Metformin and Risk of Vitamin B12 Deficiency

[jonnnyx]

Hello i have had Diabetes since 1999 --of course i was then on the Norm metformin but the diabetic nurse said after 7 years it's time to go on insulin ?? i was controlling my diabetes ok but she said it was time to go on insulin and after a few months i came off the metformin as i was controlling my sugar better with the slow release insulin the metformin well what can i say i had had diarrhoea for years and found out that was the cause so i stopped taking metformin and just used the insulin. the doctor agreed.

i now have changed Doctors as my old doctor retired

I went to see the Doctor about getting off the insulin and he prescribed the 1000mg metformin releasing tablet which is helping me reduce my insulin but at what cost. i thought i was not having any side effects well no Diarrhoea. I have been having headaches, always tired, and the worse one---Life-threatening allergic reaction called anaphylaxis, in which you may have trouble breathing, your tongue swells and/or throat closes up,
i have had to got hospital 7 times in england and once in tenerife for injections to make me breathe

Question Can the Metformin SR cause my B12 Deficiency

 

[Bluetit1802]

These are the established side effects of Metformin

https://www.drugs.com/sfx/metformin-side-effects.html

Have you considered changing your diet in order to reduce the need for medication? Carbohydrates are the main culprits in raising blood glucose levels - all carbs convert to glucose once inside the system. Starchy ones are the worst, plus any that are made with flour. Bread, potatoes, rice, pasta, breakfast cereals etc.

 

[Art Of Flowers]

Metformin can cause vitamin B12 deficiency which gives rise to neuropathy symptoms.

If you eat a low carb diet then most type 2 diabetics can lower blood sugars to non diabetic levels within nine months, quicker if they also do intermittent fasting. You then will no longer need metformin or insulin to reduce blood sugars.

 

[DavidGrahamJones]

1000mg metformin releasing tablet

Is that Slow Release Metformin?

i have had to got hospital 7 times in england and once in tenerife for injections to make me breathe

That's a severe reaction to Metformin which surely suggests you shouldn't be taking it. I'm surprised that you continued after the first hospital visit, isn't anybody listening to you?

Might be worth trying the ordinary Metformin, if the answer to my first question yes. I had to go back to it after taking another drug and found the side effects nowhere near as bad, low carb helped a lot.

 

[D._Activist]

Hi Johnnyx!

Metformin does indeed cause B12 deficiency... which if it progresses can lead to B12 deficiency dementia. This is a particular problem in people who also have the MTHFR gene abnormality as they are unable to utilize regular B6 (something most people with D are deficient in) and thereby unlock and utilize B12 for energy etc. B12 can accumulate to high levels but be locked up and inaccessible. 5-MTHF or Methyltetrahydrofolate can assist this abnormality but there are other factors that medicine doesn't work with that can effect your nutrient status... the least of them being diarrhea or frequent urination both which deplete the body of water soluble vitamins like B's and minerals. Doctors in my country are not sanctioned to provide nutritional recommendations so those of us who have D and work with nutrition are best sources for this kind of problem solving. Nutrient status is critical to health and when B vitamins are dis-regulated a cascade of other problems occur.

Carbohydrates are officially listed as insulin antagonists "against insulin" so common sense would dictate that restriction is a good thing. Added to this many D people do not make amylase which is the primary enzyme for metabolism of carbohydrates.

So... is metformin bad? If you want optimal health yes.
Are carbs bad? Not if viewed with health in mind proper sources in mind and in small amounts.

All Diabetes drugs whether insulin or others, carry side effects, some that disrupt the very endocrine function they are designed to treat... so working to get educated and finding the individual plan that can decrease drugs to a minimum and build health is the best answer.

 

[Mission_Possible]

Hello i have had Diabetes since 1999 --of course i was then on the Norm metformin but the diabetic nurse said after 7 years it's time to go on insulin ?? i was controlling my diabetes ok but she said it was time to go on insulin and after a few months i came off the metformin as i was controlling my sugar better with the slow release insulin the metformin well what can i say i had had diarrhoea for years and found out that was the cause so i stopped taking metformin and just used the insulin. the doctor agreed.

i now have changed Doctors as my old doctor retired

I went to see the Doctor about getting off the insulin and he prescribed the 1000mg metformin releasing tablet which is helping me reduce my insulin but at what cost. i thought i was not having any side effects well no Diarrhoea. I have been having headaches, always tired, and the worse one---Life-threatening allergic reaction called anaphylaxis, in which you may have trouble breathing, your tongue swells and/or throat closes up,
i have had to got hospital 7 times in england and once in tenerife for injections to make me breathe

Question Can the Metformin SR cause my B12 Deficiency

I had the same reaction to Metformin .Unbelievably violent diarrhoea. I am now on insulin and feel so much better.
It takes a lot of working out how much you need but once you get the hang of it life is so much better. I had ten years of a
restricted diet. No pasta or rice for ten years. It was so bad. We need carbs especially when we exercise. I also cut out cereals which saw my sugar levels go through the roof. But I ended up going private as my doctor just put me on a glylazide tablets to take with the metformin. Things were becoming very dire. I saw Dr Vander Pump at Cromwell hospital and it was the best decision I've ever had. He wrote to my doctor suggesting I, like you, am having a reaction to the metformin and suggested
insulin as my diet was so restricted. I had lost so much weight.My weight has gone up as I have really been indulging in the
carbs but its time now to reduce them and stop going so crazy. Its been heaven but now I will settle down and enjoy feel human again. I wish you luck with what your going through. Reducing cartbs will bring your sugar levels down but you may need some meds for those times when you do go high. St pancreas Diabetes clinic is brilliant too.

