Antacids help relieve symptoms such as heartburn, bloating, and indigestion by neutralizing stomach acid. However, long-term use can cause side effects, such as reduced absorption of vitamin B12.
According to Dr Mangesh Borkar, Consultant Gastroenterologist, Manipal Hospital, Kharadi, Pune (India), although vitamin B12 deficiency does not always occur when using antacids, if a patient needs to use antacids for a long time, it is important to monitor vitamin B12 status. The doctor may recommend periodic tests to check the vitamin B12 levels in the body and supplement if necessary.
The role of antacids
“Antacids help control heartburn and acid reflux symptoms by raising the pH of the stomach, reducing irritation of the lining of the esophagus and stomach. They contain ingredients such as calcium carbonate, sodium bicarbonate, magnesium hydroxide, and aluminum hydroxide, which work quickly,” says Mangesh Borkar, MD, PhD.
However, they are only effective in treating mild to moderate acid problems and do not address the cause of acid production. Therefore, they are less effective for severe or chronic conditions such as gastroesophageal reflux disease (GERD).
Side effects of long-term use of antacids
Dr. Borkar warns that the continued use of antacids can cause some negative side effects. Antacids containing magnesium can cause diarrhea, while aluminum hydroxide can cause constipation. Another major concern is electrolyte imbalance, when the body has too much or too little of certain minerals.
Dr. Borkar also notes that long-term use of antacids can alter stomach acid levels, affecting the ability to absorb nutrients like calcium, increasing the risk of injury and bone density problems. Additionally, prolonged use of the drugs can also change the pH of urine, leading to a risk of kidney stones.
Can long-term use of antacids cause vitamin B12 deficiency?
Long-term use of antacids, especially proton pump inhibitors (PPIs) and H2 blockers, can cause vitamin B12 deficiency, says Dr. Borkar. Stomach acid helps release vitamin B12 from food for absorption by the body. When medications reduce stomach acid, this process is disrupted, resulting in the body not absorbing enough vitamin B12 and depleting its stores.
To address vitamin B12 deficiency when using antacids long-term, Dr. Borkar recommends that patients have their vitamin B12 levels checked regularly. Depending on the severity of the deficiency, your doctor may recommend vitamin B12 supplementation, either by oral medication or intramuscular injection. Dietary changes, including foods rich in vitamin B12 such as milk, meat, fish, and fortified cereals, may also be effective.
