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So, doctors should watch B12 levels in patients on PPIs for a long time

Conclusion The vitamin B12 test is a crucial diagnostic tool for identifying deficiencies and managing health conditions related to neurological function, red blood cell formation, and DNA synthesis

Impediments to optimal absorption include a lack of intrinsic factor and inflammatory bowel conditions such as celiac or Crohns disease or irritable bowel syndrome and gut conditions like atrophic gastritis a thinning of the stomach lining

There are 2 factors that might explain this phenomenon

[DOI] [PMC free article] [PubMed] [Google Scholar] 76.Marcinkiewicz A, Gauthier D, Garcia A, Brasaemle DL