Positives

• Patients generally report omeprazole effectively controls GERD/reflux symptoms and helps with the heartburn, regurgitation, and indigestion many Long COVID patients develop alongside autonomic dysfunction Drugs.com.
  
  

Negatives

• Long-term users (over a year) report an increased risk of vitamin B12 deficiency, low magnesium, bone fractures, kidney problems, and dementia — all especially relevant for ME/CFS patients already managing nutrient absorption issues PMC.
  
  
• Patients on long-term PPIs report higher rates of GI symptoms during COVID-19 infection, possibly due to PPI-related gastric acid suppression making the stomach more permissive to viral persistence Annals of Medicine.
  
  

Hurdles & Side Effects

• Use beyond six months has been associated with vitamin B12 malabsorption, with cognitive symptoms reported in long-term users PMC.
• Hypomagnesemia is documented in roughly 25% of long-term PPI users and the FDA label specifically warns about magnesium loss after a year of use Mayo Clinic.
• Long-term PPI use has been linked to a roughly 28% increased rate of chronic kidney disease compared with alternative acid reducers Yale Medicine.