The claimEvidence C · limited
Acid-blockers (PPIs) leach your calcium and cause osteoporosis
The evidence
An effect of acid-blockers on calcium or iron is plausible but weakly supported and debated; what is solid is low blood magnesium with long-term use (FDA 2011) and low vitamin B12.
The mechanism, in brief
The same idea holds at other organs.
Sources (2)
- U.S. Food and Drug Administration. (2011). FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs). Safety announcement of 2 March 2011: prescription PPIs may cause low serum magnesium if taken for prolonged periods (in most cases longer than one year); hypomagnesemia has been reported after at least three months, but most cases occurred after a year of treatment. In approximately one-quarter of the cases reviewed, magnesium supplementation alone did not correct it and the PPI had to be stopped. Healthcare professionals should consider obtaining serum magnesium before starting prescription PPI treatment and checking it periodically thereafter in patients expected to be on prolonged treatment or taking digoxin or drugs that may cause hypomagnesemia, such as diuretics (FDA page, content current as of 08/04/2017, read via the Wayback Machine 2026-09-24).
- Lam, J. R., Schneider, J. L., Zhao, W., & Corley, D. A. (2013). Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA, 310(22), 2435-2442. In a large case-control study, two or more years of PPI use was associated with increased risk of vitamin B12 deficiency.