Posted on 05/20/2010 9:58:19 PM PDT by neverdem
LONDON (Reuters) – Patients treated over long periods with metformin, a common drug for diabetes, are at risk of developing vitamin B12 deficiency which is also likely to get worse over time, according to a study published Friday.
Dutch scientists who carried out the study said the findings suggest that regular checking of vitamin B-12 levels during long-term metformin treatment should be "strongly considered" to try to prevent deficiency and its effects.
Vitamin B12 is essential to maintain healthy nerve cells and red blood cells. It is found in meat, dairy products, eggs, fish, shellfish and fortified breakfast cereals, and it also can be taken as a supplement.
Coen Stehouwer of Maastricht University Medical Center in the Netherlands, whose study was published in the British Medical Journal, said symptoms of B12 deficiency include fatigue, mental changes, anemia and nerve damage known as neuropathy.
All these symptoms can easily be misdiagnosed as being due to diabetes and its complications, or to aging, he said, but checking B12 levels could help doctors to assess the real cause and treat it if it was found to be B12 deficiency.
"Our data provide a strong case for routine assessment of vitamin B12 levels during long term treatment with metformin," Stehouwer wrote.
An estimated 246 million people around the world have diabetes and rates are expected to rise along with the number of people who are overweight or obese. Most sufferers have type 2 diabetes, the kind linked with poor diet and lack of exercise.
Stehouwer's team studied 390 patients with type 2 diabetes, giving metformin to 196 of them three times a day for more than four years, and a placebo, or dummy pill, to the other 194.
They found that people who had taken the metformin had a 19 percent reduction in their...
(Excerpt) Read more at news.yahoo.com ...
You can link the abstract from this source.
Every drug has negative effects. It’s a matter of risk vs benefit. In the case of hypoglycemics, it is not worth the risk. They lower blood sugar but have not been proven to prevent the serious complications of diabetes.
At some point, the medical profession is going to have to get serious about insisting that drugs do more than just alter numbers. If these drugs don’t prevent amputations, heart attacks, kidney disease, etc., then who cares if your lab values are great?
My husband has Type 2. He’s been an athlete all his life, so it’s got to be genetic. I shove the vitamins down his throat - he’d never take them on his own. He gets a Super B Complex every day. It’s nice to know I’m doing the right thing!
And yes, please add me to your ping list..
I’d like on the ping list please.
I take 2000mg of metformin daily. Will have to add some B12.
At some point, the medical profession is going to have to get serious about insisting that drugs do more than just alter numbers. If these drugs don’t prevent amputations, heart attacks, kidney disease, etc., then who cares if your lab values are great?
Hyperinsulinemia is thought to be problematic as well. Some of the oral agents decrease it.
Totally agree!
Pls add me to the diabetes ping list.
Study: Yogurt-like drink DanActive reduced rate of common infections in daycare children
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FReepmail me if you want on or off my health and science ping list.
Thx for the ping.
I take a B 100 complex every day, mostly for the calming effect. Glad to know it helps with Metformin, too.
Being able to pee in bright, neon yellow is just another added plus, of course. :)
Well that’s just great. I was trying to get off the insulin and back on the metformin. Guess I’ll pick up some B12 at WallyWorld tonight.
The problem (which has long been known) involves the part of the small intestine where B-12 would ordinarily be absorbed. Metaformin and other things simply block that ability in that part of the small intestine.
BTW, most people are born with all the B-12 they will need for life since it is reprocessed by the liver with great efficiency. On the other hand, some people "leak" B-12 so they need regular replenishment.
The only way to get B12 into your system if you have a blockage is buy SUBLINGUAL B12 pills at your local pharmacy (about $5.00). Set the pill under your tongue and let it dissolve. The B12 will be absorbed at that point.
Is this subligual B12 over-the-counter?
Does this mean my B12 oral supplements are a waste of money?
I currently take 500mg of Metformin twice daily (with meals). Been taking this about a year. No side effects of note. I've been taking the B12 supplement (once daily, with a meal) since I went on the Metformin.
