Pantoprazole & Nutrient Depletion
Also searched as Protonix, Pantoloc, Protonix IV. What the clinical evidence reports, what it may mean, and what to discuss with your pharmacist.
Pantoprazole has been associated with depletion of CALCIUM, FOLIC ACID, IRON and MAGNESIUM and 5 more. This does not mean a deficiency will occur — it means these are worth knowing about and, if you take Pantoprazole long-term, worth raising with your pharmacist or healthcare provider.
Take more than one medication? Open the checker with Pantoprazole pre-loaded and add the rest to see overlapping nutrient signals.
Reported nutrient depletions with Pantoprazole
Each record below is shown as published in our licensed clinical database, with its evidence rating and citations. Expand a section for food sources and talking points.
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CALCIUM
Insignificant DepletionPROTON PUMP INHIBITORS (PPIs)
Calcium must be solubilized in order to be absorbed. The solubility of calcium is dependent on an acidic pH. Therefore, it has been assumed that decreased gastric acidity decreases absorption of calcium supplements. Some evidence also shows that patients with low gastric acid have lower calcium absorption in a fasting state compared to people with normal gastric acid secretion. Calcium citrate is significantly better absorbed than calcium carbonate in these patients in a fasting state. However, when taken with a meal, decreased gastric acidity due to drugs such as PPIs or due to achlorhydria, does not seem to significantly impair absorption of calcium carbonate or calcium citrate. For information on foods that are rich in calcium, see our chart.
Calcium is the mineral your bones, muscles, and heart depend on to stay strong and function properly. Pantoprazole works by reducing stomach acid, and since acid helps dissolve calcium so the body can absorb it, there has been some concern that less acid might mean less calcium gets in. In practice, though, this effect appears to be minimal for most people, especially when calcium-rich foods or supplements are taken with a meal. This is rated as an insignificant depletion, so most people on pantoprazole do not need to take extra calcium because of it, but if you have questions about your bone health or diet, your pharmacist or doctor is a good person to ask.
What Calcium does & food sources
Calcium builds and maintains bone and is essential for muscle contraction and nerve signaling.
Common food sources:
- Dairy products (milk, yogurt, cheese)
- Fortified plant milks and juices
- Canned fish with bones (sardines, salmon)
- Leafy greens like kale
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask your provider whether bone health monitoring (and vitamin D testing) makes sense with long-term use of an associated medication — a blood calcium level alone does not capture bone calcium status.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Calcium can interfere with the absorption of several medications (some antibiotics, thyroid medication, iron) — separate the doses and confirm timing with your pharmacist. Total intake from food plus supplements matters more than supplements alone.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Very high calcium intake has its own risks (kidney stones in susceptible people) — more is not better.
Learn more about this nutrient: Calcium — uses, safety & interactions
FOLIC ACID
Insignificant DepletionPROTON PUMP INHIBITORS (PPIs)
Folic acid absorption in the small intestine is optimal at a pH of 5.5-6. The increased pH associated with use of PPIs could theoretically reduce folic acid absorption, but preliminary data suggests use of PPIs for several years doesn't cause folate deficiency. Advise patients to maintain the recommended dietary intake of folic acid. For information on foods that are rich in folate, see our chart.
Folic acid is a B vitamin your body needs for healthy cell growth and DNA repair, including the production of red blood cells. Pantoprazole works by raising the acid level in your stomach, and since folic acid is best absorbed in a slightly acidic environment in the small intestine, there is a theoretical possibility that long-term use could reduce how well your body takes it in. That said, actual folate deficiency has not been reported with PPI use, and studies lasting several years have not shown a real problem. Eating folate-rich foods (leafy greens, beans, fortified cereals) is a reasonable everyday habit, and most patients on pantoprazole do not need a supplement for this reason.
What Folic acid (folate) does & food sources
Folate is needed for cell division, red blood cell formation, and healthy fetal development.
