Muscle pain

Are you on statins?

I had a similar problem and it was found to be a vitamin B12 deficiency, something that metformin can cause.

It's easily treated and can be found with just a blood test -- ask your GP for a B12 test and if the results are at the bottom end of normal ask for treatment. Usually either calcium and B12 orally daily or B12 injections monthly.

The symptoms of B12 deficiency are fairly vague and can easily be mistaken for secondary effects of diabetes or many other things so it's worth insisting that a blood test be done to rule it out.

I got diagnosed with B12 deficiency.
My levels went up due to injections then gp stopped them.
Then I paid privately to have an infusion done.
Three years on... Leg pain is back.
Have since had 2 tests done, one low 190 ish.. Next one 380!!??
So no injections again...considering whether to go back to Wales and pay privately again. As levels keep going up n down.

Studies done in America have shown that for a B12 deficiency caused by metformin you can take a B12 supplement along with a calcium supplement rather than injections and still achieve a good resolution of the deficiency.

Based on the credibility of the studies I chose that option and the majority of my symptions resolved in a matter of days the rest within a few weeks.

Geocacher said:

I had a similar problem and it was found to be a vitamin B12 deficiency, something that metformin can cause.

It's easily treated and can be found with just a blood test -- ask your GP for a B12 test and if the results are at the bottom end of normal ask for treatment.

Click to expand...

The regular blood test that every diabetic in this country receives regularly already indicates whether a B12 deficiency is present, a B12 deficiency or anemia will show up as a low red blood cell count, so a special blood test should not be necessary as we are already tested regularly.

Vitamin B12 is found in foods from animals, such as meat, seafood, milk products, poultry, and eggs. A healthy balanced diet is all that is needed to stave of a B12 deficiency in most instancies, metformin can cause a deficiency but it usually associated with long term use of the drug in fact the longer the use of metformin the higher the percentage of b12 deficiency is shown to occur. The exact connection is still not fully understood.

They do know the mechanism by which metformin causes B12 deficiency and diet alone will not stop it or resolve it.

Metformin disrupts the intrinsic factors necessary for the body to use B12 from food, most notably the role of calcium in the process. That's why it's necessary for calcium to be taken along with oral supplements.

B12 deficiency doesn't cause a low blood count, it's a megloblastic anemia which means that it changes the shape of the blood cells and prevents them from working efficienctly. It doesn't reduce the CBC until in the very late and dangerous stages when the nerve and organ damage is likely to be permanent. The two relaible methods of testing are looking for serum B12 in the blood, and looking at a sample of blood under a microscope to see if the blood cells are a normal size and shape. Neither are routine blood tests.

Diabetics taking metformin in the UK are not regularly tested for B12 deficiency and I've never yet found a GP who has been aware of the issue prior to my bringing it to their attention, despite it being documented in the BMJ.

Statictically 30% of metformin users will start to show signs of B12 deficiency after taking metformin for four years. The percentage goes up with patient age and with continued use of metformin. I was on metformin for seven years before I had any problems. In that time I had only one B12 test, at my request, and that was to prove that I was reacting to simvastatin and not B12 deficient after taking metformin for four years. At that point my results were in the lower range of normal despite a meat based diet. Vegetarians on metformin will always be more suseptible to B12 deficiency due to a lack of animal products in their diet.