How Metformin Causes Vitamin B12 Deficiency

We usually focus more on other vitamins than B12. But, the lack of B12 can have consequences.

How Metformin Causes Vitamin B12 Deficiency

This water-soluble vitamin is not produced in the body, providing with supplements is necessary. As the other B vitamins, B12 helps the body to turn carbs into glucose and energy production. It stimulates production of DNA and RNA and produces S-adenosyl methionine and red blood cells. This vitamin plays an important role in the central nervous system because it conducts the nerve impulses and helps in formation of myelin which protects the nerves.

Lack of B12 can be difficult to detect. It may result in health problems and nerve damage. If you take metformin (a diabetes drug), you need to be cautious because it causes vitamin B12 deficiency.

Connection between Metformin and Vitamin B12 Deficiency

Albert Einstein college of Medicine in NY conducted a research regarding the topic and acquired numerous data from the relevant institutions. The researchers also included information from people that consumed placebo and metformin 2 times daily. After five and thirteen years, their levels of Vitamin B12 were once again measured.

The data pointed out big differences in vitamin B12 levels. Those that took metformin had lower levels compared to the ones that took placebo. Additionally, many people of metformin were anemic, which is another symptom of lack of vitamin B12.

However, no institution recommends monitoring of vitamin B12 levels in people that consume metformin. The researchers suggest that the patients should ask for this themselves.

Vitamin B12 Deficiency?

About 40% of the Americans have lack of vitamin B12, which causes neurological symptoms. Another 9% had deficiency of the vitamin, and 16% were close to the deficit. Older people have more chance to have deficiency of vitamin B12. As people grow older, the stomach acid decreases and with this the body is not able to absorb this vitamin. Some of the sympytoms older people experience are probably because of lack of vitamin B12: cognitive decline, weakness of the muscles, loss of memory etc.

Signs of Deficiency of Vitamin B12

  • Unexplained anemia
  • Fatigue
  • Neuropsychiatric disorders
  • Gastrointestinal disorders
  • Weakness of the muscles
  • Mental fogginess
  • Troubles with memory

Why Is Vitamin B12 Deficiency Often Ignored?

Many of the doctors have a tendency to ignore lack of vitamin B12, even when the results show it, it may still be considered as “normal”.

Expert doctors specialized in the field recommend that people on the lower limit of the values of B12 should be treated.

Elevated urinary methylmalonic acid, holo transcobalamin and homocysteine also mean that patients should be treated.

The Role of Vitamin B12

  • Regular digestion
  • Use of Iron
  • Food absorption
  • Regulation of formation of red blood cells
  • Mood regulation
  • Mental clarity
  • Production of adrenal hormone
  • Healthy nervous system function
  • Cell formation and longevity
  • Healthy immune system function
  • Focus
  • Normal nerve growth and development
  • Proper circulation
  • Support of pregnancy and female reproductive health
  • Emotional, physical and mental energy

Additional Effects

Bone Health

Deficiency of vitamin B12 can have a serious impact on bone health, increase the risk of fractures in older men, while women suffered bone loss in the hips.

Mental and Cognitive Health

Vitamin B12 deficiency can cause neurological disorders associated with depression, dementia and other mental problems. One study from Finland found that food that area rich with B12 can decrease the risk of Alzheimer’s disease.

Foods Rich in Vitamin B12

Vitamin B12 is available in animal food, grass-fed dairy products, wild-caught Alaskan salmon, organic free-range chicken and eggs.

It is very important that children consume lots of vitamin B12, so that they wouldn’t experience cognitive troubles in puberty.

How Is Absorption of B12 Affected?

Aging causes the stomach to produce less hydrochloric acid which means less vitamin B12. Still, the absorption of this vitamin can be affected by other factors including:

  • Alcohol
  • Gut Inflammation
  • Pernicious anemia
  • Intestinal dysbiosis
  • Nitrous oxide exposure
  • Consumption of acid-suppressing drugs and metformin

Metformin and Vitamin B12

A three-year study done by the Diabetes Prevention Program found that lifestyle changes have shown to be more effective than consumption of metformin in diabetes development prevention. 15 years later, the results are unchanged.

The participants that made lifestyle changes have almost 60% lower risk of developing diabetes than the placebo group. Those that used metformin had around 30% lower risk of diabetes. The lifestyle changes also helped in treatment and reversal of diabetes.

These news are excellent for those that use metformin and thus have vitamin B12 deficiency.

In short – the longer metformin consumption last, the higher the risk of vitamin B12 deficiency.