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Sorry to do another “I told you so” (OK I really am not sorry) but a big study came out showing that taking acid lowering drugs, some of the most widely used drugs in America, HUGELY increases the rate of B12 deficiency. Like 65% hugely.

Basic physiology – the stomach produces serious acid (like concrete-melting acidity) and it needs to. Why? To protect us from nasty stuff in our food like bacteria AND to digest food. You can’t absorb B12 if you don’t have enough acid. It is not “rocket science” then to figure out that lowering stomach acid will also destroy your ability to absorb B12. To me the story of this study is that it reveals how unthinking we can be. Heartburn is uncomfortable because the acid is in THE WRONG PLACE not because there is too much acid. That is nothing new at all. I learned that 30 years ago in medical school.

Complicating the problem is that most docs don’t know how to test you for B12 deficiency. The B12 blood test misses the great majority of people with B12 deficiency. AGAIN, this is not new. I learned that in medical school. In recent years better tests have become available but too few of us know about them. If a doctor remembers that B12 deficiency throws off your ability to feel vibration and your balance, very, very few know how to discover that on physical examination unless it is so bad that you stumble down the hallway in the medical office.

Is missing B12 deficiency a big deal? When conventional estimates of the number of people over age 60 who are B12 deficient run as high as 30% and the consequences (dementia, depression, fatigue, neurologic disease) are so high, it is a very big deal.

One powerful example of the consequences of B12 deficiency is strongly common but way under appreciated. Did you know that an American over age 60 is three times more likely to die from a fall as she/he is to die from a car accident? That’s right. Over 15,000 die each year from falls and around 5,000 from car accidents. Why do so many elderly Americans stumble to their deaths? One reason is that B12 deficiency makes you unsteady on your feet.

Whereas prescribing a drug that often makes a patient quickly feel better is easy, sorting out and helping the patient cure the cause, is much more difficult. 

GERD is a symptom, not a specific diagnosis. There are many causes and, accordingly, many individual solutions. That is why simplistic one size-fits-all approaches don’t fix the problem. If you or someone you know has GERD, you and your doctor/health care provider need to consider the big picture to achieve optimal health.

Usually a person’s diet is largely to blame. Dropping lactose-containing milk products, eating several hours before going to bed, limiting carbs, alcohol, caffeine and fat, and even chewing your food more carefully can all have a big impact. Probiotics can also change the picture entirely. Even this list is far from comprehensive.

These drugs are available without a prescription. We spend well over 10 billion dollars on these drugs every year. Many of them are available without a prescription so people are hurting themselves without knowing it.

What to do? No health care provider wants any patient to suffer pain, including from GERD. But the truth, dramatically highlighted by this new study, is that treatment has consequences and ignorantly applied treatment is flat out harmful. Instead of merely suppressing a symptom, hiding it away, the point MUST be to fix the problem. The Hippocratic Oath begins “First, Do no harm“. Therein lies the nub of the matter.

Written by 

Michael Carlston, MD is an internationally recognized authority in the integration of conventional and complementary medicine in clinical practice, as well as medical education, research and organizational consulting. Practicing in Santa Rosa, California, Dr. Carlston was voted “Best General Physician In Sonoma County, California” by readers of the Sonoma County Independent newspaper and also named one of the outstanding physicians in the Bay Area by San Francisco Focus Magazine. With 30+ years in private practice, his expertise is in nutrition, homeopathy and sports medicine.

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