Test Your Knowledge

The complex relationships between some B vitamins and the human body can be disrupted by medications or medical procedures. Such factors may:

• Prevent the body from absorbing the vitamins
• Destroy the vitamins before they can be used
• Prevent the vitamins from performing their body functions

Drinking alcohol results in all three of the above factors to some extent. Therefore overuse or abuse of alcohol can lead to severe B vitamin deficiency. In industrialized countries where balanced diets are easily attained, alcoholism is the leading cause of B vitamin deficiency.

In many cases, taking in additional B vitamins in supplemental form may be needed in conjunction with certain medical conditions. Treatments or medications requiring greater intake of all the B vitamins include:

• Diuretics. Medications that increase urine output. They are used to treat conditions such as high blood pressure, cancer and edema (swelling).
  
  
• Dialysis A process to remove waste products from the blood in patients whose kidneys are damaged and therefore unable to perform this function.

Medications frequently interact with specific vitamins. Examples of these interactions include:

• Folate. Of the B vitamins, folate may be the most susceptible to interactions with drugs. Antimetabolites (e.g., methotrexate), used in the treatment of some cancers, rheumatoid arthritis, psoriasis and several other diseases, may block cells from using the vitamin. Other factors that may impact the body’s ability to use folate include regular use of aspirin, antacids, oral contraceptives and cigarettes. In addition, high doses of folic acid (synthetic folate) have been found to interact with anticonvulsant drugs (e.g., dilantin, phenytoin, primidone).
  
  
• B12. Medications used to treat gastroesophageal reflux disease (GERD) and peptic ulcers (e.g., proton pump inhibitors, H2 receptor antagonists) reduce the amount of hydrochloric acid produced in the stomach and have the potential to interfere with B12 absorption.  However, there have not yet been any confirmed cases of these medications causing vitamin B12 deficiency, even after long-term use.   Medications to treat diabetes may also reduce B12 absorption by interfering with calcium metabolism.