Brief Answer: many other problems may be possible Detailed Answer: It is certainly possible that being anemic can cause fatigue and tiredness. Therefore the first blood test to check would be a CBC (to check the hemoglobin), and then if low, to check the MCV (mean size of the red cells). This will give an idea if your husband may have some deficiencies in vitamins. In any case it is fairly easy to check Vitamin B12 levels, as well as folate level and iron studies via blood testing ordered by your doctor. Taking medication for GERD usually does not affect vitamin B12 absorption, although other medical problems may lead to vitamin B12 malabsorption (such as intestinal inflammation, in the ileum particularly - which is commonly seen in patients with inflammatory bowel disease) or having a deficiency of a protein that binds to the B12 in order for it to be absorbed in the intestine (this type of protein deficiency is called "pernicious anemia"). Pernicious anemia is most common in people from Scandinavia, so you remember correctly from nursing school. With those symptoms you mention, i would also suggest him getting checked for his thyroid and testosterone levels. Scandinavians are also prone to have gluten intolerance, but this would not explain his symptoms. Hope that helped

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