Metformin causing low Vitamin B12

martfoxy said:

I have to have 12 weekly Vitamin B12 injections after taking Metformin for many years. I notice it does say about low Vitamin B12 levels on the leaflet that comes with the Metformin. Has anyone else got the same problem? Also I have been told to take iron tablets - on a trial at the moment to see if I can come off them.

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I honestly dont know if my surgery automatically tests for B12 when they do my HB1aC, I presume so as my DN mentioned my liver and kidney results were normal.....

But it is a problem with Metformin so I take a B12 supp just in case (a dissolve under tongue one)

No practices do not routinely take b12 or folate tests. You have to display symptoms for needing a test.

If you are low there may be a dietary cause of it. Pehaps nor eating the products that have b12 in it or affected by drugs or having pernisious anaemia and needing injjectins due to bad intrinisic factor innyour innards....
If looking at diet and it cannot be improved to include more B12 then atomach investigations and or bloodsamples should be included.
Do not just add supplement in unless under GP advice has been taken.

I know hugely from my own experience of bein diagnosed as having perniscuous anaemia, undiagnosed. Levels rocketting indicating a type of cancer, told you don't look like you have that sort of cancer and then being diagnosed with a different cancer..... Levels of B12 rose and dropped remarkably after cancer treatment. Now off scale again high....
First off though I would look at how much b12 you are getting. From natural souces. And review regulatrly with GP.

Personally I do think diet is foremost.

I'm Type 1 (since May 1979), but in April 2014 when I had a camera down the throat again for stomach problems. I had another ulcer (that makes 5 now). My consultant took a stool test and loads of blood tests and confirmed that I have Pancreatic Exocrine Insufficiency (PEI which means I don't produce enough enzymes to digest food) and low levels of calcium and Vitamin B12. Now I have to take Creon capsules - one for every 6g of fat in my food whenever I eat. I have daily 2 Calcium tablets (Accrete), which are like horse pills, but better than Adcal-3D (very chalky and hard to get rid of). And every 12 weeks a Vitamin B12 injection. I have been on Metformin for about 10 years (2x1000mg daily) with insulin of course.

martfoxy said:

I have to have 12 weekly Vitamin B12 injections after taking Metformin for many years. I notice it does say about low Vitamin B12 levels on the leaflet that comes with the Metformin. Has anyone else got the same problem? Also I have been told to take iron tablets - on a trial at the moment to see if I can come off them.

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I think so

martfoxy said:

I have to have 12 weekly Vitamin B12 injections after taking Metformin for many years. I notice it does say about low Vitamin B12 levels on the leaflet that comes with the Metformin. Has anyone else got the same problem? Also I have been told to take iron tablets - on a trial at the moment to see if I can come off them.

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Not sure about the b12, but I have to take iron and folic acid tablets for life I've not been told why. I have taken metformin for about8 or 9 years I use insulin now as well so I think diabetes does effect your body in many ways .

martfoxy said:

I have to have 12 weekly Vitamin B12 injections after taking Metformin for many years. I notice it does say about low Vitamin B12 levels on the leaflet that comes with the Metformin. Has anyone else got the same problem? Also I have been told to take iron tablets - on a trial at the moment to see if I can come off them.

Click to expand...

Yes I have just had a full Blood Analysis and found to have low B12 and Vitamin D. (iron was not a problem) The specialist said that low B12 was a side affect of Metformin, now on 3 months of supplements then another blood test

Latedecember1963 said:

I have daily 2 Calcium tablets (Accrete), which are like horse pills, but better than Adcal-3D (very chalky and hard to get rid of)

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I agree with you about the Adcal I take two a day at least you can chew them though the Accrete tabs have a scored line down the middle which is to make it easier to break the tablet in two to make it easier to swallow.

mfactor said:

I honestly dont know if my surgery automatically tests for B12 when they do my HB1aC, I presume so as my DN mentioned my liver and kidney results were normal.....

But it is a problem with Metformin so I take a B12 supp just in case (a dissolve under tongue one)

Click to expand...

