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The proton pump inhibitors are a group of drugs that reduce the secretion of gastric (stomach) acid .They are powerful inhibitors of gastric acid secretion, but have not been shown to cause iron deficiency in many people.While other research & evidence show that a portion of the population taking proton pump inhibitors have significant iron deficiency.
As iron requires acidic environment to get absorbed through the lining of stomach, PPI kills that atmospheres & hence hinders the absorption.The result is that PPI users are more susceptible to anemia due to poor digestion of non-heme iron-containing foods, and then iron supplements can't be absorbed either.
A definitive answer about the relationship between PPI & iron deficiency anemia is yet to establish.
Iron deficiency anemia is caused by insufficient dietary intake or absorption of iron A reticulocyte count is a quantitative measure of the bone marrow's production of new red blood cells.It measures how fast red blood cells (called reticulocytes) are made by the bone marrow and released into the blood. A low reticulocyte count may mean fewer red blood cells are being made by the bone marrow. So the answer is iron deficiency (which can be due to insufficient iron absorption or insufficient dietary intake) can also be the cause of low reticulocyte count.
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