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Originally published Sunday, December 29, 2013 at 5:31 AM

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Vitamin B-12 deficiency from heartburn, diabetes drugs

People’s Pharmacy on vitamin deficiency as a side effect of medication, itchy scalp and skin tags.


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Q: My best friend has been having increasing difficulty this year with numbness and tingling in her feet and a loss of balance. Her doctor chalked it up to her age (79). When she fell in her bathroom and hit her head, she landed in the ICU, where a neurologist diagnosed her with vitamin B-12 deficiency.

She has been getting injections of vitamin B-12, and although she can see some improvement, she still has poor balance. She had been taking Prilosec (omeprazole) for heartburn and metformin for type 2 diabetes. Apparently both drugs can trigger this deficiency. Why don’t doctors pay attention to the side effects of the drugs they prescribe?

A: Your friend is the victim of a double whammy. Vitamin B-12 deficiency has long been recognized as a serious complication of the diabetes drug metformin. A recent study showed that acid-suppressing drugs such as omeprazole, lansoprazole (Prevacid) and esomeprazole (Nexium) also can lead to vitamin B-12 deficiency (JAMA, Dec. 11, 2013).

Low levels of this vitamin may cause irreversible nerve damage. Symptoms include numbness, tingling or pain in toes, feet or fingers, trouble walking, memory problems and confusion, depression or burning tongue. Other symptoms can include loss of appetite, constipation and anemia. People taking any of these medications should have vitamin B-12 levels tested at least once a year.

Q: What can I do for a VERY itchy scalp? I have tried blue dandruff shampoo, but it didn’t help.

A: Some people report that soaking the scalp in milk of magnesia or amber Listerine before shampooing helps calm the itch.

Dandruff shampoos can help this condition, but they may work best if they are rotated every few weeks from one type to another. It is important to leave dandruff shampoo on the scalp for at least five minutes before rinsing.

Q: I have skin tags. How can I remove them without going to the doctor’s office?

A: Most dermatologists would recommend that you have skin tags removed surgically. These fleshy growths are benign and tend to show up in skin folds such as armpits, groin or around the neck.

Readers of this column have offered a number of remedies, with varying success. They include:

• Liquid bandage: “I have used liquid bandage on skin tags with good success. Brush on twice a day. They will fall off within seven to 10 days.”

• Clear nail polish: “I use colorless nail polish for skin tags. Apply once daily and they will disappear in a short while.”

• Thread: “Years ago, I asked my doctor what to do about a skin tag. He told me to have someone tie a thread around it very tightly. It was a bit uncomfortable, but the skin tag soon disappeared.”

Others report success with applications of apple-cider vinegar or zinc-oxide ointment. If the skin tag does not respond promptly, have a doctor check to make sure it is not something more serious.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 300 W. 57th St., 15th floor, New York, NY 10019, or via their website:www.peoplespharmacy.org



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