Hi, i have to have 12weekly B12 injections but no one has ever linked it to metformin. I did ask nurse if i could take a daily tablet to avoid being so tired and low in the run up to my injection. She told me the tablets are different from the injection and aren't as effective. It might be worth asking at your next check up. I don't think tests for low b12 are standard for a diabetic review - at least they aren't at my surgery

It is pretty well-established that metformin reduces B12 levels in the longer term (the only downside of the drug apart from err.. the obvious one) -- a doctor at my diabetes clinic told me that she thought B12 tests should be a mandatory part of the annual diabetes review if you have been on metformin for more than 4 years (although she said metformin-induced B12 deficiency is normally treatable just with tablets)
But many other things can cause B12 deficiency -- and I am living proof that they don't just correspond to the lists of causes that you can find on the websites (I had ludicrously low levels and none of the causes pertained to me, unless I had major stomach surgery without noticing). Long-term B12 deficiency can do very unpleasant things, and just to make things more tricky some of these can seem like symptoms of poor diabetic control (e.g. nerve damage, low nerve velocity and loss of sensation). The problem is that once you are diagnosed as diabetic, doctors stop looking for other causes - it took years after my initial diabetes diagnosis for anyone to think to check for B12 deficiency.
But the truly wonderful thing about B12 deficiency is that it can be treated so easily with no side-effects -- if only that were true of diabetes....

I would also advise trying to add in B11 naturally through food...
Not T2 but T1. 2006 told I had pernicious anaemia from symptoms and tests.
2009/10 injections stopped. Had moved to a different GP.... Paid privately for B12 infusions from an anaetheist in Bridgend.
Moved back to England and decided that if I had PA then I should not have to pay and to wait till levels sunk low again and get GPs to start injecting again.
Had regular tests.
They started to go down but in 2014 shot over thebtarget range. Up to 1597. My endo started to look at and said to me you don't look like you have leukaemia... (Signal of elevated B12). Then in Sept 2015 had breast cancer and levels dropped to 450 after the cancer was removed.
Had another test in Jan and showed 800.
Just been phoned yesterday after seeing a GP on Friday with some problems. Apparently I was being reviewed yesterday and GP phoned me to ask me to go and get my B12 levels tested again....

I don't thonk I had an exceptionally good diet in 2005/6 when originally diagnosed with low b12 and folate. It was low carb as I alway was but it didn't have reasonable amounts of dairy, eggs or milk.
I did concentrate on raising these foods and I think my diet had some place to play with low levels... If its caused by a drug like metformin and not your bodies intrinsic factor then adding in b12 foods is worth ago.

My fear now is that my B12 is high and it apparently can be linked to cancer but I will have to wait for a few weeks to get my bloods retested...
If it is because of the bodies intrinsic factor then normally injections are needed for life... But personally if I thought is was likely to be a tablet affecting the livers reactions etc I would try to also add in a healthy amount of B12 from food too. And ask for B12 to be reviewed regularly.

In Wales I also bought cocabalim liquid to inject privately myself too... As I thought I needed it.. After 4 years the high levels were a signal that I had cancer. Now I know It can also indicate breast cancer as well as lueukemia and liver problems...

My daughters B12 injections have been stopped because her Calcium levels are so low she cannot absorb B12..

I brought up the subject of B12 levels with my GP, some 5 years after diagnosis. No routine testing for this seems to be common. I had been taking oral B12, 0.5 - 1mg, a few times a week. My levels came back at an acceptable level. B12 testing is a black art as there is a huge variation in what is taken as the normal range, and there are confusing ways of expressing the results.
I would have been happier to receive an annual 1mg B12 injection and forget about the problem, but my GP did not buy that one. So, I continue to get my B12 tabs from H&B and swallow them a few times each week.
The problem needs more airing as low B12 can lead to high Homocysteine levels, which are damaging to the vasculature and, of course,can produce neurological damage or severe anaemia.

