{"id":"6bfd70b2-9aa3-532b-988d-bc54c4ecaf52","stable_key":"7fc92b9e-9cbf-556e-8719-6b5244625250:b12-acid-suppression-h2-association","predicate":"long_term_use_associated_with_b12_deficiency","statement":"At least two years of H2-antagonist supply without PPI exposure was associated with a B12-deficiency diagnosis (OR 1.25; 95% CI 1.17–1.34).","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"positive","is_public":true,"mechanism_event_id":"81521a6b-7545-592b-8ea4-7033915c7a8c","mechanism_event_label":"A second acid-suppressing drug class showed an association in the same study.","subject":{"id":"2396c296-7c24-59e4-bfd7-3fd39da4db89","slug":"histamine-h2-antagonist-drug-class","display_name":"Histamine H2 receptor antagonist drug class","entity_type_key":"chemical_species"},"object":{"id":"ed0ea8da-9ffb-51b2-8a98-96cbf4fc919d","slug":"b12-deficiency-diagnosis","display_name":"B12 deficiency diagnosis","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"81521a6b-7545-592b-8ea4-7033915c7a8c","stable_key":"7fc92b9e-9cbf-556e-8719-6b5244625250:b12-acid-suppression-h2-association-event","event_type":"observed_intervention","label":"A second acid-suppressing drug class showed an association in the same study.","description":"At least two years of H2-antagonist supply without PPI exposure was associated with a B12-deficiency diagnosis (OR 1.25; 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no randomized acid suppression.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Not an independent cohort or a randomized comparison between drug classes; diagnosis is not the same endpoint as measured mean serum concentration.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Vitamin B12 research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"vitamin-b12","display_name":"Vitamin B12 (cobalamins)","entity_type_key":"chemical_species"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"A second acid-suppressing drug class showed an association in the same study.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[b12-lam2013] Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency (2013). https://pubmed.ncbi.nlm.nih.gov/24327038/ DOI: 10.1001/jama.2013.280490","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Human blood or whole-person endpoints","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"b806553b-0b0f-5f3a-b756-9721b607cafd","evidence_kind":"source_excerpt","locator":"Lines 1673-1683","start_line":1673,"end_line":1683,"excerpt":"### b12-acid-suppression-h2-association\nAt least two years of H2-antagonist supply without PPI exposure was associated with a B12-deficiency diagnosis (OR 1.25; 95% CI 1.17–1.34).\nCondition category: normal\nnutrient_topic: Vitamin B12 research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: A second acid-suppressing drug class showed an association in the same study.\norganism: Homo sapiens\ntissue_or_cell_type: Human blood or whole-person endpoints\nexperimental_model: Case-control study: 25956 incident B12-deficiency diagnoses and 184199 controls in Kaiser Permanente Northern California.\nlimitations: Not an independent cohort or a randomized comparison between drug classes; diagnosis is not the same endpoint as measured mean serum concentration.\nexposure: Prescription records for at least two years of PPI or H2-antagonist exposure; no randomized acid suppression.\n[b12-lam2013] Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency (2013). https://pubmed.ncbi.nlm.nih.gov/24327038/ DOI: 10.1001/jama.2013.280490","model_system":"Case-control study: 25956 incident B12-deficiency diagnoses and 184199 controls in Kaiser Permanente Northern California.","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [b12-lam2013] Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency (2013). https://pubmed.ncbi.nlm.nih.gov/24327038/ DOI: 10.1001/jama.2013.280490","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"73145023-2982-5848-aff2-8d8875d6b9c5","stable_key":"import-7fc92b9e-9cbf-556e-8719-6b5244625250","title":"Vitamin B12: mechanisms, deficiency and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"ad5b3a51d36e856aa7fdfd1cc23f690b094689bad87d28e1a621a54675a01c92","revision_id":"118bd616-0c13-549f-bfeb-bc439715b89c","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}