In this issue of Ron’s Clinical Corner, we will be talking about a common, yet sometimes overlooked, condition caused by the diabetes medication metformin.
Metformin is a common medication used in the treatment of Type 2 diabetes. It is available generically but also under the brand names of Glucophage®, Fortamet®, and Glumetza®. Metformin is considered first-line treatment, along with diet and exercise, in the treatment of both pre-diabetes and Type 2 diabetes.
Vitamin B-12 is very important to many processes within the body and deficiency can cause symptoms such as tingling in the extremities, fatigue, weakness, and in more severe cases, anemia and/or depression. Although the exact mechanism of how metformin causes B-12 deficiency is unknown, it is believed to be a result of reduced B-12 absorption from the intestinal tract.
The good news is that the deficiency can be prevented by taking a vitamin B-12 supplement along with metformin. The additional B-12 results in higher levels in the intestine, therefore increasing the amount of B-12 that is absorbed. Being that vitamin B-12 is a water-soluble vitamin, any amount that the body does not need ends up being eliminated in the urine, so the risk of accumulation is minimized. Generally speaking, taking a supplement with 500 – 1000mcg of vitamin B-12 every day prevents a deficiency.
Thanks for stopping by and see you next month at the Corner.