Common food sources:
- Leafy green vegetables
- Beans, lentils, and peas
- Fortified grains and cereals
- Citrus fruits
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask your provider whether folate monitoring or supplementation is appropriate for you — this matters most before and during pregnancy, and with long-term use of certain seizure or arthritis medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Folate needs are individual. With some medications (for example, methotrexate), folic acid is often prescribed deliberately on a specific schedule — follow your prescriber's instructions rather than adding your own.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: High-dose folic acid can mask vitamin B12 deficiency, so the two are often evaluated together.
Learn more about this nutrient: Folic Acid — uses, safety & interactions
References (2)
- Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med 1988;112:458-63.
- Termanini B, Gibril F, Sutliff VE, et al. Effect of long-term gastric acid suppressive therapy on serum vitamin B12 levels in patients with Zollinger-Ellison syndrome. Am J Med 1998;104:422-30. PubMed
IRON
Insignificant DepletionPROTON PUMP INHIBITORS (PPIs)
Gastric acid is important for the absorption of iron, particularly dietary non-heme iron. However, long-term treatment, up to 12.5 years, with proton pump inhibitors isn't associated with iron depletion or anemia in people with normal iron stores. Advise people to maintain adequate dietary iron intake. Supplements aren't necessary unless people have other factors contributing to iron deficiency. For information on foods that are rich in iron, see our chart.
Iron is something your body needs to carry oxygen in your blood and keep your energy up. Pantoprazole works by reducing stomach acid, and since that acid actually helps break down and absorb iron from food, there is a theoretical concern that less acid could mean slightly less iron absorbed. In practice, though, research following people on proton pump inhibitors for many years has not found this to be a real problem for those who start out with healthy iron levels. This one is considered insignificant for most people, so no supplement is needed unless your doctor spots another reason for concern.
What Iron does & food sources
Iron is the core of hemoglobin, which carries oxygen in red blood cells.
Common food sources:
- Red meat and poultry
- Beans and lentils
- Fortified cereals
- Spinach (plant iron absorbs better with vitamin C)
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Iron status is easy to assess (ferritin, iron studies, blood counts). Ask your provider before supplementing — unexplained low iron always deserves a medical evaluation for the cause, not just replacement.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Iron supplements commonly cause constipation or stomach upset and interfere with the absorption of several medications (thyroid medication, some antibiotics). Do not take iron "just in case" — excess iron is harmful.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Never self-treat suspected anemia; the underlying cause matters as much as the iron level.
Learn more about this nutrient: Iron — uses, safety & interactions
References (4)
- Aymard JP, Aymard B, Netter P, et al. Haematological adverse effects of histamine H2-receptor antagonists. Med Toxicol Adverse Drug Exp 1988;3:430-48. PubMed
- Termanini B, Gibril F, Sutliff VE, et al. Effect of long-term gastric acid suppressive therapy on serum vitamin B12 levels in patients with Zollinger-Ellison syndrome. Am J Med 1998;104:422-30. PubMed
- Koop H, Bachem MG. Serum iron, ferritin, and vitamin B12 during prolonged omeprazole therapy. J Clin Gastroenterol 1992;14:288-92.. PubMed
- Stewart CA, Termanini B, Sutliff VE, et al. Iron absorption in patients with Zollinger-Ellison Syndrome treated with long-term gastric acid antisecretory therapy. Aliment Pharmacol Ther 1988;12:83-98.. PubMed
MAGNESIUM
Major DepletionPROTON PUMP INHIBITORS (PPIs)
Taking a PPI long-term, especially over a year, has been linked to an increased risk of hypomagnesemia in observational research. Higher doses are associated with a two-fold increase in the odds of hypomagnesemia when compared with lower doses. Observational research in elderly hospitalized patients has also found that males, smokers, and heavy alcohol use further increase the risk of hypomagnesemia from PPI use. PPIs increase intestinal pH which is thought to inhibit active transport of magnesium in the intestine, reducing its absorption. The American College of Gastroenterology (ACG) does not provide a recommendation related to monitoring magnesium levels in patients taking PPIs. However, other experts, including the US Food and Drug Administration (FDA), recommend that serum magnesium levels should be checked at baseline and annually thereafter in patients who are likely to take a PPI long-term. In up to 25% of patients who develop hypomagnesemia, the PPI will need to be discontinued permanently to return magnesium levels to normal and maintain them. In some patients, it is possible to continue the PPI and take a magnesium supplement concurrently to maintain magnesium levels. For information on foods that are rich in magnesium, see our chart.
