Health & Longevity
The 5 Common Prescriptions That Quietly Drain Your Nutrients (and What to Put Back)
Millions of Americans over 60 take these medications every day. They work. And according to research from the Cleveland Clinic, JAMA, and the NIH, some of them quietly use up the very nutrients that keep your energy steady, your muscles calm at night, and your feet sure underneath you.
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What almost never gets discussed is the slow kind of trade: the way certain prescriptions, taken for years, deplete specific vitamins and minerals.
Researchers have documented it for decades. The Cleveland Clinic publishes it on its own patient pages.
And yet there is no line on your pharmacy printout for it, and no one in the system whose job is to replace what gets used up.
Here are the five most common examples, what each one drains, and what the research says about putting it back.
Daily Heartburn Pills (omeprazole, pantoprazole, esomeprazole)
Proton pump inhibitors, the purple pills and their cousins, are among the most prescribed drugs in America: roughly 24 million people take them, many for years on end.[1]
They work by shutting down stomach acid. The problem is that stomach acid is also what frees vitamin B12 from food so your body can absorb it, and long-term acid suppression affects magnesium absorption too.
studies show that long-term PPI use can lead to malabsorption of vitamin B12 and magnesium, and that this can lead to muscle weakness, poor balance, and falls.[2] Read that chain again.
A heartburn pill, two missing nutrients, and the steadiness of your own two feet, connected in one sentence by one of the most respected medical institutions in the country. Cleveland Clinic, Sarcopenia (Age-Related Muscle Loss)
The supporting research goes back over a decade. A study of 25,956 patients published in JAMA found that people who used PPIs for two or more years had a 65% higher likelihood of B12 deficiency.[3]
PSA on B12 Deficiency
I'm new to this subreddit but definitely not new to GERD. I've been on various PPIs and H2 receptor blockers for the last decade or so. Something I've never been told until recently (actually by an ENT helping me treat oral thrush and hearing issues exacerbated by reflux) is that PPIs and H2 receptor blockers usually leave users with a B12 deficiency, since our stomach acid isn't acidic enough to get this vitamin from our diets.
B12 deficiency causes a whole host of life-altering symptoms, from fatigue to feeling out of breath more often to unhealthier nails/hair/skin to depression/mood swings/anxiety to muscle weakness…etc. B12 is responsible for the body's ability to make red blood cells to carry oxygen to all the parts of the body, so without it, we suffer immensely. I was on B12 supplements 4-5 years ago, but then my diet went to crap while in school the last three years, and while I haven't yet gotten my B12 levels tested, my almost immediate reaction to B12 supplements has shown me just how badly I needed them.
Metformin
Metformin is the third most prescribed drug in the United States, taken by nearly 20 million people.[1]
It is a workhorse, and for most people with type 2 diabetes it has earned its place. It also has one of the best documented nutrient effects in all of medicine.
In the Diabetes Prevention Program Outcomes Study, a landmark randomized trial follow-up, 19.1% of long-term metformin users had low or borderline-low B12 at five years, roughly double the placebo group.
By year thirteen, it was 20.3%. One in five. Each additional year of use raised the odds of deficiency by 13%.[4]
The American Diabetes Association's own Standards of Care recommend periodic B12 testing for people on long-term metformin.[5]
Yet ask around: almost nobody on metformin has ever had their B12 checked.
Even physicians admit it. When the topic came up in a Reddit community for medical professionals, the thread title itself was a confession: “TIL: Metformin can cause vitamin B12 deficiency.”[6]
Long term Metformin use could cause B12 deficiencies
For anyone that wasn't aware, i recently found out that long term Metformin usage may cause B12 deficiencies which can cause neuropathy, fatigue, cognitive issues but should be reversable by supplementation.
Statins (atorvastatin, rosuvastatin, simvastatin)
Atorvastatin is the single most prescribed drug in America, and statins as a class reach roughly 50 million people.[1]
They lower cholesterol by blocking an enzyme pathway in the liver. Here is the wrinkle: that same pathway is the one your body uses to manufacture coenzyme Q10, a compound your muscles use to produce energy.
This is why the most talked-about statin complaint is muscle related: heaviness, aches, cramps, tired legs.
A meta-analysis of randomized controlled trials published in the Journal of the American Heart Association examined CoQ10 supplementation for statin-associated muscle symptoms and found it improved muscle pain, weakness, cramps, and tiredness compared with placebo.[7]
My experience w/COQ10 for muscle/joint pain while on statin
I want to share my experience with COQ10 supplement. TLDR: I take a total of 300mg of COQ10 each day and it has significantly reduced or eliminated all of the muscle/joint issues I had been experiencing.
Lipitor and muscle pain
Edit for update: It's been almost 4 months and wanted to return to thank everyone that gave me advice. It was a slow progress, but the CoQ10 supplement did help my mom. May someone else in need find this post and get some ideas that will help.
