Metformin and B12 deficiency

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Will Brink

Member
FYI, latest study does not find Metformin associated with B12 deficiency, but it should be noted B12 deficiencies are not uncommon so worth
screening for regardless of metformin use in my view.


Am J Med Sci. 2017 Aug;354(2):165-171. doi: 10.1016/j.amjms.2017.04.010.
Epub 2017 Jul 8.

Metformin Use and Vitamin B12 Deficiency: Untangling the Association.

Abstract
BACKGROUND:

Current evidence linking vitamin B12 deficiency with metformin use is
inconsistent. Hence, there is uncertainty regarding the diagnostic
approach in this scenario. Furthermore, this possible association has not
been studied in the complete spectrum of patients with diabetes.
MATERIALS AND METHODS:

We conducted a cross-sectional, controlled study with the objective of
assessing differences in serum vitamin B12 levels among patients with and
without diabetes with different metformin-treatment regimens. A total of
150 participants were recruited: patients with diabetes (group 1:
metformin alone ≥850mg/day, group 2: patients with type 2 diabetes naive
to treatment and group 3: metformin ≥850mg/day, in addition to any other
oral glucose lowering agent or insulin, or both) and without diabetes
(group 4: polycystic ovary syndrome or group 5: healthy individuals).
Serum vitamin B12, folate levels and complete blood counts were obtained
for the entire population. Methylmalonic acid and homocysteine were
obtained for patients when vitamin B12 levels were found to be borderline
or low.

RESULTS:

When patients with or without diabetes were compared, no significant
difference was found in relation to their vitamin B12 levels (517.62
versus 433.83; P = 0.072). No difference in vitamin B12 levels was found
among participants with metformin use and metformin naive participants
(503.4 versus 462.3; P = 0.380).

CONCLUSIONS:

Irrespective of metformin use, no significant difference in the serum
levels of vitamin B12 was observed, both in patients with and without
diabetes. In the light of the body of evidence and the results of this
study, a universal recommendation for vitamin B12 deficiency screening
cannot be made.

https://www.ncbi.nlm.nih.gov/pubmed/28864375
 
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