H2 Histamine Blockers Concerns and Deficiencies

Ranitidine: An H2 Histamine Blocker

(common name Zantac, Pepcid)

What You Need to Know First



Ranitidine is a member of the H-2 histamine blocker family of drugs. This medicine prevents the release of acid into the stomach.  It is used to treat stomach ulcers, GERD, erosive esophagitis, and Zollinger-Ellsion syndrome. 

This is available OTC and as a prescription medication. 

While proton pump inhibitor drugs (PPI’s) have been in the news more lately due to new side effect findings, it does not mean that Histamine blockers are free of concerns. They are both used to suppress gastric secretions but they differ in how they do this. 

While these drugs are used to suppress stomach acid, be aware that we need stomach acid.  An easy to read and informative book that I suggest you get to understand why stomach acid is vital to our overall health is “Why we need stomach acid” by Wright and Lenard. 

What H-2 Histamine Blockers May Deplete

  • Folate: Folate is needed by the body to utilize vitamin B12. Zantac and similar medications inhibit folate absorption.  Thus, taking this medication may cause a deficiency in folate and B12
  • Iron: Stomach acid may facilitate iron absorption. Beta blockers reduce stomach acid and are associated with decreased dietary absorption of iron.  People with ulcers may be deficient due to blood loss.  It is best to check iron levels on your blood work. 
  • B12: Stomach acid is needed to release B12 from food so that it can be absorbed by the body. Since beta blockers reduce stomach acid, your B12 levels will also be low.  B12 supplementation does not need stomach acid.
  • Magnesium: These drugs can block the active transport of magnesium in the intestines causing low magnesium and resulting in depression.
  • Other possible nutrient deficiencies include: vitamin A, vitamin D, calcium and zinc

What you Should ask Yourself Before Taking an H-2 Histamine Blocker (or a PPI)

  • These drugs reduce stomach acid. Do you know that elevated stomach acid is your issue?  For some it could be something else and low stomach acid can cause the same symptoms as high stomach acid. 
  • These drugs are meant to be taken only short term, 4-8 weeks, but most people take these meds long term, sometimes for years. Would you rather get to the root of your problem and address it?
  • Would life style and dietary changes be better (and safer with no side effects) be better than taking a drug?

What May Be Causing Your Stomach Issues

  • Hiatal Hernia
  • Hormones (yours and those from your food)
  • Eating too much, too quickly and too late
  • Relaxation of the esophageal sphincter
  • High or low stomach acid
  • Coffee, caffeine, carbonated drink, spicy foods
  • Gall bladder issues (which can also mean liver issues since bile is made in the liver and is stored in the gallbladder)

Natural Options


It is always best to work with a professional to address your root causes and find out what would be the best method of body balance and digestive relief but here are a few things you can try on your own in the meantime. 

  • Try drinking 1 tablespoon of Braggs Apple Cider Vinegar in 8 ounces of water before a meal. If this helps, you may have low stomach acid. If it makes it worse, try ½ teaspoon of baking soda in a glass of water. If this resolves your issue, you may have high stomach acid.

o   If you have high stomach acid limit the amount of spicy foods you eat during gut healing (which includes coffee). 

o   As we age our stomach acid levels go down, thus older people tend to have low not high stomach acid. 

  • Add in digestive bitters before a meal. Bitter foods and herbs stimulate our bile and digestive juices to aid with meal digestion. 
  • Add in a digestive enzyme, a full spectrum one is best, so that is has the needed enzymes to break down your fats, sugar (carbs/starches), and proteins in the meal.
  • Chew DGL (licorice) before a meal
  • CHEW! Don’t inhale your food. Chew each bite 15-20 times.  This aids the digestive process.  It may seem simple but just this step alone can be very effective for some. 
  • Work with someone to determine if you have food intolerances. Or start by removing a food group for 2 to 4 weeks and see if the issue resolves. The main culprits include gluten, dairy, soy and corn.  

Bottom Line

Ask yourself if you want to address the cause or use symptom management. The choice is yours. 


  2. Bauman, E. & Friedlander, J. (2014) Foundations in Nutrition. CA: Bauman College
  3. Bauman, E. & Friedlander, J. (2014) Therapeutics in Nutrition. CA: Bauman College
  4. Gaby, A. (2006) A-Z Guide to Drug-Herb-Vitamin Interactions. NY: Three Rivers Press
  5. Wright, J. & Lenard, L. (2001) Why Stomach Acid is Good For You. NY: M. Evanns


If you are sick and tired of feeling sick, tired, fatigued, depressed, anxious and more and have given up hope then Karen’s simple, effective, individualized and sustainable approach may be what you need. 

Karen Brennan, MSW, CNC, Board Certified in Holistic Nutrition and Herbalist is the author of Tru Foods Depression Free Nutrition Guide; How Food Supplements and herbs can be used to lift your mood and owner of Tru Foods Nutrition Services, LLC. 

For more information visit

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As a nutrition professional, Karen does not treat, cure nor diagnose. This information is for educational purposes only.

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