{"id":637300,"date":"2026-10-26T09:00:41","date_gmt":"2026-10-26T13:00:41","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=637300"},"modified":"2026-09-29T23:17:21","modified_gmt":"2026-09-30T03:17:21","slug":"what-depletes-b12","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/what-depletes-b12\/","title":{"rendered":"Common medications that are quietly draining your B12"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/vitamin-b-12\">Vitamin B12<\/a> is an essential nutrient for healthy nerve function and making red blood cells. Deficiency is fairly <a href=\"https:\/\/www.aafp.org\/pubs\/afp\/issues\/2017\/0915\/p384.html\">common<\/a>, especially among vegans and older adults, since the most B12-rich foods are animal products. That said, a handful of everyday prescriptions, including over the counter medicines,\u00a0 can also quietly lower B12 levels by preventing the body from absorbing dietary B12. These medications don&#8217;t belong to a single class of drugs, so there&#8217;s no clear warning label to tie them together.<\/p>\n<p>Keep reading to learn which medications can silently drain B12, how to know if your prescriptions are affecting B12 levels, and what to do about it.<\/p>\n\t\t\t<div id=\"coupon-cta\" class=\"coupon-cta master-template\">\n\t\t\t\t<p id=\"headline\">Save up to 80% on Vitamin B12 with SingleCare<\/p>\n\t\t\t\t<p id=\"subheadline\">Different pharmacies offer different prices for the same medication. 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A few others may have an impact on your B12 levels, but the evidence is more limited.<\/p>\n<h3 id=\"acid-reducers-proton-pump-inhibitors-and-h2-blockers\">Acid reducers: Proton pump inhibitors and H2 blockers<\/h3>\n<p>People with heartburn or<a href=\"https:\/\/www.singlecare.com\/conditions\/gerd-treatment-and-medications\"> gastroesophageal reflux disease (GERD)<\/a> may be prescribed <a href=\"https:\/\/www.singlecare.com\/drug-classes\/proton-pump-inhibitors\">PPIs<\/a> and <a href=\"https:\/\/www.singlecare.com\/drug-classes\/h2-antagonists\">H2 blockers<\/a>, which suppress stomach acid production. However, because stomach acid is also needed to release vitamin B12 from food, PPIs and H2 blockers can gradually<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30032223\/\"> lower B12 levels<\/a>. &#8220;With prolonged use, [these medications] can reduce the amount of food-bound vitamin B12 that the body is able to absorb,&#8221; says <a href=\"https:\/\/www.linkedin.com\/in\/anthea-nwandu-md-mph-facp-dipablm-2576a322\">Anthea Nwandu, MD<\/a>, a double board-certified internist, lifestyle medicine physician, and clinical assistant professor at the University of Maryland School of Medicine. Meaning, you may not get enough B12 from your regular diet, even if you&#8217;re eating well.<\/p>\n<p>Some PPIs and H2 blockers that could cause deficiencies include:<\/p>\n<ul>\n<li>Prilosec (<a href=\"https:\/\/www.singlecare.com\/prescription\/omeprazole\">omeprazole<\/a>)<\/li>\n<li>Nexium (<a href=\"https:\/\/www.singlecare.com\/prescription\/esomeprazole-magnesium\">esomeprazole<\/a>)<\/li>\n<li>Pepcid AC (<a href=\"https:\/\/www.singlecare.com\/prescription\/famotidine\">famotidine<\/a>)<\/li>\n<li>Tagamet (<a href=\"https:\/\/www.singlecare.com\/prescription\/cimetidine\">cimetidine<\/a>)<\/li>\n<\/ul>\n<p>The good news is that <a href=\"https:\/\/www.singlecare.com\/conditions\/b12-deficiency-symptoms\">B12 deficiency<\/a> from acid reducers takes time, so regular blood work can catch it early if you take these medications long-term. &#8220;The body<a href=\"https:\/\/ods.od.nih.gov\/factsheets\/VitaminB12-HealthProfessional\/\"> maintains substantial stores of vitamin B12<\/a>,&#8221; Dr. Nwandu says. &#8220;A brief course of an acid-suppressing medication is unlikely to cause a clinically significant deficiency in an otherwise well-nourished person.