When vitamin C intake is too low for too long, it can start to show up in the muscles and joints as deep, aching pain and stiffness rather than just “simple” fatigue. Vitamin C is essential for building and maintaining healthy collagen in cartilage, tendons, and bone, so deficiency can cause bone tenderness, joint pain, and, in children, impaired growth and skeletal deformities similar to rickets or scurvy. In more advanced cases, people may notice difficulty walking, painful swelling around joints, and slower recovery from everyday strains or minor injuries because the connective tissues simply cannot repair and mineralize properly without adequate vitamin C. This medication is commonly used for Stomach Acid.
Mangano KM, Noel SE, Dawson-Hughes B, Tucker KL. Sufficient Plasma Vitamin C Is Related to Greater Bone Mineral Density among Postmenopausal Women from the Boston Puerto Rican Health Study. J Nutr. 2021 Dec 3;151(12):3764-3772. Kim YA, Kim KM, Lim S, Choi SH, Moon JH, Kim JH, Kim SW, Jang HC, Shin CS. Favorable effect of dietary vitamin C on bone mineral density in postmenopausal women (KNHANES IV, 2009): discrepancies regarding skeletal sites, age, and vitamin D status. Osteoporos Int. 2015 Sep;26(9):2329-37. Ratajczak AE, Szymczak-Tomczak A, Skrzypczak-Zielińska M, Rychter AM, Zawada A, Dobrowolska A, Krela-Kaźmierczak I. Vitamin C Deficiency and the Risk of Osteoporosis in Patients with an Inflammatory Bowel Disease. Nutrients. 2020 Jul 29;12(8):2263. Souza M, Moraes SAS, de Paula DR, Maciel AA, Batista EJO, Silva DGF, Bahia CP, Oliveira KRHM, Herculano AM. Local treatment with ascorbic acid accelerates recovery of post-sutured Achilles tendon in male Wistar rats. Braz J Med Biol Res. 2019;52(9):e8290.
Some side effects may be linked to nutrient depletion caused by this medication.
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.
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.
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.