Why Metformin Takers Should Have B12 Levels Checked

People taking the drug metformin may want their vitamin B12 levels monitored by a doctor.

Researchers at the Albert Einstein College of Medicine in New York analyzed data from a comprehensive longterm diabetes study and found those taking metformin* are at increased risk for either low levels of vitamin B12, or a vitamin B12 deficiency.

Why We Need It

We know most medications come with a chance of side effects. Fortunately, a B12 inadequacy is one that is easy to detect and correct, and there are excellent reasons why we should:

  • The B vitamins, including B12, play a role in the conversion of carbohydrates into glucose.
  • Vitamin B12 helps maintain our nervous system. It’s involved in the manufacture of myelin sheaths that cover and protect our nerves, facilitates nerve growth, and the conduction of nerve signals.
  • Vitamin B12 is a player in the creation of our DNA and RNA, and it teams up with folate to produce red blood cells and SAMe (S-adenosylmethionine). SAMe influences our mood and immune system function.
  • Bone health, mental clarity, memory, and concentration, blood circulation, proper digestion, adrenal hormone production, reproductive health, cell formation, and longevity require vitamin B12.

Because regular monitoring of vitamin B12 levels is not formally recommended by The American Diabetes Association nor the U.S. Food and Drug Administration, the Albert Einstein researchers suggest people taking metformin request their doctors do so.

Signs and Susceptibility

Testing for B12 levels is important since the early stages of a deficiency - when B12 absorption problems lead to cellular depletion - may go undetected.

Sub-par levels of B12 can eventually lead to memory issues, mental fogginess, muscle weakness, or fatigue. The earliest signs of a deficiency are typically unexplained anemia, neuropsychiatric problems, and gastrointestinal disorders.

People over the age of 50 are especially susceptible to B12 insufficiency because the stomach produces less hydrochloric acid as we grow older—and hydrochloric acid releases vitamin B12 from our food. Absorption of B12 can also be hampered by gut inflammation, medications such as antacids, use of proton pump inhibitors (PPIs), exposure to nitrous oxide, and alcohol consumption.

Getting Enough B12

Vitamin B12 is a water-soluble vitamin that our body cannot manufacture. We have to get it through diet or by taking supplements. Dietary sources are primarily animal foods: meat, fish, poultry, dairy products, and eggs.

Getting B12 via supplementation would be easy, except for the matter of size. Oral B12 supplements generally have poor absorbability because B12 is a large molecule; it does not enter our system easily. This size issue renders many oral supplements ineffective, and why B12 is often given by injection.

If B12 by injection is off putting, sublingual (under-the-tongue) sprays are effective because they allow the big B12 molecule - with its many health benefits - to go directly into our bloodstream.

Source: Mercola
Photo credit: jennie-o

*Metformin is a popular drug used to help control blood sugar levels in people with type 2 diabetes.

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