Metformin is often the first -line medication given to people diagnosed with a type 2. diabetes. Although it does a very good job to control blood sugar, this can also endanger a vitamin B12 deficiency.
Connection B12-Métformin
As one of the eight vitamins B-Complex, B12 (Cobalamine) is naturally found in fish, milk, yogurt, cheese, poultry, lean red meat and fortified foods, according to the Academy of Nutrition and Dietetics. It is an essential vitamin, necessary to produce healthy red blood cells, among its other important jobs.
With regard to metformin, part of a class of drugs called Biguanids, it is a pill that helps reduce your blood sugar by reducing the amount of glucose produced by your liver and helping your body better respond to insulin made in your pancreas, according to the American Diabetes Association (ADA).
In addition to lifestyle changes – including eating a healthy diet, exercising regularly and maintaining normal weight – people with diabetes may need drugs, such as metformin, to help their bodies use insulin more efficiently and avoid long -term damage to diabetes, says ADA.
But there is a warning. “Metformin decreases the absorption of vitamin B12 of the intestine”, explains Audrey Koltun, RDN, CDE, certified diabetes and dietitian educator in the division of pediatric endocrinology at Cohen Children’s Medical Center in Lake Success, New York.
Find out more: Benefits and side effects of the B-Vitamin complex
Are you at risk?
B vitamins are soluble in water, which means that they leave the body in the urine. People with diabetes tend to urinate more frequently, which can put them at a higher risk of deficiency, even when they consume enough, warn the foundation on research and education on diabetes action.
Some people may be more likely to miss B12 than others, regardless of their diabetes status. “People who are strict vegetarians or vegans or those who have undergone weight loss surgery are at high risk of deficiency in B12,” said Koltun.
Symptoms of a deficiency may include fatigue or weakness, changes in balance and coordination and the feeling of pins and needles in your limbs, which is also a symptom of diabetic nerve lesions, Koltun explains. Due to its role in the manufacture of red blood cells, a lack of B12 can also lead to anemia, according to the National Library of Medicine.
Ajaykumar D. Rao, MD, associate professor of medicine at the Lewis Katz School of Medicine at Temple University and at the Center for Metabolic Disease Research of the Temple University Hospital in Philadelphia, regularly tests B12 blood levels in its patients who take metformin. The good news is that the remedy is simple.
“B12 deficiency is easily treated with the replacement of B12 in the form of a pill,” said Dr. Rao, adding that everyone on metformin should speak to his doctor to pass the blood test and take supplements of vitamin B12 according to the results.
Find out more: Current symptoms of vitamin B complex deficiency
Learn more about vitamins B
B12 is part of the B complex, with B1 (thiamine), B2 (Riboflavine), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin) and B9 (folic or folic acid). It should be noted in particular for people with diabetes, vitamin B6 helps to produce insulin, according to the Academy of Nutrition and Dietetics.
However, Koltun warns that excess B6 can cause nerve damage or neuropathy, already a risk of uncontrolled diabetes. In addition, too much vitamin B3 can cause high blood sugar, another serious situation for people with diabetes.
High levels of additional biotin can interfere with certain laboratory tests. For example, he can mask troponin, which helps doctors diagnose heart attacks, according to the Food and Drug Administration. Cardiac disease is cause 1 of death for people with diabetes, it is therefore an important consideration, says Dr. Rao. “Pay attention to biotin and always tell your doctor if you take supplements from this vitamin B,” he said.
Work with your doctor or a diabetes certified educator to offer a healthy diet that offers the right quantities of all B vitamins for you. “The one that is low in carbohydrates and refined sugars, and rich in fiber, healthy fats (nuts, seeds, fatty fish), vegetables and fruits is good for diabetes”, explains Koltun.
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