Chronic use of Proton Pump Inhibitor Leading to Iron Deficiency Anemia in a Middle Aged Women

Abstract

 Iron deficiency anemia (IDA) is one of the most common hematological disorders. Proton pump inhibitors (PPIs) are widely used to treat various gastrointestinal diseases; however, their prolonged use has been increasingly associated with nutrient deficiencies, including iron deficiency. The underlying mechanism involves the alteration of the acidic gastric environment, resulting in impaired iron absorption. This case describes a case of a 43-year-old female who presented with fatigue and hair loss. She had a history of hypothyroidism, migraine, and gastroesophageal reflux disease (GERD), and had been taking omeprazole for the past eighteen years. Investigations revealed microcytic hypochromic anemia, characterized by low serum iron and ferritin levels. Other causes of iron deficiency anemia were ruled out through clinical assessment and laboratory workup. Oral iron therapy was poorly tolerated; however, intravenous iron led to symptomatic and hematologic improvement.