Q. A gentleman wrote you that he had been taking a prescription heartburn pill for years. Through his own research he learned that he might have a B12 deficiency due to his use of the drug over an extended period of time. He had symptoms such as fatigue and mild depression.
Upon reading the article, I realized that I had similar symptoms and was taking Nexium. I saw the doctor for a routine blood work-up and he checked the B12 level. It turned out that I was extremely deficient! The nurse called immediately and I was put on a protocol of monthly shots.
When I visited my gastroenterologist, he said he never heard of such a thing. I was quite surprised and would like to educate him.
A. This issue has been controversial for years, but there is growing recognition that long-term use of powerful acid-suppressing drugs can interfere with vitamin B12 absorption (American Journal of Gastroenterology, March, 2009, Suppl.).
Calcium, iron and vitamin B12 are all more readily absorbed from an acid environment. The blood tests for vitamin B12 deficiency should include a measurement of methylmalonic acid (MMA) and not just serum vitamin B12.
