Q. I heard that people on acid-reflux drugs like Prilosec may need extra vitamin B12. How much vitamin B12 do you need when taking Prilosec on a daily basis? Some days I take two pills of Prilosec if my acid reflux is acting up.

A. Acid-suppressing drugs (Aciphex, Nexium, Prilosec, Protonix) can make it much harder to absorb vitamin B12 from food. This can eventually lead to a deficiency of this crucial nutrient. Symptoms may be subtle and include loss of appetite, constipation, depressed mood, confusion and weakness in arms and legs.
People who take these strong acid-blocking drugs for four years or more should have their vitamin B12 levels monitored. If your doctor finds that your B12 level is low and your homocysteine and methylmalonic acid levels are high, an oral supplement of 1000 micrograms (1 mg) of vitamin B12 daily may correct the problem.

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  1. Joyce L.
    Reply

    I have recently been diagnosed with anemia (hgb 10, Hct 30) and have been evaluated by a hemotologist. A number of blood test were done and myeloma was ruled out. I was put on high dose of iron for 6 weeks and returned to find the hgb and hct had not changed. The doctor performed a bone marrow biopsy and advised me to stop the iron. I told him I was taking Nexium at night for GERDS and wondered if it was causing a problem with absorption of nutrients, vitamins, ect. and he said it might very well be but not to stop the Nexium as acid reflux needs to be treated.
    I now take the Nexium in the middle of the night when I usually wake up about 4AM. I am to see the doctor next week at which time he will discuss the findings from the bone marrow biopsy. He told me that one option may be IV iron possibly every 6 months. What is your opinion on IV iron? Have you any research on this treatment? What are some of the side effects of such treatment? Thank you for valuable service you provide in clarifying people’s concerns.

  2. E.A.Dill
    Reply

    In 2003 I was a wreck with insomnia. I could sleep for an hour and wake up. I read an article in your column from someone who found relief with B12. The amount she was taking was in the order of 2700 (+/-). I started taking as much B12 as my system would tolerate without a gas attack (1500 MCG about 6 times in 24 hours). My internist says it is a placebo. I have been on Nexium for several years.
    I now sleep like a baby–no more RLS; if I wake at night I’m able to go right back to sleep. When I started taking Nexium he said to take 3G per day (1000MG at meal time). Thanks for the cure that would have sent me over the edge if I had not discovered your incrediblely valuable columns.
    Also treat toenail fungus and athlete’s foot with Vick’s VapoRub. It doesn’t cure it but a daily application restores my feet to perfect health.
    Please, keep up the good work!! People like me never write until my son also on Nexium came down with the same symptoms. Without B12 he would be on some form of opiate.

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