Any info would be helpful.
Thanks!
CA....
The Sublingual B12 is a replacement for the old-fashioned B-12 shots granny and your crazy cousin Vini used to get every week (or once a month if they weren't so bad off).
It's OVER THE COUNTER.
I take the stuff. BTW, Wal Mart is a good source.
This would seem to me to be a method for reducing the incidence of diarrhea that drug can create in so many people.
I've started taking Metaformin AFTER eating, not before. Made a big difference.
Remember, Metaformin is a double-header. It's supposed to have an effect on your fat cells ability to suck down surplus sugar or glycogen. It also reduces the ability of your intestines to absorb carbohydrates ~ so they just go on down the drain!
I can eat a slice of bread and get all the diarrhea I would need in 10 lifetimes, so there's no reason to add to the burden with Metaformin.
Yes, I know it is thought to be the problem, but it could be just a symptom. If someone is going along thinking they are fine because their meds lower their blood sugar numbers, they could be in for a rude shock years later. No drug company has done a long term study (would need decades probably) that clearly shows that the oral hypoglycemic drugs do anything to prevent the serious complications of diabetes. It’s like getting rid of your cough when you have pneumonia. You may feel better, but you still have pneumonia.
The few studies they do cite as proof their drugs work, actually do no such thing. The results are reported in terms of relative risk rather than absolute risk. Even then, it takes some serious massaging of the data for them to attempt to claim their drugs are helpful.
Drug companies often stop trials prematurely if a drug looks really good (quit while we are ahead!) or bad (oops, try again). That is why so many side effects don’t show up until months or years later.
I am not anti-business nor do I believe the drug companies are evil. They are in business to sell drugs, and there is always the tendency towards bias. That is why doctors and scientists need to be sure they are being objective and not blinded by their own preconceptions. Every time there is a study that goes against conventional wisdom it is always disregarded and excuses are made for why the results weren’t as they were “supposed” to be.
Exercise and diet should be the first line of defense against diabetes. Yes, I know that’s easier said than done. I’m not doing so hot myself. People need to realize that the lower numbers they achieve by means of drug therapy may not be doing them much good. The jury is still out.
My doc characterizes my diabetes as “very mild” presently (that's his quote). I test twice daily, and most days it's like 150s/160s in the morning upon awakening, and later in the afternoon or evening (they suggested random times) it's usually in the 110s/120s. There are, of course, variations, but that's the way it usually goes down.
The doc characterizes my feet as “real good”, and says I have excellent circulation in both feet.
Other than supplements, all of which the doctor and nutritionist like, I'm on simvastatin for cholesterol (145 was my last reading). I take Co-Q10 to counter any bad effects that stuff might have.
I'll talk to my doctor about the 2-hours after a meal (I just checked the label, and it says take WITH a meal) thing, but thanks for the info and the quick reply!
CA....
The doctors all have contracts with Fruit of the Loom so they’re not going to tell you about “2 hours later”
Interesting news. As a vegan, I’m always concerned with getting enough B12. My understanding is that if you’ve been eating the Standard American Diet for most of your life, B12 depletion isn’t a concern until about 3 years out, and I’m almost there. As a diabetic, I’m currently taking metformin and have taken it off and on for the past 10 years.
Getting enough B12 is easy to do. You can take a B12 supplement or make sure it’s in your daily multivitamin. Some veg products have B12 in them. I add nutritional yeast to many foods. It’s like a Parmesan cheese and you can put it on top of spaghetti, chili, etc.
So, no one has to be deficient in this, but maybe docs need to up their awareness so that they will check these levels when diabetics come in for their regular blood work. After requesting a Vit D test, I found out I was in the lowest levels for Vit D and now take a prescription strength Vit D tab 2x a month until my levels get back up. It’s worth it to keep on top of this stuff as a patient so you can ask for tests other than the Ha1c when you go to your endo.
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