Magnesium is a mineral your muscles, heart, and nerves depend on to work properly, and pantoprazole can genuinely lower your levels over time. Because pantoprazole raises the pH inside your intestines, it appears to interfere with the active transport system your gut uses to pull magnesium into your bloodstream, so you absorb less of it with each dose. This is rated a major depletion, meaning long-term users, especially those on higher doses or taking it for more than a year, have a real, documented risk of running low. If you have been on pantoprazole for a while, it is worth asking your doctor or pharmacist whether checking your magnesium level makes sense for you.
What Magnesium does & food sources
Magnesium is involved in muscle and nerve function, heart rhythm, blood sugar control, and bone health.
Common food sources:
- Nuts and seeds (almonds, pumpkin seeds)
- Whole grains
- Leafy green vegetables
- Beans and legumes
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask whether a magnesium level is worth checking if you take an associated medication long-term — particularly with symptoms like muscle cramps, twitching, or palpitations. Blood levels do not always reflect total body stores, which is worth discussing too.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Magnesium supplements come in many forms and can cause loose stools at higher doses. They can also bind some medications in the gut (certain antibiotics, thyroid medication), so timing matters — check with your pharmacist.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Magnesium supplementation can be risky in kidney disease, where magnesium can accumulate — always check with a clinician first if your kidney function is reduced.
Learn more about this nutrient: Magnesium — uses, safety & interactions
References (18)
- Safety Alert. Proton Pump Inhibitor drugs (PPIs): Drug Safety Communication - Low Magnesium Levels Can Be Associated With Long-Term Use. U.S. Food and Drug Administration, March 2, 2011. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/
- Mackay JD, Bladon PT. Hypomagnesaemia due to proton-pump inhibitor therapy: a clinical case series. QJM 2010;103:387-95. PubMed
- Kuipers MT, Thang HD, Arntzenius AB. Hypomagnesaemia due to use of proton pump inhibitors--a review. Neth J Med 2009;67:169-72.
- Cundy T, Dissanayake A. Severe hypomagnesaemia in long-term users of proton-pump inhibitors. Clin Endocrinol (Oxf) 2008;69:338-41. PubMed
- Doornebal J, Bijlsma R, Brouwer RM. [An unknown but potentially serious side effect of proton pump inhibitors: hypomagnesaemia]. Ned Tijdschr Geneeskd 2009;153:A711.
- Epstein M, McGrath S, Law F. Proton-pump inhibitors and hypomagnesemic hypoparathyroidism. N Engl J Med 2006;355:1834-6. PubMed
- François M, Lévy-Bohbot N, Caron J, Durlach V. [Chronic use of proton-pump inhibitors associated with giardiasis: A rare cause of hypomagnesemic hypoparathyroidism?]. Ann Endocrinol (Paris) 2008;69:446-8.