Water Pills (hydrochlorothiazide, furosemide)
Diuretics are prescribed to roughly 25 million Americans for blood pressure and fluid retention.[1]
They work by helping your kidneys flush excess fluid. But minerals travel in that same water.
The NIH Office of Dietary Supplements lists diuretic use among the recognized causes of magnesium depletion.[8]
There is a reason so many people meet the 2 a.m. calf cramp within weeks of starting a water pill.
And the backdrop makes it worse: 48% of Americans already consume less magnesium than their bodies require, before any prescription enters the picture, and older adults are among the highest-risk groups.[8]
“Her very first night on the water pill she woke up with terrible leg and toe cramps. The magnesium supplement is what finally seemed to help.”
The “Gentler” Heartburn Pills (famotidine and other acid reducers)
Many people switched from the stronger daily heartburn pills to famotidine or similar acid reducers believing the trade-offs were gone.
Smaller, yes. Gone, no. These medications also reduce stomach acid, and the same JAMA study that examined PPIs found that two or more years of these acid reducers was associated with a 25% higher likelihood of B12 deficiency.[3]
The reason matters for everyone over 60, whether you take an acid reducer or not: your stomach naturally produces less acid with age.
The NIH notes that older adults often cannot absorb food-bound B12 efficiently for exactly this reason, which is why the form of any B12 you take becomes more important every year.[9]
An acid reducer simply accelerates a road you were already on.
“Chronic use of acid blockers and metformin are all associated with decreased absorption of B12. Deficiency contributes to neuropathy. I wish more people knew this.”
Notice What All Five Have in Common
Three nutrients keep appearing: B12, magnesium, and CoQ10.
And three complaints keep appearing with them: tiredness that coffee stopped fixing, muscles that cramp and wake you at night, and a vague unsteadiness that everyone files under “just aging.”
Now notice something else. The research above is published by the Cleveland Clinic, JAMA, the American Diabetes Association, the American Heart Association's journal, and the NIH.
None of it is hidden. It simply lives in clinical documents, while the people taking these prescriptions live at kitchen tables.
Your doctor prescribes correctly. Your pharmacist fills accurately.
But replacing what the medication uses up is nobody's job. Nobody's except yours.
What to Put Back
(And why your last bottle failed.)
If you have been on any of these five prescriptions for two years or more, the practical response is not dramatic. It is a short conversation with your doctor, and a smarter approach to three nutrients. But the form matters more than the bottle, and this is where most people have already been burned:
“I tried magnesium before and felt nothing. Turns out it was the oxide kind. Switched forms and the difference at night was real.”
Introducing The Medicine Cabinet Refill
Steady in 90 nights. Two formulas, four capsules, one job: put back what your prescriptions use up.
That is the entire protocol. It fits the two moments you already own: breakfast, and lights-out. No new pills at lunch, nothing to remember at odd hours. And this matters: most people notice the nights change first, often within the first week. That is the magnesium. The morning half works quieter and slower, and we will show you exactly what to expect and when.
LongevityRx built the Refill for exactly the people on this page. MitoMultiply is methylated, pre-activated B vitamins built for how absorption works after 60, two capsules with breakfast. Mag18 is peptide-bound magnesium for the muscles that have been waking you at 2 a.m., two capsules before bed. Most people notice the nights change first, often within the first week.
Your order includes $212 in practical tools, free:
Your Order Includes:
BONUS First Three Chapters of Heal Your Cells, by Dr. Will Cole & Dr. Josh Axe
Why I Wrote Heal Your Cells
Everything on this page comes down to one idea: some of the most common long-term prescriptions quietly draw down specific nutrients, and almost nobody ever tells you which ones or what to put back. That gap is exactly why my co-author Dr. Josh Axe and I wrote an entire book about it. Heal Your Cells goes past any single medication to the bigger question underneath, why cellular aging is starting earlier for so many people, and what an actual plan to reverse it looks like. For a limited time, I'm sending you the first three chapters free, ahead of the book's official release.
-
01
Reset Your Cellular Age
Josh opens with his own health crisis, a scare serious enough that a doctor told him he might never walk normally again, and the recovery that followed. It's the case study behind the book's core claim: the body is built to regenerate, and most of what we call "aging" is a slower, everyday version of the same repair process, the same repair process this page is really about.
-
02
Why Our Cells Are Sicker Than Ever
The chapter that explains why the pattern on this page, medications quietly drawing down nutrients, is starting to show up earlier and more often, and why a standard checkup rarely catches it until it's already progressed.
-
03
Chemical Chaos at the Cellular Level
My own chapter, on the everyday exposures most people never think to account for, prescriptions included, and what they're quietly doing at the cellular level.
