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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Do PPIs Cause Low Magnesium Levels?

I have been on Nexium 20 mg for about 8 years due to GERD and lately I have been reading about the PPI causing some health issues including decrease in Magnesium and Vit. B and increased risks for dementia. I tried to slowly wean myself off the PPI but the heartburn was too much to tolerate especially at night so I started back on it. I m 70 yrs old and in good health. I had upper endoscopy in April and biopsy didn t show any problems other than some mild inflammation. Was told to continue Nexium but no one has said anything about the decrease in the magnesium and Vit. B. Any suggestions?
Sat, 10 Feb 2018
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General & Family Physician,  's  Response
Dear Sir, Hi & Welcome.

I can understand your concern regarding the safety of PPIs.
Yes, they may cause low magnessium levels on prolonged use.

Prescribed mainly to reduce stomach acid in conditions such as gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and esophageal inflammation, the proton-pump inhibitors (PPIs) like Nexium are generally well tolerated.

The most common side effects include: headache, diarrhea, constipation, nausea, or itching. Long-term use can be associated with osteoporosis, increased risk of infections, hypomagnesemia (low magnessium levels) and Vitamin B12 deficiency.

It seems that PPIs affect the gastrointestinal absorption of magnesium and Vitamin B12

Generally hypomagnesemia can asymptomatic, however it can cause serious muscle spasms (tetany), arrhythmias, tremors, and seizures.

You should consult your treating doctor if you develop the symptoms of low magnesium levels as listed above.

You may need periodic monitoring of serum magnesium levels and may require magnesium supplements.

Hope to have answered your query.
Best wishes for your health.
A feed back is appreciated.




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Do PPIs Cause Low Magnesium Levels?

Dear Sir, Hi & Welcome. I can understand your concern regarding the safety of PPIs. Yes, they may cause low magnessium levels on prolonged use. Prescribed mainly to reduce stomach acid in conditions such as gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and esophageal inflammation, the proton-pump inhibitors (PPIs) like Nexium are generally well tolerated. The most common side effects include: headache, diarrhea, constipation, nausea, or itching. Long-term use can be associated with osteoporosis, increased risk of infections, hypomagnesemia (low magnessium levels) and Vitamin B12 deficiency. It seems that PPIs affect the gastrointestinal absorption of magnesium and Vitamin B12 Generally hypomagnesemia can asymptomatic, however it can cause serious muscle spasms (tetany), arrhythmias, tremors, and seizures. You should consult your treating doctor if you develop the symptoms of low magnesium levels as listed above. You may need periodic monitoring of serum magnesium levels and may require magnesium supplements. Hope to have answered your query. Best wishes for your health. A feed back is appreciated.