I am a 79 year old male and do not have Diabetes.
I was diagnosed Small Fiber Neuropathy about 2 months ago. I have numness in my lower legs and toes. My legs burn while I sleep and cause me to get up frequently.

I use MsD's Metanx equivalent. I have tried Amytripaline for a month and Gabapentin for a month but both caused serious constipation and did little to control the pain while sleeping. I can contend with the crazy pain and numbness during the day because I stay physically active, I don't have a rocking chair!

I have been using Omeprazole (Proron pump anhibitor) for over 20 years for GERD, during the 30 years before that I ate thousands of Tums and Rolaids.

I understand Omeprazole negatively affects B12 absorbtion. Will it also affect the absorbtion of Methylcobalamin? I take 5000Mg of Methylcobalamin and 20 Mg Omeprazole each morning with a cup of coffee (half decaf), I eat cereal and drink a glass of orange juice about 30 minutes later and 2400 Mg Fish oil and 720 Mg Omega-3 after that.

If Omeprazole negatively affects B12 absorbtion are their other choices, possibly supplements or OTC, that will prevent GERD?

I have been taking PPI's for over 7 years now. I dont have any issue with Vitamin B12 Absorption. Take the 5000Mg of Methylcobalamin as soon as you wake up. Wait 30 mins and then take your PPI. Ofcourse everyonwe is different as far as how we abosorb. I would recommend you get you B levels check via blood test. Its simple to do and will take the guess work out.

You can also split the pill in half and take 2500 in morning and take another 2500 before dinner or at night.

I am wondering about those PPI's myself. I had to take DOUBLE Nexium doses for nearly 5 years to treat LPR (that is the ONLY treatment that works), although I'm now in remission and off of Nexium, hooray!

I've looked back and it seems that I've had intermittent foot/nerve issues during that timeframe. I did take B12, but not religiously (because it is stored in the liver). And every time I tested it was normal.

Nonetheless, I'm beginning to suspect that this (necessary at the time) treatment may be causative. Unfortunately it is getting worse every day. Starting this week I will begin all the supplements that have been suggested here.

It took years to heal the throat, I guess I'll need to use that old mindset that it could take awhile to heal the nerves. Interestingly, allopathic medicine claims that even with healing, LPR symptoms remain - WRONG (but admittedly uncommon). So I'm going to be of the opinion that the same is true with this PN, relying on the shared experiences express on the sticky.

I have read and understand that PPI's do cause B12 deficiency.

I guess each person is differnt and individual though, so it's really hard to say. I also believe you have to wait an hour after B12 before eating. I think taking only water with your B12 would be better also, but that's just cuz they say water is what all supplements and medications should be taken with.

Thankfully I learned to control my gerd with ACV and baking soda. I took nexium for 3 weeks but quit and when it acts up I do the ACV and baking soda 3 times a day, otherswise once a day for maintainence.

Hope you find what helps for you, I am still searching myself.

--taken over a long period of time, do impact the absoprtion of a number of vitamins and minerals, B12 prominent among them, as the reduced acid production makes it much more difficult to break these nutrients out of food by the usual chemical digestion process.

It is a good idea to take the methylcobalamin B12--the megadosing, 1000-5000mcg/day is designed so that 1-2%, enough for daily requirements and perhaps a bit more, will be passively absorbed, bypassing the usual stomach route--but it's best to take it on an empty stomach, well apart from anything else, as the cobalamin molecule is the largest the body regularly uses and it is very to interfere with its absorption--any fiber or food will interfere with best absorption, as will a lot of medications.

Thanks to all for the information.

Sounds like I need to have a 30 minute timer, a glass of water and my B12 on my night stand for my new schedule:
Upon waking, take B12 and go back to bed.
After 30 min take PPI with water, go get the newspaper.
After 30 minutes eat breakfast.
After breakfast take other pills (P-5-P, Metafolin, Fish oil/Omega-3 and Gabapentin) with orange juice.
I won't go into all the other 14 pills I take after lunch, dinner and before bed.

I think I will be seeing a psychiatrist long before I get relief from the SFN.

Stacy 2012, what is ACY? How much and how much baking soda and how often? Maybe I can save 30 min in the morning,

I take Apple Cidar Vinegar for blood sugar control before my yummy smoothie. I have no glucose problem, but I love to keep my level even, that and my supplements are the key to my healing.

I used to take baking soda and after a urine test, my urologist told me to stop. So just make sure you don't forget to get tested for ph if you do it a while. Don't want to trade problems.

Hi, just a quick comment. Please keep taking your meds for Gerds. I failed to do that and just chewed tums. Wound up with Barretts esophagus. I have a physiasist. Works the whole body together. She does have me on several kind of B vitamines. I also take B-12 shots. This was also a concern she had for me. I take a large dose called Dexilant 60 mg, twice a day. I hope to be able to cut this back after my next scope and biopsy. I do wish you all the best. Maybe look into what a Physiasist doctor is. I had no idea, until I found her. I do feel better. ginnie

I stopped taking prilosec after 10 years of use. I had many alarming symptoms of PN and PPI's seem to be the cause of it for me. To help combat the GERD I lost weight, ate healthier and took supplements listed on this site. I rarely feel the effect of heartburn anymore although I need to avoid high acid foods.

MrsD had some great insight about how Omega 3 fish oil helps control GERD. I suspect it has something to do with the anti-inflammatory abilities (EPA) of the supplement. She can offer more insight on this than me.

Other nutrients that PPI's can reduce besides B12 are folate, magnesium, iron and calcium. Additional B12 , folate and magnesium all helped me feel better over time.

I am curious to know what your PN symptoms and what partof your body did they appear? When did they first appear? How long before your symptoms went away after discontinuing te PPI? Did you ever get your Vitamin levels checked via a blood test while on the PPIs?