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Medications

Supplements and Acid reducers (PPIs)

omeprazole, esomeprazole, pantoprazole, lansoprazole

Caution

IronCautionHuman data

PPIs reduce iron absorption. Stomach acid helps absorb iron. In iron-deficient patients taking omeprazole, most responded poorly to oral iron. If you're treating low iron on a PPI, have your levels rechecked.

  1. 01Ajmera AV et al. Suboptimal response to ferrous sulfate in iron-deficient patients taking omeprazole. Am J Ther 2012.
  2. 02NIH Office of Dietary Supplements — Iron Fact Sheet for Health Professionals

Note

Vitamin B12NoteHuman data

Long-term PPI use is linked to low vitamin B12. In a large study, taking a PPI for 2 years or more was associated with a 65% higher risk of B12 deficiency. B12 supplements are a common fix — ask about checking your level.

  1. 01Lam JR et al. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA 2013.
  2. 02NIH Office of Dietary Supplements — Vitamin B12 Fact Sheet for Health Professionals
MagnesiumNoteHuman data

PPIs can lower magnesium. Long-term PPI use is linked to low blood magnesium. That's a reason to have your level checked, not a reason to avoid magnesium.

  1. 01Cheungpasitporn W et al. Proton pump inhibitors linked to hypomagnesemia: a systematic review and meta-analysis of observational studies. Ren Fail 2015.
Check your stack with Acid reducers (PPIs)

Common questions

Can I take Iron with Acid reducers (PPIs)?

PPIs reduce iron absorption. Stomach acid helps absorb iron. In iron-deficient patients taking omeprazole, most responded poorly to oral iron. If you're treating low iron on a PPI, have your levels rechecked.

Can I take Vitamin B12 with Acid reducers (PPIs)?

Long-term PPI use is linked to low vitamin B12. In a large study, taking a PPI for 2 years or more was associated with a 65% higher risk of B12 deficiency. B12 supplements are a common fix — ask about checking your level.

Can I take Magnesium with Acid reducers (PPIs)?

PPIs can lower magnesium. Long-term PPI use is linked to low blood magnesium. That's a reason to have your level checked, not a reason to avoid magnesium.

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