If you are a Word Press user with administrative privileges on this site please enter your email in the box below and click "Send". You will then receive an email that helps you regain access. One of the most common and beneficial T2DM drugs may contribute to neuropathy and vitamin deficiency The link between metformin and vitamin B12 lowering is well-known and mentioned in American Diabetes Association guidelines as a disadvantage of the drug. However, there are no recommendations for monitoring and prevention of vitamin B12 deficiency for patients taking metformin. Vitamin B12 deficiency is associated with adverse effects such as fatigue, mental status changes, and neuropathy. Given the prevalence of neuropathy in diabetic patients, metformin-induced vitamin B12 deficiency is clinically relevant. The relationship between vitamin B12 deficiency and metformin was studied in a recent randomized placebo-controlled trial. The trial lasted 52 months and included 390 type 2 diabetes patients. They were treated with 850 mg metformin at doses up to three times a day or placebo.
Joseph Pritchard graduated from Our Lady of Fatima Medical School with a medical degree. View Full Profile How much metformin you take and the duration you take it affect your risk of developing vitamin B-12 deficiency, according to a study published in a 2006 issue of the journal “Archives of Internal Medicine.” The study had 155 participants who suffered from vitamin B-12 deficiency resulting from metformin use. Pritchard writes as a San Francisco biology expert for a prominent website and thoroughly enjoys sharing the knowledge he has accumulated. The results of the study indicated that each 1 g daily of metformin caused a ratio of 2.88 increase in the risk of developing vitamin B-12 deficiency. Patients using metformin for three or more years had a lower ratio of 2.39. This suggests that it is possible to use metformin, by dosage and duration of treatment, as a basis for devising a method of preventing vitamin B-12 deficiency. The results also help determine how much supplementation is needed to maintain healthy levels of the vitamin B-12. Treating vitamin B-12 deficiency generally involves the use of either oral or intramuscular vitamin B-12 supplements, according to the American Family Physician website. Incidence of Type II Diabetes Mellitus (T2DM) is increasing; majority of which is managed in primary care. NICE recommends starting Metformin as a first-line therapy. Studies have linked Metformin use with Vitamin B12 deficiency and suggest that regular monitoring of levels is warranted. Literature suggests that the risk of developing B12 deficiency is greatly influenced by high doses and long duration of therapy. An audit was conducted at Hucknall Road Medical Centre in Nottingham, to determine whether GPs are checking serum B12 level in patients on Metformin. The first phase of the audit concluded that 64% of patients have not had their Vitamin B12 tested. The first phase revealed that 6.4% of the patients were already deficient and on replacement injections while on Metformin. The second phase of the audit determined whether patients would comply if invited to have their Vitamin B12 tested.
Unfortunately for diabetics taking metformin, research has found that long-term use of the drug can lead to a vitamin B12 deficiency. This study took place over a number of years, with a control group receiving a placebo, while the test group received metformin. During this time, the levels of B12 were monitored for any changes. After the study, it was found that those taking metformin on average had lower levels of vitamin B12 in their bodies. The metformin group was also more likely to be anemic than the control group, a telltale sign of deficiency. Though the role of medication is important for the management of many chronic diseases, lifestyle alterations also play a significant part. For those at risk of diabetes, instead of metformin, it may be better to ensure enough exercise is obtained. Furthermore, a healthy diet that is light on fats, salts, and sugars can decrease the risk of diabetes and other harmful conditions. Metformin, also known as Glucophage, is prescribed to more than 120 million patients worldwide. It works by reducing the amount of glucose produced by the liver as well as increasing a patient’s sensitivity to insulin. A recent study from research conducted by two hospitals in the United Kingdom confirms a concern the medical world has been aware of for quite a few years. Metformin is causing varying degrees of vitamin B12 deficiency in approximately 10 percent of prescribed patients. Kaenat Mulla and colleagues at Hucknall Road Medical Centre in Nottingham. The researchers conducted an audit of vitamin B12 screening and deficiency among female patients with type 2 diabetes who were taking metformin. “The audit findings indicated that 64 percent of patients had not had their vitamin B12 levels checked at all, and that 9.6 percent of patients were deficient but only 6.4 percent were being treated with vitamin B12,” a press release from the study states. The most significant concern is that even a patient who is managing their blood sugars at healthy levels could still experience severe and permanent nerve damage.
Association of Biochemical B 12 Deficiency With Metformin Therapy and Vitamin B 12 Supplements The National Health and Nutrition Examination Survey, 1999. Among those taking metformin, average vitamin B12 levels were lower and 4 percent were deficient compared to 2 percent in the placebo group. 3 Further, nearly 20 percent of those taking metformin had borderline low vitamin B12 levels compared to 10 percent of those taking a placebo.