump inhibitors in the elderly population may increase the risk of vitamin B12 deficiency, as gastric acid is needed for vitamin B12 absorption. It is unclear whether the same risk is present for non-elderly adults reporting chronic use of proton pump inhibitors. The aim of this study was to determine whether chronic use of proton pump inhibitors results in increased urinary methylmalonic acid levels in non-elderly adults, indicating risk for vitamin B12 deficiency. Fifteen men and women who had been taking proton pump inhibitors daily for a minimum one year or longer were recruited. Fifteen proton pump inhibitor non-users, ageand gender-matched to subjects in the user group, were recruited. Urinary methylmalonic acid levels determined vitamin B12 status. Urinary methylmalonic acid levels were within the normal range for all study participants. There was no significant difference in urinary methylmalonic acid levels between the proton pump users Mdn=1.50 mcg uMMA /mg creatinine, and non-users Mdn=1.70 mcg uMMA/mg creatinine, p=0.29. Chronic use of proton pump inhibitors did not affect vitamin B12 status of subjects in this pilot study of non-elderly adults. Regular monitoring of vitamin B12 status does not appear to be needed in this age group; however, studies using larger groups are indicated.