View Full Version : Pharmaceuitcal drugs that can cause/contribute to B12 deficiency

Apr 25th, 2004, 10:13 PM
From http://www.spectracell.com/vitamins.html

"Pharmaceutical drugs that can cause a B12 deficiency include aminoglycosides, cephalosporins, chlorotrianisene, chlortetracycline, cholestyramine resin, cimetidine, colchicine, colestipol, co-trimoxazole, demeclocycline, famotidine, fluoroquinolones, lansoprazole, macrolides, metformin, minocycline, neomycin, nizatidine, omeprazole, oral contraceptives, oxytetracycline, penicillins, phenytoin, potassium chloride, ranitidine bismuth citrate, ranitidine hydrochloride, sulfonamides, tetracyclines, trimethoprim and zidovudine."

May 17th, 2004, 07:33 PM
"Drug residues in the environment are of growing interest worldwide. In both human and veterinary medicine a large number of drugs are used. After excretion, these drugs and their metabolites can contaminate the environment. Residues of pharmaceuticals used in human medicine occur in water by passing sewage treatment plants. New investigations show, that more than 40 different drugs can be found in surface waters from the low to the very low µg/L concentration range."http://agriculture.de/acms1/conf6/ws4tetra.htm

Chlortetracycline, mentioned in the first post in this thread, is found in soil that is been fertilized with liquid manure. This means that even if one tries to avoid chemical fertilizers, and use animale manure instead, the soil (and plants) are exposed to B12 reducing chemicals!

May 18th, 2004, 04:44 PM
I tried a new internet browser yesterday (Opera 7.5), that lets the user double click on a word to find out more about it through search engines. I tried it on the chemicals listed in the first post in this thread - which all are knownto disturn B12 levels - and below is some of the info I found:

Cholestyramine is used to lower high cholesterol levels in the blood.

Cimetidine is used to treat and prevent the recurrence of ulcers and to treat other conditions where the stomach makes too much acid.

Colchicine is used to prevent or treat attacks of gout (also called gouty arthritis)

Colestipol is an oral cholesterol-lowering agent. Colestipol hydrochloride is not absorbed into the blood stream, but acts in the intestine, where it absorbs bile acids.

Co-trimoxazole is a combination of trimethoprim and sulfamethoxazole, a sulfa drug. It eliminates bacteria that cause various infections, including infections of the urinary tract, lungs (pneumonia), ears, and intestines. It also is used to treat travelers diarrhea.

Demeclocycline is an antibiotic used to treat bacterial infections.

Famotidine is a histamine blocker used to treat and prevent ulcers.

Fluoroquinolones are used against pneumonia, urinary tract
infections, bacterial diarrhea, and skin and soft tissue infections. F. are Íbroad spectrum antibioticsÍ, and are often used for treating severe cases of food poisoning caused by bacteria, such as Campylobacter or Salmonella bacteria. ( for more interesting info on F., check http://www.fact.cc/fluoroquinolones.htm )

Lansoprazole is used to prevent ulcers and to treat other conditions in which the stomach produces too much acid.

Macrolides are a family of antibiotics used to treat a wide range of
bacterial infections.

Metformin was approved for use in the US for treatment of Type 2 Diabetes in December, 1994. It can induce ovulation in some women with infertility. Metformin was also used recently as an "antidote" to weight gain induced by several different medications.

Minocycline is used to help treat periodontal disease (a disease of your gums). It is an antibiotic used most commonly for the treatment of young people with troublesome acne. It has also been found to be beneficial in some people with inflammatory arthritis.

Neomycin is mainly used topically in the treatment of skin and mucous membrane infections, wounds, and burns.

Nizatidine is used to treat and prevent ulcers in the stomach and intestines, and it can trat conditions in which the stomach produces too much acid and conditions in which acid comes up into the esophagus and causes heartburn.

Omeprazole is also used to treat ulcers, gastroesophageal reflux disease (GERD or heartburn), and other conditions involving excessive stomach acid production.