About the Author
Dr. Will Cole, MD
Functional Medicine Practitioner
Dr. Will Cole is a leading functional medicine practitioner who works to find the root cause of fatigue, inflammation, and hormone imbalance. After reviewing thousands of genetic profiles in his clinic, he formulated MitoMultiply for Longevity Rx to give the body the methylated nutrients it can actually use.
Frequently Asked Questions
Why isn't B12 checked at a normal physical?+
The standard panel is built to catch disease markers your doctor is watching for at night, like your A1c, blood pressure, and kidney function. B12 is not part of that default panel. The American Diabetes Association's own Standards of Care say measurement should be considered for people on long-term metformin, but "considered" is easy to lose inside an eleven-minute visit unless someone asks for it directly.[1]
How common is B12 deficiency in people on metformin?+
In the Diabetes Prevention Program Outcomes Study, 19.1% of long-term metformin users had low or borderline-low B12 at five years, compared with 9.5% on placebo. By year thirteen, it was 20.3%, roughly one in five. Each additional year of use raised the odds of deficiency by 13%.[2]
What does low B12 actually feel like?+
It tends to show up slowly, which is part of the problem. Tiredness that gets filed under age. Tingling feet that get filed under diabetes. Foggy thinking that gets filed under getting older. These symptoms look exactly like what people already expect to feel in their 60s and 70s, which is why a test matters more than a guess.
Should I stop taking metformin?+
No. Metformin has decades of evidence behind it and has helped protect many people from the consequences of uncontrolled blood sugar. Nothing here suggests stopping or changing it. The point of this page is the nutrient it can quietly use up over time, not the medication's value. Never stop or change a prescription medication without consulting your healthcare provider.
What should I actually say to my doctor?+
Something as direct as: "I've been on metformin for years. Could we check my B12?" This is already inside the ADA's own published Standards of Care, so it is not an unusual request. Bringing a printed summary with citations can help keep the conversation short and specific.
Why does the form of B12 matter?+
Most drugstore B12 is cyanocobalamin, a form your body has to convert before it can use it, and that conversion slows with age. Methylated B12 arrives already in the active form, which is why it's used instead of cyanocobalamin in formulations built for this stage of life.[3]
What if my B12 test comes back normal?+
That's a genuinely good outcome, and the honest majority result: about four out of five long-term metformin users are not in the low range. A normal result means one less thing to wonder about. The point of testing is finding out which group you're in rather than guessing.
The Medicine Cabinet Refill
Steady in 90 nights. Two formulas, four capsules, one job: put back what your prescriptions use up.
That is the entire protocol. It fits the two moments you already own: breakfast, and lights-out. No new pills at lunch, nothing to remember at odd hours. And this matters: most people notice the nights change first, often within the first week. That is the magnesium. The morning half works quieter and slower, and we will show you exactly what to expect and when.
LongevityRx built the Refill for exactly the people on this page. MitoMultiply is methylated, pre-activated B vitamins built for how absorption works after 60, two capsules with breakfast. Mag18 is peptide-bound magnesium for the muscles that have been waking you at 2 a.m., two capsules before bed. Most people notice the nights change first, often within the first week.
Your order includes $212 in practical tools, free:
Your Order Includes:
References
[1] ClinCalc DrugStats Database, 2024 prescription and patient estimates (MEPS-based): atorvastatin, metformin, omeprazole, pantoprazole, hydrochlorothiazide, furosemide.
[2] Cleveland Clinic. Sarcopenia (Age-Related Muscle Loss). my.clevelandclinic.org/health/diseases/23167-sarcopenia.
[3] Lam JR, Schneider JL, Zhao W, Corley DA. Proton Pump Inhibitor and Histamine 2 Receptor Antagonist Use and Vitamin B12 Deficiency. JAMA. 2013;310(22):2435-2442.
[4] Aroda VR, Edelstein SL, Goldberg RB, et al. Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab. 2016;101(4):1754-1761.
[5] American Diabetes Association. Standards of Care in Diabetes. Section 9, Pharmacologic Approaches to Glycemic Treatment.
[6] Reddit, r/medicine. “TIL: Metformin can cause vitamin B12 deficiency.” Community discussion among medical professionals.
[7] Qu H, Guo M, Chai H, et al. Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2018;7(19):e009835.
[8] National Institutes of Health, Office of Dietary Supplements. Magnesium Fact Sheet for Health Professionals. ods.od.nih.gov.
[9] National Institutes of Health, Office of Dietary Supplements. Vitamin B12 Fact Sheet for Health Professionals. ods.od.nih.gov.
Community quotes are lightly edited for length and clarity from public patient discussions on Mayo Clinic Connect and Reddit; they reflect individual experiences, not clinical evidence, and are not endorsements of any product.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Never stop or change a prescription medication without consulting your healthcare provider.
I've been on metformin about 2 years. 2 months they started me on B12 when my levels started dropping. Now they are normal again.