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Thanks everyone and being very new to TRT I learned a lot from you guys. Taked to Dr Saya and I am so greatful that he got me in quickly. I am overseas and had to stay up like past midnight to talk to him but it was worth it. He put me on 4 weeks of 200 iu HCG per day to jump start my system...
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Proton Pump Inhibitors (Antiacids) May Interfere with Iron Absorption
Non-heme iron is the predominant form of iron found in plant foods and must be reduced prior to absorption in the small intestine. Therefore, PPI use may affect its absorption. However, there is little conclusive evidence of an increased risk of iron deficiency in PPI users in the short term. A few case reports have documented that omeprazole-induced achlorhydria may impair the response to iron supplementation in patients who were previously iron-deficient [23]. No cases of impaired iron response with omeprazole use have been reported in iron-replete individuals. Furthermore, a small, exploratory, cross-over intervention study in nine healthy adults found no difference in iron absorption between the control phase and a four-day omeprazole treatment phase [208]. In a study of patients with Zollinger Ellison syndrome, a disease in which tumors cause the stomach to produce too much acid, PPI use was not associated with diminished iron status [209].
However, in a retrospective cohort study of adult patients, chronic PPI therapy for >1 year was associated with a significant decrease in hemoglobin, hematocrit, and mean corpuscular volume from baseline, while no hematological changes were observed in matched controls [210]. In a large case–control study of 77,046 patients diagnosed with iron deficiency, the odds ratio (OR) for developing this condition was 2.49 fold higher (95% confidence interval (CI): 2.35–2.64) for patients taking PPI for ≥2 years [211]. Additionally, PPI use for >1 year was found to decrease phlebotomy requirements for hereditary hemochromatosis patients. This same study also found that the use of PPIs for one week decreased the absorption of non-heme iron by 50% in these individuals [212].
In summary, there is some evidence to indicate PPI use may negatively impact iron absorption. PPI users already at elevated risk for iron-deficiency or those with pre-existing iron deficiency may be at greater risk for impaired iron absorption during PPI therapy. Similar to its stance on the routine monitoring of vitamin B12 status in those taking PPI, the AGA does not currently recommend routine monitoring of iron status [207].
The long-term use of prescription and over-the-counter drugs can induce subclinical and clinically relevant micronutrient deficiencies, which may develop gradually over months or even years. Given the large number of medications currently available, the number of research studies examining...
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