Oxytetracycline belongs to a group of antibiotics called tetracyclines. It is an antibiotic which has the ability to inhibit the growth of a wide variety of bacteria. It interferes with the production of proteins that the bacteria need to multiply and divide. This inhibits the ability of the bacteria to grow (bacteriostatic) and therefore stops the spread of the infection. What is it used for? Acne vulgaris. Chronic bronchitis. Chronic inflammatory disorder of the facial skin (acne rosacea). Dental infections. Disease caused by infection with Leptospira bacteria (Weil's Disease/leptospirosis). Infection caused by Brucella bacteria (brucellosis). Infections caused by Rickettsiae micro-organisms transmitted by lice, fleas, ticks and mites. Infections of the sex organs and organs associated with urination (genito-urinary infections). Lyme disease.

Phenytoin sodium is an antiepileptic drug, and is used
to treat various types of convulsions and seizures.

Potassium is a mineral that is found naturally in foods and is necessary for many normal functions of your body, especially the beating of your heart. Potassium chloride is routinely used whenever a patient is dehydrated or debilitated or unable to take nourishment by mouth. (It is deadly in its concentrated form, short- circuiting the same muscle and nerve functions it protects in dilute amounts.) Potassium chloride is used as a fertilizer, in photography, pharmaceutical preparations and in preparing other potassium compounds such as the chlorate, carbonate, sulfate, nitrate and the hydroxide (electrolysis of potassium chloride produces potassium hydroxide, called caustic potash). It is also used in petroleum industry, rubber industry, electroplating industry. Pharmaceutical grade is used as a potassium supplement administered by oral or injection. Potassium chloride is used in manufacturing liquid detergents and soft soaps as a viscosity-regulator. Potassium chloride (and urea) are common icemelters that are often perceived as Ísafe products to use around vegetationÍ.

Ranitidine bismuth citrate is used to decrease the amount of acid in the stomach and to treat Helicobacter pylori, a bacterial infection involved in causing stomach ulcers (H. pylori is known to cause B12 deficiency too). Ranitidine bismuth citrate is most commonly used with clarithromycin (Biaxin), an antibiotic, to treat this infection.

Sulfonamides are a family of antibiotics used to treat a wide range
of bacterial infections. From a site for veterinaries: îSulfonamides have come under great scrutiny in recent years. Their dosage and withdrawal periods are very important. As a basic rule, it is good to remember that in many cases: Treated animals must not be slaughtered for use in food for at least 10 days after the latest treatment with these drugs. Milk taken from treated animals within 4 days (96 hours) after the latest treatment must not be used in food. Sulfonamides "must not be added to swine feed."

Ranitidine hydrochloride inhibits stomach acid secretion.

Although the sulfonamides have, for the most part, been replaced with other agents, there is still a significant demand in certain types of infection, most notable urinary tract infections, such as acute cystitis or prostatitis, and in cases of acute otitis media. An inadvertently toxic preparation of sulfanilamide also had a central influence on the US Food and Drug Administration. A preparation called Elixir Sulfanilamide contained ethylene glycol as a solvent, which is toxic. This preparation killed over one hundred people, mostly children, and led to the passage of the 1938 Food, Drug, and Cosmetic Act.

Tetracyclines are medicines that kill certain infection-causing microorganisms. Physicians may prescribe these drugs to treat eye infections, pneumonia, gonorrhea, Rocky Mountain spotted fever, urinary tract infections and other infections caused by bacteria. The medicine is also used to treat acne / skin diseases. Tetracycline, or one of its derivatives are most often used for acne, rosacea or perioral dermatitis and are frequently effective . (However tetracyclines only suppress these conditions, they do not cure them.)

The tetracycliness are broad-spectrum antibiotics whose value has decreased owing to increasing bacterial resistance. They remain, however, the treatment of choice for infections caused by chlamydia (trachoma, psittacosis, salpingitis, urethritis, and lymphogranuloma venereum), rickettsia (including Q-fever), brucella (doxycycline with either streptomycin or rifampicin), and the spirochaete, Borrelia burgdorferi (Lyme disease„see section They are also used in respiratory and genital mycoplasma infections, in acne, in destructive (refractory) periodontal disease, in exacerbations of chronic bronchitis (because of their activity against Haemophilus influenzae), and for leptospirosis in penicillin hypersensitivity (as an alternative to erythromycin).

Trimethoprim eliminates bacteria that cause urinary tract infections. It is used in combination with other drugs to treat certain types of pneumonia. It also is used to treat 'travelers' diarrhea' and people with urinary tract infections. The combination drug product trimethoprim/sulfamethoxazole (TMP/SMX) is used to treat a wide variety of bacterial infections and some infections due to parasites.

