Steve's recent poll regarding anemia led me to think about a cause of iron deficiency anemia that most of us, and many MDs, are unaware of or have forgotten. That is the long term use of proton pump inhibitors to reduce stomach acid, reflux, and acid diarrhea. It would seem like a treatment without any downside.
However, besides the fact that they can lead to vitamin B-12 deficiency (due to malabsorption) and C-difficile infections, they also can cause iron deficiency anemia because iron is less well absorbed without the acid environment. The impact is not huge with the proton pump inhibitor, but if you already run low in your iron stores, it could be enough to drive you down into the clinical range.
So, if other causes, such as occult blood loss and inadequate intake, have been ruled out, you need to rethink chronic use of proton pump inhibitors. It is never as simple as we would like it to be...
http://www.clinicalcorrelations.org/?p=7828
Jan
Original Post