The Diabetes Drug Metformin Linked to Vitamin B12 Deficiency
You may not be thinking about the importance of vitamin B12 simply because you concentrate more on other vitamins or you can’t think about it. This is because a lack of this vitamin can affect your ability to think clearly about many things.
Your body does not produce this water-soluble vitamin, so you have to provide the recommended dose with supplements. Along with other B vitamins, vitamin B12 helps the body convert carbs into glucose and produce energy.
Vitamin B12 promotes the production of RNA and DNA as well as works with folate to produce S-adenosyl methionine and red blood cells.
As we have mentioned, Vitamin B12 plays a crucial role in the central nervous system since it conducts the nerve impulses as well as it produces myelin sheath which protects the nerves.
However, a lack of this vitamin can be difficult to detect. Unfortunately, it can cause different health conditions including nerve damage. You should be careful in case you take metformin, a diabetes drug since it can cause vitamin B12 deficiency.
Metformin and Vitamin B12 Deficiency
The effects of metformin on vitamin B12 were analyzed by the researchers from Albert Einstein College of Medicine in NY. They have used the data from the Diabetes Prevention Program Outcomes Study and the Diabetes Prevention Program.
Also, there were included data from people taking a placebo and metformin twice a day. After 5 and 13 years, their levels of Vitamin B12 were once again measured.
This analysis showed significant differences in the levels of Vitamin B12. Those who used to take metformin had lower levels of vitamin B12 in comparison to those who took the placebo. Also, many people from the metformin group were anemic, another characteristic of the vitamin B12 deficiency.
Unfortunately, neither the American Diabetes Association nor the U.S Food and Drug Association recommends monitoring of the levels of vitamin B12 in people who take metformin. However, the researchers suggest that the patients themselves should ask their doctors to do so.
Vitamin B12 Deficiency?
According to the studies from the U.S Framingham trial, about 40% of the Americans have low levels of vitamin B12 which in turn cause neurological symptoms. Other 9% percent experienced Vitamin B12 deficiency while 16% were near deficient.
It is important to point out that older people are more prone to vitamin B12 deficiency. This is because as people grow older, their stomach acid decreases. With low stomach acid, the body is not able to absorb the vitamin B12.
The Framingham trial also found that vitamin B12 deficiency is common in both young and old people.
Also, some of the symptoms typically attributed to older people are probably the results of vitamin B12 deficiency. These symptoms include cognitive decline, memory loss, muscle weakness and many others.
Signs of Vitamin B12 Deficiency
- Unexplained anemia
- Neuropsychiatric disorders
- Gastrointestinal disorders
- Muscle weakness
- Memory troubles
- Mental fogginess
Why Is Vitamin B12 Deficiency Often Ignored?
Most of the doctors tend to ignore the importance of the Vitamin B12 levels in the body. Even when tested, the “normal” levels of Vitamin B12 may still be low.
Normal levels of Vitamin B12 are from 200pg/ml to 1100 pg/ml. However, many people have between 200-350 pg/ml which is the lowest end of the spectrum, and this is considered vitamin B12 deficiency.
So, if you’re levels of Vitamin B12 are below 600 pg/ml, you may experience vitamin B12 deficiency.
According to Chris Kresser, the integrative medicine practitioner, in Europe and Japan, the lower limit of this vitamin is between 500-550 pg/ml. This level can bring about many behavioral and psychological conditions such as dementia, cognitive decline, and memory loss.
Jeffery Stuart and Sally Pacholok, experts, specialized in diagnosis and treatment of Vitamin B12 deficiency recommend that all patients with less than 450 pg/ml of B12 in their body should be treated.
Also, patients with elevated urinary methylmalonic acid, holo transcobalamin, and homocysteine but normal levels of B12 should undergo certain treatment.
The Role of Vitamin B12
- Proper digestion
- Food absorption
- Iron use
- Regulate the formation of red blood cells
- Adrenal hormone production
- Mood regulation
- Healthy nervous system function
- Cell formation and longevity
- Healthy immune system function
- Mental clarity
- Normal nerve growth and development
- Proper circulation
- Support of pregnancy and female reproductive health
- Emotional, physical and mental energy
Additional Roles of Vitamin B12
According to some researchers, vitamin B12 deficiency can seriously affect people’s bone health. Also, low level of vitamin B12 can increase the risk of bone fractures in older men while older women experienced rapid bone loss in the hips.
Mental and Cognitive Health
Vitamin B12 deficiency can lead to some neurological disturbances that promote dementia, depression and other mental illnesses.
The journal Neurology has published a small Finnish study which found that foods rich in B12 can reduce the risk of Alzheimer’s disease.
Foods Rich in Vitamin B12
People who fail to consume animal products have a high risk of vitamin B12 deficiency since it is available in the animal food sources. Other foods rich in B12 include grass-fed dairy products, wild-caught Alaskan salmon, organic free-range eggs, and chicken.
It’s highly important that children receive plenty of vitamin B12 in order not to experience impaired cognitive performance as adolescents.
Factors That Can Affect the Absorption of Vitamin B12
As people get older, the stomach produces less hydrochloric acid and in turn less vitamin B12. However, the absorption of vitamin B12 can be influenced by other factors, such as:
- Pernicious anemia
- Intestinal dysbiosis
- Exposure to nitrous oxide
- Gut inflammation
- Usage of acid-suppressing drugs and metformin
Metformin and Vitamin B12
According to a three-year study conducted by the Diabetes Prevention Program, lifestyle changes have proved more effective than the use of metformin in the prevention of diabetes development. After 15 years, the follow-up study has shown that lifestyle changes are still more effective than the use of metformin.
So, those participants in the study who made some lifestyle changes have 58% lower risk to develop diabetes than the placebo group. The participants who used metformin had 31% lower risk of diabetes.
Also, these lifestyle changes help people treat and reverse diabetes. So, these are excellent news for those people who use metformin and thus experience vitamin B12 deficiency.
To sum up, the longer the person takes metformin, the higher the risk of Vitamin B12 deficiency development.