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If you or a family member have diabetes, chances are metformin is being taken, or at least has been taken in the past.
This medication is metformin, also known by the brand names Glucophage, Glumetza, Fortamet, Riomet, and Glucophage XR. The brand names may vary depending on where in the world you live.
If you or a family member is on this drug, you will want to make sure you are aware of this common vitamin deficiencies it can cause.
Although metformin does a good job lowering blood sugar, by making your insulin more efficient, it may cause various nutrient deficiencies, including a Vitamin B12 deficiency.
Ironically, vitamin B12 deficiency is associated with numbness and tingling in the lower legs, feet and toes. This is something doctors call peripheral neuropathy or diabetic neuropathy in those with diabetes.
Low vitamin B12 levels can also affect the memory so optimizing blood levels is important.
However, it is important to realize that diabetes and elevated blood sugar readings can also cause neuropathy symptoms, so don't assume your neuropathy is 100 % due to vitamin B12 deficiency. It is possible that both diabetes and the b12 deficiency are contributing to neuropathy symptoms. Likewise, diabetes can also affect memory and appears to be a risk factor for Alzheimer's disease.
If you are on metformin, ask your physician to measure your blood Vitamin B12 level at least once per year.
Most laboratories report vitamin B12 levels between 200 pg/mL and 1100 pg/ml being in the normal range. Many integrative medicine doctors and even many neurologists recommend blood levels of 500 pg/mL or more to optimize nerve and brain health.
Vitamin B12 deficiency can also be tested by measuring one's homocysteine level or one's methylmalonic acid level. Both will be elevated when vitamin B12 is suboptimal. Although sometimes, the vitamin B12 blood test itself may be in a normal range.
Other Nutrients depleted by metformin include
Vitamin B6 and Co-enzyme Q10
Both of these are important for brain, heart and nerve health.
Vitamin B6 and C0Q10 also can be measured doing a blood test. However, depending on one's insurance, the costs may not be covered so one may consider simply taking the supplements without doing a lab test.
The recommend dosing for these Supplements are as follows:
Vitamin B12 (500 mcg to 1,000 mcg daily )
Vitamin B6 (25 mg to 100 mg daily)
Co-enzyme Q10 (50 mg minimum)
These nutrients may be present in a quality multivitamin but chances are, not at the doses advised so a separate supplement may need to be taken.
DISCLAIMER: If you have diabetes, do not stop taking your medication. The information in this video is for informational purposes only. Consult with your own personal physician before stopping any medications.
Follow Dr. Madrid on instagram and twitter @ericmadridmd
References:
Supplement Your Prescription Copyright 2007 by Hyla Class, MD
Drug Muggers by Suzy Cohen, RPh. Copyright 2011, Rodale Publishing.
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