Can omeprazole cause tingling in hands and feet? Understanding the connection

October 9, 2025 •

3 min read

Yes, studies have shown that prolonged use of omeprazole and other proton pump inhibitors (PPIs) can interfere with vitamin B12 absorption, leading to deficiencies. This can explain how can omeprazole cause tingling in hands and feet, a symptom of potential nerve damage.

Quick Summary

Tingling, or peripheral neuropathy, is a reported side effect of long-term omeprazole use, primarily due to deficiencies in vitamin B12 and/or magnesium. Diagnosis involves blood tests and a clinical evaluation. Management strategies include supplementation, dose adjustment, or discontinuing the medication under a doctor's supervision.

Key Points

Tingling is a potential side effect: Long-term use of omeprazole has been associated with tingling or numbness in the hands and feet, a form of peripheral neuropathy.
Linked to Vitamin B-12 deficiency: The primary cause is often a deficiency in vitamin B-12, as omeprazole reduces stomach acid needed for its absorption.
Low magnesium is another factor: Long-term use can also lead to low magnesium levels, which can cause muscle cramps and spasms in the extremities.
Neurological side effects are more frequent with PPIs: Some analyses of adverse event data have shown higher rates of neurological issues with PPIs compared to similar medications.
Medical consultation is crucial: You must contact your doctor if you experience tingling, and never stop taking your medication without their advice.
Diagnosis requires tests: A doctor will likely perform a physical exam and blood tests for vitamin B-12 and magnesium to identify the cause.
Treatment involves management: Management may include supplementation, dosage adjustment, or switching medication, all under medical supervision.

Omeprazole and its mechanism

Omeprazole, also known as Prilosec, is a proton pump inhibitor (PPI) used to decrease stomach acid for conditions like GERD and ulcers. While effective, long-term use can lead to side effects such as peripheral neuropathy, experienced as tingling or numbness in the hands and feet.

The primary connection: Vitamin B-12 deficiency

Omeprazole's impact on stomach acid can impair vitamin B-12 absorption, as acid is needed to release B-12 from food. Long-term use, often exceeding 3 years, can lead to deficiency. Vitamin B-12 is crucial for nerve health, and its deficiency can cause numbness, tingling, and other neurological symptoms in the extremities. Muscle weakness and cognitive issues are also possible.

Another potential cause: Low magnesium levels

Extended use of PPIs like omeprazole can also result in low blood magnesium (hypomagnesemia). Although the exact reason isn't fully understood, this is a known risk with prolonged therapy. Magnesium is important for nerve and muscle function, and low levels can cause muscle pain, cramps, weakness, tremors, and even hand and foot spasms.

The broader context: Drug-induced neuropathy

Research suggests a potential link between PPIs and neurological issues beyond specific deficiencies. A 2019 analysis found higher rates of reported neurological conditions, including peripheral neuropathy, in PPI users compared to those on H2-receptor blockers. This suggests a possible broader effect on the nervous system, which is still being investigated.

Diagnosing the cause of tingling

Experiencing tingling or numbness while on omeprazole warrants a medical consultation to determine the cause. A doctor can assess if it's medication-related or due to another condition. Diagnosis may involve:

Physical examination: To evaluate reflexes, muscle strength, and sensation.
Blood tests: To check vitamin B-12 and magnesium levels, and rule out other issues.
Nerve conduction studies (NCS): To measure nerve electrical activity and function.

Comparison of potential causes for tingling with omeprazole


Feature	Vitamin B-12 Deficiency	Low Magnesium (Hypomagnesemia)
Mechanism	Impaired absorption due to reduced stomach acid.	Altered magnesium balance or absorption from long-term PPI use.
Common Duration of Use	Typically, prolonged use over 3 years.	Can occur after 3 months or longer.
Key Symptoms	Numbness, tingling, "pins and needles" in extremities, weakness, fatigue, mood changes.	Muscle cramps, tremors, spasms (including in hands and feet), jitteriness, weakness.
Onset	Gradual, due to slow depletion of body stores.	Can be more acute in onset, but chronic with long-term therapy.
Diagnostic Test	Blood test for serum vitamin B-12 levels.	Blood test for serum magnesium levels.

Management and treatment options

If omeprazole is determined to be the cause of tingling, several strategies exist:

Supplementation: For confirmed B-12 or magnesium deficiency, supplements may be recommended.
Dose adjustment or medication change: A doctor might suggest a lower dose or alternative medication under medical supervision.
Addressing underlying conditions: Other causes of tingling, like diabetes, must also be managed.
Safety measures: For reduced sensation, simple steps like regular foot checks and supportive footwear can prevent injury.

Important considerations

Report any tingling or serious side effects to your healthcare provider immediately. Do not change your omeprazole dosage without medical advice to avoid worsening your original condition or causing withdrawal. The information here is for educational purposes and not a substitute for professional medical advice. For more on drug-induced neuropathy, refer to the MedlinePlus resource.

Conclusion

Omeprazole is effective for acid-related issues, but long-term use carries risks, including tingling in the extremities due to potential B-12 or magnesium deficiencies. Proper diagnosis by a healthcare professional is vital to determine the cause and guide treatment. With monitoring and appropriate management, side effects can be mitigated while continuing necessary gastrointestinal care.

Frequently Asked Questions

Omeprazole works by reducing stomach acid. Stomach acid is required to release vitamin B-12 from dietary proteins, so its long-term reduction can lead to malabsorption and a resulting deficiency over time.

Tingling related to vitamin B-12 or magnesium deficiency typically occurs with long-term use of omeprazole, often defined as use for 3 years or longer. However, the timeline can vary by individual.

You should immediately contact your healthcare provider. They can perform tests to determine the cause of your symptoms and advise on the best course of action, which may include blood tests for vitamin levels.

If the tingling is caused by a vitamin or mineral deficiency, treating the deficiency (e.g., with supplements) and adjusting the medication may help resolve the symptoms over time. You should never stop omeprazole without first consulting your doctor.

Yes, aside from muscle cramps and spasms, low magnesium levels can also cause muscle weakness, fatigue, an irregular heartbeat, and tremors.

Yes, many other medications can cause peripheral neuropathy, including some chemotherapy drugs, heart medications, antibiotics, and HIV treatments. Your doctor will consider all medications you are taking.

Management is determined by your doctor based on the cause. It may involve taking supplements for B-12 or magnesium, adjusting your omeprazole dose, or exploring alternative medications. Pain management and safety measures may also be recommended.