Meat, and especially liver, functions as a kind of B12 supplement. Vegans don't eat meat. So if we are exposed to a period of reduced B12 intake, for example after having used some of the drugs above, we don't necessarily get back our old B12 levels after stopping being exposed to the B12 reducing chemicals. This doesn't necessarily mean that 'once B12 deficient, always B12 deficient', but if you have been exposed to any of the chemicals above and do not take supplements, you should pay extra attention to your B12 status, and have your blood or urine tested (which is a good idea anyway!).

May 4th, 2005, 08:25 AM
You'll find a lot more info on how B12 is affected by various drugs* here:

Omeprazole (Prilosec®)
Oral Contraceptives
Ranitidine (Zantac®)
Valproic Acid
Zidovudine (AZT)

May 26th, 2005, 03:08 PM
From http://www.nutritionfocus.com/nutrition_supplementation/vitamins/vitamin_b12.html :

Absorption of vitamin B12 is impaired by: alcohol consumption, aminosalicylates, cholestyramine, colchicine, ethylphenacemide, folic acid (large doses decrease serum B12), metformin, neomycin (oral forms only), omeprazole1 (drug causes stomach acid to decline)2, para-aminosalicylic acid, phenformin, phenobarbitone, phenytoin, potassium (increases the need for B12), prilosec1 (drug causes stomach acid to decline)2, primidone, tobacco use, vitamin B6 deficiency [...].

Jun 16th, 2005, 07:44 AM
Here's another site listing drugs that that deplete B12:

adam antichrist
Jun 16th, 2005, 08:15 AM
aminosalicylates; 2, para-aminosalicylic acid

Salicylic acid is the original form of aspirin (as found in willow bark). Could these salicylate compounds be found in modern aspirins?

Jun 16th, 2005, 08:45 AM
From http://www.hairfacts.com/methods/rxoral.html :

'Some dermatologists recommend testing vitamin B12 levels in CPA users. CPA can cause B12 levels to drop and this can lead to depression or anxiety problems.'
(CPA = Cyproterone acetate, not available in the US).

Jun 16th, 2005, 09:02 AM
The listings are pretty daunting, makes me glad to have come off the couple of medications I was taking, though they aren't in any of those lists.

I did once get a listing of the contraindications of taking certain herbs while on medications - common herbs such as St Johns Wort, etc.

Mar 6th, 2006, 04:01 PM
What medications affect vitamin B-12?
Categories of drugs that can diminish the body's supply of vitamin B-12 include antibiotics, anticancer medications, anticonvulsants, anti-gout medications, antihypertensives, antiParkinson's medications, antipsychotics, antituberculosis medications, birth control pills, cholesterol-lowering drugs, and potassium replacements. Examples of specific medications in each category are listed below.

Antibiotics Kantrex (kanamycin)
Anticancer Drugs Methotrexate
Anticonvulsants Dilantin (phenytoin)
Mysoline (primidone)
Antigout Drugs Colbenamid (colchicine)
Antihypertensives Aldomet (methyldopa)
AntiParkinson's Larodopa (levodopa)
Antipsychotics Thorazine (chlorpromazine)
Drugs INH (isoniazid)
Birth Control
Pills Ovulen (ethynodiol diacetate)
Ovral (ethinyl estradiol)
Ortho-Novum (norethindrone ethinyl estradiol)
Drugs Cholestyramine
Atromid (clofibrate)
Replacements K-Lor (potassium chloride)

Nutrient Interactions
How do other nutrients interact with vitamin B-12?
Vitamin B6 is required for proper absorption of vitamin B-12, and deficiency of vitamin B6 has been shown to impair B-12 absorption in animal studies.

Conversion of vitamin B12 from its non-active into its biologically active form requires the presence of vitamin E. Individuals at risk for vitamin E deficiency may show signs of vitamin B12 deficiency as well.

Contrary to research from the mid 1970s, supplemental doses of vitamin C above the 500 milligram level do not appear to compromise B-12 function.

Excessive intake of folic acid can mask B-12 deficiencies, and individuals at risk for vitamin B12 deficiency who are also taking folic acid in supplement form should consult with their healthcare practitioner.

Source: http://www.whfoods.com/genpage.php?tname=nutrient&dbid=107