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B12 Deficiency Anaemia

BrianTheElder

Well-Known Member
Messages
574
Location
Surrey, UK
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Snide people
I have been diagnosed with this. It is quite debilitating and leaves me with very low energy levels, so I walk round very slowly like a geriatric.

The cause is that my body is unable to absorb B12 from food, so I have to have B12 injections. The deficiency leads to malformed red corpuscles which are unable to hold enough oxygen, hence the lack of energy. I am trying to get the medication balanced, but the problems keep coming back.
Anyway, to my question. When I was on metformin a few years ago, my B12 went down, and I had to go onto a dietary supplement for it. I came off the supplement when I went onto the keto diet and off metformin. Is anyone aware of any long-term effects of metformin on the body's ability to absorb B12 from food?
 
Thanks @Goonergal
I was warned of the relationship only after I started metformin and then a regular blood test revealed low B12.
I haven't seen any direct statement that metformin can cause long-term B12 deficiency even after you stop taking it. Your references don't say much about the long-term effects, only when you keep taking metformin.
I am concerned about low oxygen levels leading to brain, heart and other organ damage and damage to the nervous system. There doesn't seem to be any system to properly diagnose what I have or what the cause is, and no plan for treatment, other than B12 injections every 3 months. My loading dose seems to have worn off after 3 weeks.
My GP practice sems to haven given up trying to care for their patients.
 
BrianTheElder said:
I haven't seen any direct statement that metformin can cause long-term B12 deficiency even after you stop taking it. Your references don't say much about the long-term effects, only when you keep taking metformin.
Click to expand...
I think things like an altered gut biome/bacterial overgrowth can linger and cause longer term issues. Probably worth exploring.
 
Yes, @Goonergal I think you're right. Gut biome, bacteria and chemistry are very important in B12 assimilation. But not important now as things have gone too far, and I can no longer process B12 effectively through the stomach.

I need to find out what is causing the problem before I can fix it, I just need the GP's help...
 
Many people with b12 deficiency, through causes other than diet, don’t find the 3 monthly injections enough. From memory I believe the frequency is supposed to be determined by symptoms And testing is pointless once supplementing. There are also other tests like mma and homocysteine which help determine effectiveness and uptake etc. hard to get a GP to do them though. There are a number of online groups that have a lot of resources to try and convince health care providers of the need for this and also offer advice on how to source and administer for yourself (legally I would add). I’m sure a bit of Googling will locate a few of them as I probably shouldn’t link to them here.
 
Thanks @HSSS , I think you are correct. It is amazing on the PA website forum how many people are desperate to get hold of B12 doses. Some even source it from abroad and self-inject eod.
My plan is to wait for the 3 months to see if the loading dose is effective - it hasn't been so far.
But then I can't see a way forward as the only "cure" seems to be continued injections. Despite further tests to find the cause, that wouldn't really help if there is no satisfactory remedy.
 
if it’s not enough now how is waiting longer (without more) going to be be any better?

Any serum b12 test within 4 months of any supplementing will be impossible to say what’s a true level. I think with active b12 that’s much shorter but the nhs don’t do it.

Unless theres a known and treatable cause (diet, medication you can stop, infection, etc) then yes it could be needed for life. Hence the importance of convincing your dr of the regularity you need to remain symptom free - or accepting you will need to source it elsewhere. Some seem to find sublingual lozenges effective at alleviating symptoms as it bypasses the gut if that’s the issue. Other say they don’t work - even if numbers rise. Might be worth a try in addition to the injections you can get to see if it works for you. There are different forms of b12 - cyanocobalamin, adenosylcobalamin, methylcobalamin, and hydroxycobalamin so it’s worth reading up which might be best for you.
 
Well, my GP always has a blocking answer for anything I ask. In this case, it's easy. The loading B12 dose will allow normal blood cells to be produced. Since it takes three months to replace all the blood cells, I will see a gradual improvement over that time as the bad red cells get replaced with the good ones. As I'm about halfway, I may not be seeing the full benefit yet. In the meantime, I am coping with oxygen deficiency rather than B12 deficiency.
 
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