- Broeren MA, Geerdink EA, Vader HL, van den Wall Bake AW. Hypomagnesemia induced by several proton-pump inhibitors. Ann Intern Med 2009;151:755-6. PubMed
- Hoorn EJ, van der Hoek J, de Man RA, et al. A case series of proton pump inhibitor-induced hypomagnesemia. Am J Kidney Dis 2010;56:112-6. PubMed
- Regolisti G, Cabassi A, Parenti E, et al. Severe hypomagnesemia during long-term treatment with a proton pump inhibitor. Am J Kidney Dis 2010;56:168-74. PubMed
- Cundy T, Mackay J. Proton pump inhibitors and severe hypomagnesaemia. Curr Opin Gastroenterol 2011;27:180-5. PubMed
- Delgado MG, Calleja S, Suarez L, Pascual J. Recurrent confusional episodes associated with hypomagnesaemia due to esomeprazol. BMJ Case Rep 2013;2013. PubMed
- Krupa LZ, Fellows IW. Lansoprazole-induced hypomagnesaemia. BMJ Case Rep 2014;2014. PubMed
- Liao S, Gan L, Mei Z. Does the use of proton pump inhibitors increase the risk of hypomagnesemia: An updated systematic review and meta-analysis. Medicine (Baltimore). 2019;98(13):e15011. PubMed
- Srinutta T, Chewcharat A, Takkavatakarn K, et al. Proton pump inhibitors and hypomagnesemia: A meta-analysis of observational studies. Medicine (Baltimore). 2019 Nov;98(44):e17788. PubMed
- Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022;117(1):27-56. PubMed
- Anna Vermeulen Windsant-van den Tweel AM, Derijks HJ, Gadiot NPPM, Keijsers CJPW. Proton Pump Inhibitors and Hypomagnesemia in Older Inpatients: An Observational Study. Sr Care Pharm 2022;37(12):623-630. PubMed
- Fernández-Fernández FJ, Sesma P, Caínzos-Romero T, Ferreira-González L. Intermittent use of pantoprazole and famotidine in severe hypomagnesaemia due to omeprazole. Neth J Med 2010;68:329-30.
ZINC
Insignificant DepletionPANTOPRAZOLE (Protonix)
Each 40 mg vial of pantoprazole IV contains 1 mg EDTA, which can chelate zinc. This is a very low dose of EDTA compared with those used in EDTA chelation therapy. The manufacturer reports that pantoprazole IV 240 mg daily for 7 days increases urinary zinc excretion, but serum zinc levels are unchanged. Zinc supplements are not usually necessary with typical doses of pantoprazole IV.
Zinc plays a role in immune function, wound healing, and keeping your senses of taste and smell working properly. Pantoprazole IV contains a small amount of a compound called EDTA, which can latch onto zinc and pull a bit more of it out through the urine. That said, even at higher intravenous doses studied, actual zinc levels in the blood stayed normal, and this is rated as insignificant depletion. For most people taking standard doses of pantoprazole, this is not something that requires action, but if you have questions about your zinc status, your pharmacist or doctor is a good place to start.
What Zinc does & food sources
Zinc supports immune function, wound healing, taste and smell, and many enzyme systems.
Common food sources:
- Meat and shellfish (especially oysters)
- Beans and lentils
- Nuts and seeds
- Whole grains
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask about zinc status if you take an associated medication long-term and notice slow wound healing, frequent infections, or taste changes — a clinician can decide whether testing or an empiric plan makes sense.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Zinc competes with copper for absorption — long-term, higher-dose zinc without medical guidance can cause copper deficiency. Zinc also binds some antibiotics in the gut, so dose timing matters.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Keep zinc doses moderate and time them away from interacting medications — ask your pharmacist.
Learn more about this nutrient: Zinc — uses, safety & interactions
References (1)
- Personal communication: Pantoprazole IV - safety and tolerability of EDTA. Medical Information Department, Wyeth Pharmaceuticals Inc., Philadelphia, PA. February 24, 2005.
VITAMIN B12
Moderate DepletionPROTON PUMP INHIBITORS (PPIs)
The reduced secretion of gastric acid and pepsin produced by PPIs can reduce absorption of protein-bound (dietary), but not supplemental, vitamin B12. This is because gastric acid is needed to release vitamin B12 from protein for absorption. Reduced vitamin B12 levels may be more common with PPIs than with H2-blockers, because they are more likely to produce achlorhydria. However, PPI therapy is unlikely to cause clinically significant vitamin B12 deficiency. Some evidence suggests that vitamin B12 deficiency is more likely in the case of prolonged PPI therapy (2 years or more) or insufficient dietary vitamin B12 intake. The odds of developing vitamin B12 deficiency are 65% higher in individuals taking PPIs for 2 years or more when compared with non-users. Also, vitamin B12 deficiency is more likely with prolonged, high-dose PPI therapy than with prolonged, low-dose therapy. Vitamin B12 deficiency is expected to diminish upon discontinuation of PPI therapy. The American College of Gastroenterology (ACG) does not recommend increased intake of vitamin B12 or routine monitoring of serum vitamin B12 levels for patients who are taking PPIs and have no other risk factors for vitamin B12 deficiency. For information on foods that are rich in vitamin B12, see our chart.