&#8221; In other words, you don\u2019t need to worry if you occasionally take a Pepcid after a spicy meal. While over-the-counter antacids, such as Tums, may also cause deficiency by blocking acid, it\u2019s much less likely than prescription-strength acid reducers taken daily.<\/p>\n<h3 id=\"metformin\">Metformin<\/h3>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin\">Metformin<\/a> is commonly prescribed to treat<a href=\"https:\/\/www.singlecare.com\/blog\/type-1-vs-type-2-diabetes\/\"> Type 2 diabetes<\/a>. It is also widely recognized<a href=\"https:\/\/www.singlecare.com\/blog\/metformin-and-vitamin-b12\/\"> as a contributor to B12 deficiency<\/a>. &#8220;The risk appears to increase with higher doses and longer duration of treatment,&#8221; Dr. Nwandu says.<\/p>\n<p>Like acid reducers, metformin slowly and decreases Vitamin B12 levels rather than having an immediate impact.<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10236989\/\"> Research<\/a> shows that metformin reduces the amount of B12 the intestine can absorb. Dr. Nwandu says that&#8217;s why current clinical guidelines recommend periodic B12 assessments for people taking metformin long-term.<\/p>\n<h3 id=\"glp-1-medications\">GLP-1 medications<\/h3>\n<p><a href=\"https:\/\/www.singlecare.com\/drug-classes\/glp-1-agonists\">GLP-1 medications<\/a> such as<a href=\"https:\/\/www.singlecare.com\/prescription\/ozempic\"> Ozempic<\/a> (<a href=\"https:\/\/www.singlecare.com\/blog\/semaglutide-cost-per-month\/\">semaglutide<\/a>),<a href=\"https:\/\/www.singlecare.com\/prescription\/mounjaro\"> Mounjaro<\/a> (<a href=\"https:\/\/www.singlecare.com\/blog\/zepbound-generic\/\">tirzepatide<\/a>), and<a href=\"https:\/\/www.singlecare.com\/prescription\/foundayo\"> Foundayo<\/a> (<a href=\"https:\/\/www.singlecare.com\/blog\/news\/fda-approves-foundayo\/\">orforglipron<\/a>) slow digestion, which may change how the body absorbs B12 from food. Given that, these medications <i>might<\/i> contribute to a vitamin deficiency.<\/p>\n<p>That said, Dr. Nwandu emphasizes that B12 deficiency is not a known<a href=\"https:\/\/www.singlecare.com\/blog\/ozempic-side-effects\/\"> side effect of GLP-1s<\/a> yet. The relationship between GLP-1s and B12 is less established than it is for metformin or acid suppressants. In other words, more research is needed, but it&#8217;s still a good idea for people taking GLP-1s to focus on their nutrition, including B12 intake.<\/p>\n<h3 id=\"other-medications-to-watch\">Other medications to watch<\/h3>\n<p>Some other medications may affect vitamin B12 levels, but the evidence is limited. For instance, a review in the<a href=\"https:\/\/e-acnm.org\/journal\/view.php?doi=10.15747\/ACNM.2022.14.1.20\"> <i>Annals of Clinical Nutrition and Metabolism<\/i><\/a> found that some studies link <a href=\"https:\/\/www.singlecare.com\/prescription\/colchicine\">colchicine<\/a>, a<a href=\"https:\/\/www.singlecare.com\/conditions\/gout-treatment-and-medications\"> gout treatment<\/a>, to lowered vitamin B12 levels. Some<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/1889697\/\"> data<\/a><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3410054\/\"> suggest<\/a> that taking<a href=\"https:\/\/www.singlecare.com\/resources\/antibiotics\"> antibiotics<\/a> and oral<a href=\"https:\/\/www.singlecare.com\/drug-classes\/contraceptives\"> contraceptives<\/a> might also cause a slight drop in B12.<\/p>\n<p>Ultimately, none are proven to cause B12 deficiency. &#8220;None rises to the level of importance of metformin or long-term acid-suppressing medications,&#8221; Dr. Nwandu says. Still, it&#8217;s always worth mentioning to your provider if you experience fatigue or other symptoms of B12 deficiency after starting a new medication.