Vitamin B12 Deficiency is Linked with Long-Term Use of Proton Pump Inhibitors in Institutionalized Older Adults: Could a Cyanocobalamin Nasal Spray be Beneficial?

The purpose of this study was to determine whether institutionalized older individuals taking proton pump inhibitors (PPI) for more than 12 months were more likely to have vitamin B12 deficiency than individuals not taking PPI, and whether cyanocobalamin nasal spray would improve their vitamin B12 status. Participants were long-term care residents aged 60–89 years. PPI users (n = 17) were treated with cyanocobalamin nasal spray for 8 weeks; non-PPI users (n = 19) were not treated but were followed for the same time duration. Serum samples from all subjects were analyzed for vitamin B12 and serum methylmalonic acid (sMMA) at baseline and the end of the 8-week treatment. There was a significant difference in mean vitamin B12, sMMA, and frequency of deficiency between control and intervention groups at baseline. After treatment, there was an increase (p = 0.012) in serum vitamin B12 concentration, and a decrease (p = 0.004) in frequency of deficiency in PPI users. Thus, we found that institutionalized older individuals on PPI for more than 12 months may be more likely to be vitamin B12 deficient than non-PPI users. Additionally, treatment of PPI users with cyanocobalamin nasal spray for 8 weeks could improve vitamin B12 status.