Supplements and PPIs.
Proton pump inhibitors raise gastric pH. The downstream effect on supplements is twofold. Some supplements are not interacted with directly but their absorption pattern changes (non-haem iron, vitamin B12, magnesium). Long-term PPI use itself depletes these nutrients, which is why chronic PPI users sometimes need to supplement them at higher doses than the general population.
The strongest recommendations: monitor B12 after a year of daily PPI use, particularly in over-50s; consider magnesium repletion if blood levels run low; use iron bisglycinate rather than ferrous sulphate if iron is needed (less pH-dependent). None of these are emergency interactions; all are worth knowing if you take a daily PPI.
Something missing?
If a supplement or medication you take isn't in our autocomplete, tell us and we'll add it in the next quarterly update.