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Hypomagnesemia recurred if PPI therapy was re-introduced[226] Another recent review of 4 cases examined the clinical consequences and mechanisms of electrolyte disorders that resulted from the elderly patients taking a PPI for a period of 1 to 13 years.[227] They developed severe low magnesium levels with low calcium levels, hypoparathyroidism (low parathyroid hormone), and extremely low urinary calcium and magnesium excretion

Today the situation is more straightforward

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This treatment especially benefits individuals with difficulty absorbing B12 through food or supplements

While Vitamin B12 supplements are common, other methods might suit certain patients better

Thus, parenteral or nasal therapy may be needed