<\/p>\n<h2 id=\"how-to-know-if-your-medication-is-affecting-your-b12\">How to know if your medication is affecting your B12<\/h2>\n<p>Tell your healthcare provider if you develop<a href=\"https:\/\/www.singlecare.com\/conditions\/b12-deficiency-symptoms\"> symptoms of B12 deficiency<\/a>, such as:<\/p>\n<ul>\n<li>Fatigue<\/li>\n<li>Pale skin<\/li>\n<li>Neuropathy (tingling in the hands or feet)<\/li>\n<li>Brain fog<\/li>\n<li>Glossitis (sore, reddened tongue)<\/li>\n<\/ul>\n<p>A healthcare professional can order a simple blood test to measure vitamin B12 levels. In most cases, providers recommend a <a href=\"https:\/\/www.singlecare.com\/prescription\/b-complex-b12\">B complex<\/a> or vitamin <a href=\"https:\/\/www.singlecare.com\/prescription\/vitamin-b12\">B12 supplement<\/a>, but they might want to first investigate further.<\/p>\n<p>&#8220;If a medication is the contributing factor to B12 deficiency, I want to do more than simply tell someone to take a supplement,&#8221; says Erin Jowett, RD, a functional dietitian and founder of<a href=\"https:\/\/www.integrativeweightandwellness.com\"> Integrative Weight &amp; Wellness<\/a> in Salem, Massachusetts.<\/p>\n<p>Dr. Nwandu agrees, explaining that the cause of low B12 could be any one or more of the following:<\/p>\n<ul>\n<li>A chronic medication such as omeprazole or metformin<\/li>\n<li>Vegan or vegetarian diet<\/li>\n<li>Pernicious <a href=\"https:\/\/www.singlecare.com\/conditions\/anemia-treatment-and-medications\">anemia<\/a> (an autoimmune condition in which there&#8217;s not enough <a href=\"https:\/\/medlineplus.gov\/ency\/article\/002381.htm\">intrinsic factor<\/a> in the small intestine)<\/li>\n<li>Gastrointestinal conditions such as Crohn&#8217;s disease or celiac disease<\/li>\n<li>Gastrectomy or gastric bypass surgery<\/li>\n<\/ul>\n<h2 id=\"what-to-do-if-your-medication-is-lowering-your-b12\">What to do if your medication is lowering your B12<\/h2>\n<p>The good news is B12 deficiency is very treatable, and most patients will not need to stop taking the medication causing the low Vitamin B12 level. First, talk to your healthcare provider, get your B12 levels checked, and create a plan to identify the underlying cause and correct the deficiency.<\/p>\n<p>&#8220;We can personalize the solution, whether that\u2019s eating more B12-rich foods, targeted supplementation or injections, while strategically monitoring levels over time,&#8221; Jowett explains.<\/p>\n<p>Foods that are <a href=\"https:\/\/www.singlecare.com\/blog\/what-vitamins-should-i-take\/\">rich in vitamin B12<\/a> include:<\/p>\n<ul>\n<li>Organ meats<\/li>\n<li>Shellfish<\/li>\n<li>Meat and dairy<\/li>\n<li>Fortified foods such as nutritional yeast and breakfast cereals<\/li>\n<\/ul>\n<p><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12681447\/\">B12 supplement types<\/a> include:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/b-complex\">B complex<\/a> multivitamins<\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/cyanocobalamin\">Cyanocobalamin<\/a>, a synthetic B12<\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/methylcobalamin\">Methylcobalamin<\/a>, an active B12<\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/hydroxocobalamin-acetate\">Hydroxocobalamin<\/a>, an injectable B12<\/li>\n<\/ul>\n<p>It&#8217;s important to follow your provider&#8217;s instructions for correcting a B12 deficiency. Left untreated, <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK441923\/\">low B12<\/a> can lead to pernicious anemia, megaloblastic anemia, folate deficiency, nerve damage, and other health conditions.<\/p>\n<h2 id=\"frequently-asked-questions\">Frequently asked questions<\/h2>\n<h3 id=\"do-antidepressants-or-other-mental-health-medications-affect-b12\">Do antidepressants or other mental health medications affect B12?