Deficiency of calcium over time can sometimes show up in the skin, hair, and nails as dryness, pruritus, brittle or ridged nails, and diffuse hair shedding, especially when hypocalcemia is more chronic. Clinicians often see these dermatologic changes accompanying other signs of calcium and vitamin D deficiency, such as muscle cramps or bone pain, and they may improve as serum calcium and overall mineral status are normalized. The practical point is that, when patients present with unexplained dry skin, fragile nails, and hair loss, particularly in the setting of poor diet, malabsorption, or endocrine disease, assessing and correcting calcium (and related nutrient) deficiencies can be an important part of restoring healthier skin and adnexal structures. This medication is commonly used for Stomach Acid.
Lee SE, Lee SH. Skin Barrier and Calcium. Ann Dermatol. 2018 Jun;30(3):265-275. Elias P, Ahn S, Brown B, Crumrine D, Feingold KR. Origin of the epidermal calcium gradient: regulation by barrier status and role of active vs passive mechanisms. J Invest Dermatol. 2002 Dec;119(6):1269-74. Baumann J, Wandrey F, Sacher R, Zülli F. A novel Ca2+ double cone vector system to treat compromised skin. Int J Cosmet Sci. 2024 Apr;46(2):228-238. Bouhmadi, A.E., Fatoiki, F.E., Rachadi, H. et al. Hypocalcemia-related pustulosis: a case report. J Med Case Reports 19, 497 (2025).
Some side effects may be linked to nutrient depletion caused by this medication.
Long-term use of PPIs might raise the risk of calcium deficiency and weaken bones. A potential mechanism for this is chronic hypergastrinemia, a condition where the stomach produces excess gastrin due to PPI use. This can lead to parathyroid hyperplasia, where the parathyroid glands overproduce a hormone that pulls calcium from bones. Additionally, PPIs significantly reduce stomach acid production, which can hinder calcium absorption from food in the intestines. Individuals taking PPIs, especially individuals at higher risk of bone issues or those on long-term PPI therapy, should consider calcium supplementation to help protect against deficiency.
Research suggests that long-term use of medications that reduce stomach acid, like H2 blockers and PPIs, may be linked to vitamin B12 deficiency. Stomach acid plays a role in releasing vitamin B12 from food, and reduced acid levels caused by these medications could hinder proper B12 absorption. Some studies find an increased risk of B12 deficiency, particularly in older adults or those using these medications for extended periods. Individuals taking H2 blockers or PPIs long-term should consider vitamin B12 supplementation.
There is evidence that proton pump inhibitors (PPIs) might decrease vitamin C levels in the body. A study showed that even a short course of omeprazole, a common PPI, reduced vitamin C levels in healthy volunteers, regardless of their dietary intake. This suggests that PPIs may reduce the bioavailability of vitamin C, meaning the body has a harder time absorbing and using it. Vitamin C plays a crucial role in immune function and antioxidant defenses and therefore individuals using PPI therapy should consider supplementation with vitamin C to protect against a deficiency.
Studies find that proton pump inhibitors (PPIs) may increase your risk of magnesium deficiency. A large study involving over 100,000 participants found a significant association between PPI use and lower magnesium levels (hypomagnesemia). PPIs work by reducing stomach acid production, which can also play a role in magnesium absorption. Individuals taking PPIs, particularly long-term use, should consider magnesium supplementation to help protect against deficiency.