Anyone seen research on long term Proton Pump Inhibitor use and PN?

I started getting the tingling in hands and feet after +1-year on them - I decided to give them up - did so for around 4/5 months and symptoms disappeared - then went back on PPIs and have been on since (2020) and started getting tiredness/fatigue and now Neuropathy has returned - B12 was borderline in July and ok in November but I hear that this doesn't verify Functional B12???

https://bnrc.springeropen.com/articles/10.1186/s42269-023-01107-9
PPIs have been found associated with peripheral neuropathy in multiple studies. One suggested cause is B12 deficiency. B12 binds to proteins in foods gastric acid is essential to break the bond to make B12 useable. Serum B12 is not a reflection of useable B12 status. Two other serum levels rise when B12 in the serum is unuseable, methylmelonic acid and homocystiene. If these are high you might counter with an injection of B12 or an under the tongue spray or tablet. Solgar has a nice under the tongue tablet that you can find on Amazon.

Have they proved a connection between long term use of PP’Is and peripheral neuropathy. I have taken Lansoprazole for many years and now have PN. Should I discontinue

John

Hi John @bigjohnscho, You will notice that we merged your post into an existing discussion on PPI's and neuropathy so that you can connect with others who have experience. If you click the link below it will take you to the beginning of the discussion.
-- Anyone seen research on long term Proton Pump Inhibitor use and PN: https://connect.mayoclinic.org/discussion/anyone-seen-research-on-long-term-proton-pump-inhibitor-use-and-pn/

Have you discussed your concern with taking Lansoprazole for a long term with your doctor?

I have a very unreceptive GP who doesn’t respond well to questions. He seems to regard them as challenging his authority

John

bigjohnscho, the connection between PPIs and PN is associative. Unproven, but suspected because seen in association with. A theory linking the cause/effect is the lessened ability to absorb B12 in the GI tract. You might ask for an injection of B12. I don't know enough to say, but I think it isn't wise to stop PPI's without addressing gastric acid in another way because there is some rebound making acid production even higher. Can you change or add a physician who would field your questions.

I have had two episodes in my life of peripheral neuropathy, associated with documented B12 deficiency after PPI use. With stopping the PPI, oral B12 supplementation and normalization, my symptoms resolved. The PPI use had been for GI issues. I believe this is described in the medical literature.

I’ve been on a PPI for years, should I be taking a vitB12 tablet

Have you been tested for vitamin B12 deficiency? You might want to check with your doctor to see if the long term PPI usage is affecting your B12 level.

I have been taking a PPI for 50 years. It is what saved my quality of life. I did not develop neuropathy until chemo … definitely related to my chemo. I have also taken a B12 supplement for a long time.