<\/h3>\n<p>No, there&#8217;s no evidence that antidepressants affect B12, but having a B12 deficiency <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S1555415526001789\">can lead to or worsen <\/a>depression symptoms.<\/p>\n<h3 id=\"can-taking-a-b12-supplement-interfere-with-my-other-medications\">Can taking a B12 supplement interfere with my other medications?<\/h3>\n<p>Probably not. &#8220;I\u2019m usually more concerned about the medication interfering with B12 than the other way around,&#8221; Jowett says.<\/p>\n<h3 id=\"how-long-does-it-take-for-a-medication-to-cause-b12-deficiency\">How long does it take for a medication to cause B12 deficiency?<\/h3>\n<p>It can take <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4953733\">months or even years<\/a> for a medication to cause B12 deficiency.<\/p>\n<h3 id=\"what-s-the-best-way-to-take-b12-if-i-m-on-one-of-these-medications\">What&#8217;s the best way to take B12 if I&#8217;m on one of these medications?<\/h3>\n<p>The best way <a href=\"https:\/\/ods.od.nih.gov\/factsheets\/VitaminB12-HealthProfessional\/\">to take B12<\/a> (pills, sublingual drops, or injections)\u00a0depends on the cause and severity of the deficiency, not the other medications you&#8217;re taking.<\/p>\n<h3 id=\"will-i-need-to-stop-my-medication-if-it-s-lowering-my-b12\">Will I need to stop my medication if it&#8217;s lowering my B12?<\/h3>\n<p>Not necessarily. Consult a healthcare provider familiar with your medical history, health conditions, and other medicines for personal medical advice if you think a medication is lowering your B12.<\/p>\n<h2 id=\"the-bottom-line\">The bottom line<\/h2>\n<p>In some cases, vitamin B12 deficiency can develop or worsen because of a medication you are taking. Fortunately, this drop in B12 is easy to spot and manage. Watch for signs of deficiency, and ask your healthcare provider to order a simple blood test if you&#8217;re concerned. If your B12 levels are low, the problem can usually be treated with affordable supplements and is not a reason to stop taking your medications.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vitamin B12 is an essential nutrient for healthy nerve function and making red blood cells. Deficiency is fairly common, especially among vegans and older adults, since the most B12-rich foods are animal products. That said, a handful of everyday prescriptions, including over the counter medicines,\u00a0 can also quietly lower B12 levels by preventing the body [&hellip;]<\/p>\n","protected":false},"author":135,"featured_media":637313,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[11],"tags":[814,812],"coauthors":[20942],"class_list":["post-637300","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-wellness","tag-drug-interactions","tag-supplements","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.6 (Yoast SEO v28.6) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Common medications that are quietly draining your B12<\/title>\n<meta name=\"description\" content=\"Wondering what depletes B12? PPIs, metformin, and other common prescriptions can quietly lower your levels. Here&#039;s what to watch for and how to protect yourself.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.singlecare.com\/blog\/what-depletes-b12\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Common medications that are quietly draining your B12\" \/>\n<meta property=\"og:description\" content=\"Wondering what depletes B12? PPIs, metformin, and other common prescriptions can quietly lower your levels. 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PPIs, metformin, and other common prescriptions can quietly lower your levels. 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