Vitamin B12 is a nutrient your nerves and red blood cells depend on, and pantoprazole can make it harder for your body to absorb the form found in food. Here is why: your stomach acid normally helps pry B12 loose from the proteins it is bound to in food, and pantoprazole works by significantly reducing that acid. Over time, less acid can mean less B12 gets freed up and absorbed. This is rated as a moderate concern, meaning most short-term users are unlikely to notice a problem, but if you have been on pantoprazole for two or more years, it is worth asking your pharmacist or doctor whether your B12 level should be checked.
What Vitamin B12 does & food sources
Vitamin B12 supports red blood cell formation, nerve function, and DNA synthesis.
Common food sources:
- Meat, poultry, and fish
- Eggs and dairy products
- Fortified cereals and nutritional yeast
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
If you take an associated medication long-term, ask your healthcare provider whether checking a vitamin B12 level (sometimes with methylmalonic acid) is appropriate — especially if you notice fatigue, numbness, tingling, or memory changes.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
B12 status is easy to check and low levels are usually straightforward to address, so testing before supplementing is often the sensible order. High-dose folic acid can mask a B12 deficiency, which is one reason B12 and folate questions are best sorted out together with your provider.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: B12 deficiency can look like other conditions — do not self-diagnose from symptoms alone.
Learn more about this nutrient: Vitamin B12 — uses, safety & interactions
References (10)
- Termanini B, Gibril F, Sutliff VE, et al. Effect of long-term gastric acid suppressive therapy on serum vitamin B12 levels in patients with Zollinger-Ellison syndrome. Am J Med 1998;104:422-30. PubMed
- Bellou A, Aimone-Gastin I, De Korwin JD, et al. Cobalamin deficiency with megaloblastic anaemia in one patient under long-term omeprazole therapy. J Intern Med 1996;240:161-4. PubMed
- Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B12 absorption. J Am Coll Nutr 1994;13:584-91. PubMed
- Marcuard SP, Albernaz L, Khazaine PG. Omeprazole therapy causes malabsorption of cyanocobalamin. Ann Intern Med 1994;120:211-5.
- Ruscin JM, Page RL, Valuck RJ. Vitamin B12 deficiency associated with histamine-2-receptor antagonists and a proton-pump inhibitor. Ann Pharmacother 2002;36:812-6.
- Force RW, Meeker AD, Cady PS, et al. Increased vitamin B12 requirement associated with chronic acid suppression therapy. Ann Pharmacother 2003;37:490-3.
- Xu QF, Fang XL, Chen DF. Pharmacokinetics and bioavailability of ginsenoside Rb1 and Rg1 from Panax notoginseng in rats. J Ethnopharmacol 2003;84:187-92. PubMed
- Lerman TT, Cohen E, Sochat T, Goldberg E, Goldberg I, Krause I. Proton pump inhibitor use and its effect on vitamin B12 and homocysteine levels among men and women: A large cross-sectional study. Am J Med Sci 2022;364(6):746-751. PubMed
- Lam JR, Schneider JL, Zhao W, et al. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA 2013;310:2435-42.
- Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022;117(1):27-56. PubMed
BETA-CAROTENE
Insufficient EvidencePROTON PUMP INHIBITORS
Proton pump inhibitors reduce stomach acid, which might in turn reduce absorption of supplemental beta-carotene, but it is not known if this is clinically significant, or if it affects absorption of dietary beta-carotene.
Beta-carotene is a plant pigment your body converts into vitamin A, which supports healthy vision, skin, and immune function. Pantoprazole works by turning down acid production in the stomach, and there is some thought that lower stomach acid could reduce how well beta-carotene from supplements gets absorbed. That said, the evidence here is genuinely thin, and researchers are not even sure it matters for beta-carotene from food. For now, this is something to keep in the back of your mind rather than act on, but if you take beta-carotene supplements regularly, it is worth mentioning to your pharmacist or doctor.
