Acid Suppressants May Lower B12 Levels

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.