I wasn’t aware that multiple studies have confirmed that there is an association between metformin use and B12 deficiency. A 2014 study found that among its participants, vitamin B12 concentrations were much lower for those who used metformin than for those who used a placebo or rosiglitazone. Both diabetes and B12 deficiency can result in peripheral neuropathy. The underlying pathophysiology of metformin’s effect on B12 concentrations is unclear (Wainwright, 2017).
Wong et al. (2018) conducted a study including 1996 institutionalized elderly individuals. 53.2% of those studied who took metformin also had a B12 deficiency compared with 31% of diabetic patients who were not taking metformin.
Be aware of the symptoms of B12 deficiency including weakness, tiredness, heart palpitations, shortness of breath, pale skin, a smooth tongue, constipation, diarrhea, loss of appetite, nerve problems like numbness and tingling, vision loss, and mental problems like depression and memory loss. Call your doctor if you experience these symptoms. B12 can be supplemented or obtained in diet with poultry, seafood, dairy products, and eggs.
References:
Wainwright, P. (2017). Metformin and vitamin B12 deficiency. Diabetes & Primary Care, 19(2), 63–66. Retrieved from http://proxy.pba.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,uid&db=ccm&AN=123016602&site=ehost-live
Wong, C. W., Leung, C. S., Leung, C. P., & Cheng, J. N. (2018). Association of metformin use with vitamin B12 deficiency in the institutionalized elderly. Archives of Gerontology & Geriatrics, 79, 57–62. https://doi-org.proxy.pba.edu/10.1016/j.archger.2018.07.019
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