Vitamin C shortfalls can matter more than people realize because they can quietly undermine iron status and contribute to microcytic, iron‑deficiency–type anemia. Vitamin C is one of the few nutrients that significantly boosts non‑heme iron absorption, helping convert dietary iron into a form the gut can take up more easily and counteracting common inhibitors found in grains, legumes, tea, and coffee. In people whose diets are low in both iron and vitamin C, this combination can show up as persistent fatigue, pallor, and microcytic red blood cells on lab work, with studies in iron‑depleted women showing that added ascorbic acid improved iron absorption and anemia markers over just a few weeks. This medication is commonly used for Stomach Acid.
Alhatem A, Cai D. Behind the Skin: A Rare Case of Scurvy-Associated Megaloblastic Anemia. Clin Med Insights Case Rep. 2019 May 10;12:1179547619849036. Ricaurte FR, Kewan T, Daw H. Scurvy: A Rare Cause of Anemia. Cureus. 2019 Sep 18;11(9):e5694.Golding PH. Experimental folate deficiency in human subjects: what is the influence of vitamin C status on time taken to develop megaloblastic anaemia? BMC Hematol. 2018 Jun 19;18:13. Kim YL. Vitamin C and functional iron deficiency anemia in hemodialysis. Kidney Res Clin Pract. 2012 Mar;31(1):1-3.
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.