Most long heartburn prescriptions deserve a second look at the blood test.
The little purple counter
I stood behind a hospital pharmacy counter for thirty-two years, and the acid reducers never stopped coming. First the one that calmed the burn, then the stronger one, then the one you took every morning before your feet even found the slippers. People stayed on them for years. Nobody asked why, least of all the person swallowing the pill.
I am not saying these medicines are bad. I am saying they change the kitchen. Stomach acid is not the enemy. It is the cook that breaks your food down small enough to use. Turn that cook down for a decade and some vitamins never make it to the plate. B12 is the one I watched most closely.
What the gas taught me
The strangest B12 story I ever learned was not about a stomach pill at all. It was about laughing gas. Joseph Priestley first made nitrous oxide in 1772, and by 1799 the British upper class were throwing laughing gas parties. A dentist named Horace Wells finally used it for a tooth extraction on 11 December 1844, and it worked.
The part that stayed with me came much later. The gas essentially switches the vitamin off inside the body. I remember reading that and thinking, so this is what B12 starvation looks like when you speed it up. Numb feet. Foggy head. A person who laughs at a party and cannot feel their toes by morning.
The acid reducer does the same job slower and quieter. You do not feel it at year one. You might feel it at year ten.
The brown bag on my table
This is why the first thing I ask for is the brown bag. Every bottle, every box, the nightly allergy tablet included. I wrote down my whole method once, and it still lives in my head as the brown bag review I run at the senior centre on Elm Street. Nine times out of ten there is an acid reducer in that bag, and next to it a complaint about memory.
Bev from the walking group brought me her bag last spring. She had been on the same acid reducer for eleven years. Her words were fine. Her numbers were low. I did not tell her what was wrong. I told her to ask her doctor for a simple blood test and to write the date on her paper calendar. That is all. She did, and the number came back low enough to matter.
A worked example with dates
Here is what one year looked like for a man I will call Ed, because he asked me to keep his real name out of it. Ed started his acid reducer on 3 March 2014 after a bad stretch of heartburn.
Ed’s doctor did not panic. She checked his diet, asked about the medicine, and rechecked him three months later on 15 May 2023. Same low number. His daughter told me in September that he had finished a crossword in pen for the first time in two years. I do not call that a lasting fix. I call it a correction that started with one blood test.
If you take an acid reducer every day, pull up the video after this note and watch the acid-reducer explainer video before you refill another bottle.
The mistake I made myself
I am not immune. About six years ago I noticed my own words going soft at the edges. Names I had known for decades took an extra beat to arrive. I blamed age, which is the laziest diagnosis in the world. I had been taking an acid reducer every night for my own heartburn, prescribed after a miserable winter of reflux.
I never got my B12 checked. Not once. I just kept swallowing the pill and complaining to my husband that my brain was turning to soup. When I finally mentioned it to my own doctor, she ordered the test. My number was low-normal, not terrible, but low enough that we changed the routine. What it cost me was two years of quiet worry I did not need to carry, and one embarrassing evening when I introduced Bev to Carol as Deb. Carol still brings it up.
There are two roads with acid reducers, and I have walked both. The first is the daily pill, every morning, for the long term. It works. The burn stays down. But after years of it, your B12 can drift so low that your nerves start to mumble. I took that road for a while, and I did not like where it led.
The second road is the shorter course, the one you take for a few weeks to let the irritation heal, then you stop and see how you do. This is the road I use now. It asks more of you. You have to notice what you eat at night, and you have to be honest about the coffee. But your stomach acid stays closer to its old self, and your B12 has a fighting chance. I am not telling you which road to take. I am telling you I have driven both, and one of them required a map.
The myth is that less acid is always better. People believe heartburn means their stomach is too strong, too acidic, too much. So they shut it down completely and keep it shut for a decade.
I watched hundreds of people swallow daily acid reducers for years without a single follow-up question. Their heartburn stayed quiet, sure. But some of them started dropping words, misplacing keys, losing the thread of a story they had told a hundred times. Their families worried about memory. Nobody looked at the bottle on the counter. I am not saying the medicine caused every slip. I am saying it is the easiest thing to check, and almost nobody checks it.
I keep my own routine simple, and I will share it because people ask.
I fill my pill organiser every Sunday morning at the kitchen table. I write any new medicine on the paper calendar by the phone with the date I started it. I ask my pharmacist about B12 whenever an acid reducer shows up in my bag or anyone else’s. I get my own blood checked once a year, same month, so I cannot forget. I keep the names notebook on the counter, and when a word goes missing I write down what I was doing, not just what I forgot. It helps me see patterns instead of panic.
Why memory slips after sixtyWatch the video and see how to get your memory back on track.
If any of this sounds familiar, open the video and play the acid-reducer walkthrough video before your next refill.
My sister Carol called from Arizona last Tuesday. She had been on an acid reducer since 2019 and could not remember the word for a colander. I told her to write 12 March on her calendar and ask for a B12 test that day. She laughed and said I sounded like a pharmacist. I am a pharmacist. The colander is still sitting in her sink, unnamed.