 

[Seewalk]

Hi Johnnyx!

Metformin does indeed cause B12 deficiency... which if it progresses can lead to B12 deficiency dementia. This is a particular problem in people who also have the MTHFR gene abnormality as they are unable to utilize regular B6 (something most people with D are deficient in) and thereby unlock and utilize B12 for energy etc. B12 can accumulate to high levels but be locked up and inaccessible. 5-MTHF or Methyltetrahydrofolate can assist this abnormality but there are other factors that medicine doesn't work with that can effect your nutrient status... the least of them being diarrhea or frequent urination both which deplete the body of water soluble vitamins like B's and minerals. Doctors in my country are not sanctioned to provide nutritional recommendations so those of us who have D and work with nutrition are best sources for this kind of problem solving. Nutrient status is critical to health and when B vitamins are dis-regulated a cascade of other problems occur.

Carbohydrates are officially listed as insulin antagonists "against insulin" so common sense would dictate that restriction is a good thing. Added to this many D people do not make amylase which is the primary enzyme for metabolism of carbohydrates.

So... is metformin bad? If you want optimal health yes.
Are carbs bad? Not if viewed with health in mind proper sources in mind and in small amounts.

All Diabetes drugs whether insulin or others, carry side effects, some that disrupt the very endocrine function they are designed to treat... so working to get educated and finding the individual plan that can decrease drugs to a minimum and build health is the best answer.

My GP is an Egyptian and spent a year in med school studying drugs this does not happen in the US. My Endo is a product of our med schools here in the US. She is highly influenced by pharma reps (admitted this to me) and advised metformin. My doc spent an hour with me explaining the potential horrible effects of metformin. As in liver destruction over time. Not for me. I am 74 and need that liver for awhile longer

 

[douglas99]

My GP is an Egyptian and spent a year in med school studying drugs this does not happen in the US. My Endo is a product of our med schools here in the US. She is highly influenced by pharma reps (admitted this to me) and advised metformin. My doc spent an hour with me explaining the potential horrible effects of metformin. As in liver destruction over time. Not for me. I am 74 and need that liver for awhile longer

I'm interested in the liver destruction.
What did he say the mechanism for that was?

 

[ickihun]

My GP is an Egyptian and spent a year in med school studying drugs this does not happen in the US. My Endo is a product of our med schools here in the US. She is highly influenced by pharma reps (admitted this to me) and advised metformin. My doc spent an hour with me explaining the potential horrible effects of metformin. As in liver destruction over time. Not for me. I am 74 and need that liver for awhile longer

The liver, metformin and high carbs caused raised enzymes released from liver. Tablets other than metformin does the same. Most meds do.
Metformin, low carb and liver blocks give diabetic control and lower fbg results.

 

[winbeck90]

I'm slightly aghast that so many people on here are suggesting "have you tried a low carb diet" surely any doctor will make that the first port of call before putting you on medication?! Plus it's not always an option for everyone on whether it works or not in 4 month/6 months/9 months or ever! I was diagnosed with supposed type 2 although there still not sure and are looking into whether its another type. I tried being on a low carb diet and spent all my time crashing out feeling terrible as i've got a fast metabolism i wasn't getting enough carbs to function on a very low carb diet and my HBA1C didn't come down at all. Got put onto metformin slow release which i agree gives you terrible side effects of an upset stomach, tired all the time, headaches just generally feeling washed out. No warnings or mention ever given about it causing the B12 problem just happened to stumble across a thread about it - started taking B12 and now don't feel as dead to the world all the time. HBA1C now technically so low i could be classed as pre-diabetic but sugars rocket so much after even the lightest of meals that I'm kept on metformin. I control my bloods mainly through a balanced diet and exercise, but as many diabetics will know everyone of us reacts differently to everything so there isn't a one size fits all rule even with low carb diets

 

[ickihun]

I'm slightly aghast that so many people on here are suggesting "have you tried a low carb diet" surely any doctor will make that the first port of call before putting you on medication?! Plus it's not always an option for everyone on whether it works or not in 4 month/6 months/9 months or ever! I was diagnosed with supposed type 2 although there still not sure and are looking into whether its another type. I tried being on a low carb diet and spent all my time crashing out feeling terrible as i've got a fast metabolism i wasn't getting enough carbs to function on a very low carb diet and my HBA1C didn't come down at all. Got put onto metformin slow release which i agree gives you terrible side effects of an upset stomach, tired all the time, headaches just generally feeling washed out. No warnings or mention ever given about it causing the B12 problem just happened to stumble across a thread about it - started taking B12 and now don't feel as dead to the world all the time. HBA1C now technically so low i could be classed as pre-diabetic but sugars rocket so much after even the lightest of meals that I'm kept on metformin. I control my bloods mainly through a balanced diet and exercise, but as many diabetics will know everyone of us reacts differently to everything so there isn't a one size fits all rule even with low carb diets

