From the Research
There is no clear evidence that Ativan (lorazepam) directly decreases vitamin B12 levels. Lorazepam is a benzodiazepine medication primarily used to treat anxiety disorders, insomnia, and seizures, and it does not have a known mechanism that would interfere with vitamin B12 absorption or metabolism 1, 2, 3. However, long-term use of certain medications, particularly proton pump inhibitors and metformin, can reduce B12 levels, but lorazepam is not typically included in this category. If you're taking Ativan and concerned about vitamin B12 levels, it's worth noting that symptoms of B12 deficiency include:
- Fatigue
- Weakness
- Constipation
- Loss of appetite
- Neurological changes like numbness and tingling in the hands and feet If you experience these symptoms, consult your healthcare provider who can order a blood test to check your B12 levels 4, 5. While taking Ativan, it's always good practice to maintain a balanced diet rich in B12 sources like meat, fish, dairy, and fortified foods, or consider a supplement if recommended by your healthcare provider.
The most recent and highest quality study on vitamin B12 deficiency and its management suggests that screening for vitamin B12 deficiency is not recommended for average-risk adults, but may be warranted in patients with one or more risk factors, such as gastric or small intestine resections, inflammatory bowel disease, or use of certain medications 2. The study also recommends oral administration of high-dose vitamin B12 (1 to 2 mg daily) as an effective treatment for correcting anemia and neurologic symptoms.
In terms of vitamin B12 supplementation, a systematic review and meta-analysis found that vitamin B12 supplementation is likely ineffective for improving cognitive function and depressive symptoms in patients without advanced neurological disorders 4. However, another study found that vitamin B12 supplements administered orally or parenterally at high dose (1 mg daily) were effective in correcting biochemical deficiency and improving cognition in patients with pre-existing vitamin B12 deficiency 5.
Overall, while there is no clear evidence that Ativan decreases vitamin B12 levels, it's essential to be aware of the potential risk factors for vitamin B12 deficiency and to maintain a balanced diet rich in B12 sources or consider supplementation if recommended by a healthcare provider.