What Vitamin A does & food sources
Vitamin A supports vision, immune function, and skin health.
Common food sources:
- Liver and fish oils
- Dairy and eggs
- Orange and yellow vegetables (as beta-carotene)
- Leafy greens
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Ask your provider before supplementing vitamin A — status testing is not routine, and intake from food plus multivitamins is often already adequate.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Vitamin A is fat-soluble and accumulates; excess is harmful (and dangerous in pregnancy). Prefer food sources unless a clinician advises otherwise.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Caution: Avoid high-dose vitamin A in pregnancy or when trying to conceive unless a clinician directs it.
Learn more about this nutrient: Beta-carotene — uses, safety & interactions
References (1)
- Tang G, Serfaty-Lacrosniere C, Camilo ME, et al. Gastric acidity influences the blood response to a beta-carotene dose in humans. Am J Clin Nutr 1996;64:622-6. PubMed
CHROMIUM
Insufficient EvidencePROTON PUMP INHIBITORS (PPIs)
PPIs increase the gastric pH, which might decrease chromium absorption due to formation of less soluble chromium salts. However, the clinical significance of this is not clear.
Chromium is a trace mineral your body uses to help insulin work properly and keep blood sugar in balance. Pantoprazole reduces stomach acid, and there is some thought that a less acidic stomach environment could make chromium harder to absorb, since the mineral may become less soluble at higher pH levels. That said, the evidence here is quite thin, and right now it is not known whether this matters in any practical way for people taking pantoprazole. If you have concerns, it is worth a quick conversation with your pharmacist or doctor.
Learn more about this nutrient: Chromium — uses, safety & interactions
References (1)
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
VITAMIN C
Insufficient EvidencePROTON PUMP INHIBITORS (PPIs)
Preliminary research suggests omeprazole reduces vitamin C levels, possibly due to increased destruction of vitamin C at higher gastric pH levels. It is not known if this interaction results in clinically significant reductions in vitamin C levels.
Pantoprazole reduces stomach acid, and there is early research suggesting that less acid in the stomach may actually speed up the breakdown of vitamin C before your body can absorb it. Vitamin C is something your body depends on for immune defense, wound healing, and keeping tissues strong. That said, the evidence here is preliminary and the clinical significance is simply not known, so this is more of a 'keep it on your radar' finding than a cause for concern. If you take pantoprazole long-term and eat a varied diet, you are likely fine, but it is worth mentioning to your pharmacist or doctor if you have questions.
What Vitamin C does & food sources
Vitamin C is an antioxidant that supports the immune system, collagen formation, and iron absorption.
Common food sources:
- Citrus fruits
- Bell peppers
- Strawberries and kiwi
- Broccoli and Brussels sprouts
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
What to discuss with your clinician
Frank vitamin C deficiency is uncommon with a varied diet. If your diet is limited and you take an associated medication, ask your provider whether your intake is adequate.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Supplement considerations
Vitamin C is water-soluble and generally low-risk at food-level intakes; very high supplemental doses can cause stomach upset and may not add benefit.
Do not start or stop medications or supplements without professional guidance — supplements can interact with prescription medications.
HelloPharmacist pharmacist-reviewed education — separate from the licensed record above.
Learn more about this nutrient: Vitamin C — uses, safety & interactions
References (1)
- Mowat C, Carswell A, Wirz A, McColl KE. Omeprazole and dietary nitrate independently affect levels of vitamin C and nitrite in gastric juice. Gastroenterology 1999;116:813-22. PubMed
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
More about Pantoprazole
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
Pantoprazole & nutrients: FAQs
Does Pantoprazole deplete CALCIUM?
Should I take a supplement because I take Pantoprazole?
Should I stop taking Pantoprazole?
Where does this information come from?
Questions about Pantoprazole and your nutrition?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Nutrient depletion records for Pantoprazole are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.