On a flight to Ireland the woman next to me was a doctor and commented on my nails - they were curving over the ends of my fingers. She said it was iron deficiency. I thought that couldn't be right as I eat a really nutritious diet, but after researching on the internet I found the link to long term Metformin use and went to my GP to get tested. I had been experiencing neuropathy symptoms and now my B12 injections and iron supplements keep my symptoms in check. I have now moved from 12 weekly to 8 weekly. I actually look forward to my jabs as my energy flags and neuropathy pains return just before it is due.

martfoxy said:

I have to have 12 weekly Vitamin B12 injections after taking Metformin for many years. I notice it does say about low Vitamin B12 levels on the leaflet that comes with the Metformin. Has anyone else got the same problem? Also I have been told to take iron tablets - on a trial at the moment to see if I can come off them.

Click to expand...

I lived in Turkey for a number of years,. On initial contact with the Doctor he asked if I was taking Vitamin B supplement? He was shocked when I replied in the negative as it is the norm there when taking Metformin. On returning here, signing to a surgery, and asking for the same on my script the Doctor almost laughed at me as if I was pulling a fast one for vitamins. He stated he had never heard of such a thing. Sad thing is he is the surgery Diabetic specialist???

desidiabulum said:

It is pretty well-established that metformin reduces B12 levels in the longer term (the only downside of the drug apart from err.. the obvious one) -- a doctor at my diabetes clinic told me that she thought B12 tests should be a mandatory part of the annual diabetes review if you have been on metformin for more than 4 years (although she said metformin-induced B12 deficiency is normally treatable just with tablets)
But many other things can cause B12 deficiency -- and I am living proof that they don't just correspond to the lists of causes that you can find on the websites (I had ludicrously low levels and none of the causes pertained to me, unless I had major stomach surgery without noticing). Long-term B12 deficiency can do very unpleasant things, and just to make things more tricky some of these can seem like symptoms of poor diabetic control (e.g. nerve damage, low nerve velocity and loss of sensation). The problem is that once you are diagnosed as diabetic, doctors stop looking for other causes - it took years after my initial diabetes diagnosis for anyone to think to check for B12 deficiency.
But the truly wonderful thing about B12 deficiency is that it can be treated so easily with no side-effects -- if only that were true of diabetes....

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ive not long 6 moths) been diagnosed with type 2 , can you tell me what the err..the obvious one) is thanks, im on metaformin 500 daily, im pilling on the pounds and have no energy at all thanks for all your help,

honies1 said:

ive not long 6 moths) been diagnosed with type 2 , can you tell me what the err..the obvious one) is thanks, im on metaformin 500 daily, im pilling on the pounds and have no energy at all thanks for all your help,

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Metformin may cause flatulence and loose bowels, unfortunately. If you are going to experience it, you probably will have by now, so heave a big sigh of relief!

People should be told to start off on one tablet for a week or two, then up their dose slowly, to avoid the issues (pun!). But I think health care professionals often forget, because not everyone gets the issues.

Re overdosing on B12 - it is actually quite difficult, since it is a water soluble vit, so any excess should just widdle out. There is one contraindication for it, for cancer patients, mentioned by the Mayo Clinic, so that is probably your connection, @donnellysdogs but it shouldn't be a problem for the rest of us.

https://www.consumerlab.com/answers...ntains+50,000%+the+Daily+Value!/too_much_b12/

http://www.mayoclinic.org/drugs-supplements/vitamin-b12/safety/hrb-20060243

There is another issue people seem to be unaware of, which is that the body cannot utilise B12 in its normal, water soluble, form, but must first metabolise it to a lipid soluble form which can be absorbed by the tissues.

In some people, this conversion doesn't work so well, so even if your levels of B12 are measured as "normal", it may be that you can't actually use it.

I think I have this problem so I take my B12 as its methyl form (Aka Methyl Cobolamine) and, in conjunction with alpha Lipoic Acid I find it helps with my Neuropathy problems, and also with my FBG levels.

I'm type 2, diagnosed July 2014 and taking 3 x 500mg Metformin daily. I was taking 4, but after adding the supplements I found 3 to work fine. Going down to 2 though seemed to be sending them the wrong way....

There's lots of information on the Pernicious Anaemia Society website. My B12 deficiency has been established as being caused by metformin. Because I'm getting most of the symptoms despite injections I'm trying to get off metformin one way or another . . .