@winbeck90 no your gp won't suggest a low carb diet but will suggest you stop carbs like cakes/pastries, white bread, biscuits, and deep/shallow fried foods. Yes a lower carb diet.
I have the same as you. Low carb diet (lchf) at first made me ill and on more tablets but since tweaking it to low carb, low fat im losing weight and still using less insulin units. My insulin resistance is too huge to stop my diabetic meds for now.
I'll be reviewed after bariatric surgery thou.
Weight loss does make a huge difference, if you can lose weight!
The common concensus is lifestyle change improves diabetes control.

 

[DavidGrahamJones]

We need carbs especially when we exercise.

The question has to be how hard we exercise and how much carb? Carbohydrate is much better in that it can be used more easily but protein and fat will produce glucose quite happily as I have found out and in my case very effectively.
I have kept down to 40gms carb per day for 3 or more years and have at times done a lot of swimming (5 X 1km a week). There are days when I feel like ****, but I haven't keeled over yet.

 

[ickihun]

I think there are other b12 deficiency threads but I must admit I haven't read them. I may have to now as I'm lacking in vitamins since losing 2 stones with help of metformin.
Vit d and need multivitamins. I will press gp about vitb12 specifically.

 

[Duncan57]

Eat Marmite and cheese sandwiches. B vitamins right there.

 

[serenity648]

Eat Marmite and cheese sandwiches. B vitamins right there.

marmite contains very little B12

 

[Hotpepper20000]

Eat Marmite and cheese sandwiches. B vitamins right there.

For me it's not just about consuming enough VitB, even before I was taking Metformin I was very low.
My body does not absorb it well. So along with foods that contain Vit B I have to take high dose tablets.
The only way to make sure is to have blood tests regularly.

 

[jonnnyx]

I had the same reaction to Metformin .Unbelievably violent diarrhoea. I am now on insulin and feel so much better.
It takes a lot of working out how much you need but once you get the hang of it life is so much better. I had ten years of a
restricted diet. No pasta or rice for ten years. It was so bad. We need carbs especially when we exercise. I also cut out cereals which saw my sugar levels go through the roof. But I ended up going private as my doctor just put me on a glylazide tablets to take with the metformin. Things were becoming very dire. I saw Dr Vander Pump at Cromwell hospital and it was the best decision I've ever had. He wrote to my doctor suggesting I, like you, am having a reaction to the metformin and suggested
insulin as my diet was so restricted. I had lost so much weight.My weight has gone up as I have really been indulging in the
carbs but its time now to reduce them and stop going so crazy. Its been heaven but now I will settle down and enjoy feel human again. I wish you luck with what your going through. Reducing cartbs will bring your sugar levels down but you may need some meds for those times when you do go high. St pancreas Diabetes clinic is brilliant too.

MY deficiency is now Folic Acid not B12 i was told it was b12 been to see the doctor he said the receptionist should not have told me it was A B12 def

Thanks for your reply your right about needing the meds when i go high, So the doctor lets me ring up when i need the insulin and they are there the next day at the chemist, The metformin 1000mg SR do not give me the diarrhoea thank god? i was hoping to find a link to my deficeincy the doctor gave me them to help me get off the insulin. Someone mentioned don't the doctor listen to you well in a way no i am on supplements for the folic acid deficiency but something else as happened i have psoriasis on my hands and after taking folic acid 5mg tablets my psoriasis is clearing up ?? gone have all the split fingers the plaques have gone and i have only been on the folic acid tablets for 1 week and 3 weeks to go i have explained and showed my hands to the doctor but he said when the 28days are up i won't get any more ?????? BUT THEY ARE HELPING MY PSORIASIS????
So can metformin lower your folic acid def ????

 

[Resurgam]

I'm slightly aghast that so many people on here are suggesting "have you tried a low carb diet" surely any doctor will make that the first port of call before putting you on medication?! Plus it's not always an option for everyone on whether it works or not in 4 month/6 months/9 months or ever!

No - absolutely not. My doctor never mentioned diet, just handed over a prescription straight after news of diagnosis. Nurses and diabetes educators pushed the Eatwell plate, and complex carbs as they do not elevate blood sugars - absolutely not - beans do not even need any insulin for type ones. Wholemeal bread, jacket potatoes, brown rice, all excellent foods for all diabetics.

 

[anon125]

The jenny ruhl blood sugar 101 books are very useful. she also has a diabetic book.
sound advice.

 

[ickihun]

I think there are other b12 deficiency threads but I must admit I haven't read them. I may have to now as I'm lacking in vitamins since losing 2 stones with help of metformin.
Vit d and need multivitamins. I will press gp about vitb12 specifically.

I did. No deficiency for me. I've been on metformin for decades. 2+ to be precise. Maybe just lucky.
I've taken multivitamins off and on for past 5yrs.
Nearing 3stone loss now!