Metformin and hypovitaminosis

Metformin intake is associated with the development of vitamin B12 deficiency

Anna Stavina, XX2 century

Although metformin is not able to completely get rid of polycystic ovary syndrome, it remains the drug most often prescribed to women with this disease. A new study found a link between long-term metformin intake and vitamin B12 deficiency (cyanocobalamin). However, doctors still rarely prescribe an analysis for the level of this vitamin to patients who drink metformin. B12 deficiency can lead to serious irreversible damage to the nervous system.

Here we have collected what people who have been taking metformin for a long time need to know.

What is metformin?

Metformin is a drug that increases insulin sensitivity. For this purpose, it is prescribed to people suffering from type 2 diabetes. In Russia, metformin is sold under the trade names Glucophage, Siofor, Bagomet, Glycon, Gliformin, Formetin, etc.

Metformin lowers blood glucose and insulin levels in several ways. It reduces the intensity of glucose production in the liver, increases the sensitivity of cells to insulin synthesized by the body and reduces the absorption of carbohydrates coming from food. Metformin has been shown to reduce not only glucose concentration, but also cholesterol levels in women suffering from polycystic ovary syndrome, and also improves ovulation.

Metformin use and vitamin B12 deficiency

The study of the results of the Diabetes Prevention Program Outcomes Study (DDPOS) is one of the largest and longest-running works on the use of metformin. New (published 01.04.2016 – VM) analysis of DDPOS results, published in the publication The Journal of Clinical Endocrinology and Metabolism, was devoted to vitamin B12 levels in patients with prediabetes who took 850 mg of metformin twice a day, compared with those who drank a placebo. The vitamin level was assessed on the 5th and 13th years of intake.

The results of the study showed that the use of metformin increases the risk of hypovitaminosis. In the 5th year of administration, the level of cyanocobalamin was reduced in 5.3% of the study participants who took the drug. In the 13th year, a deficiency of this vitamin was found in 9.2% of volunteers.

It is believed that metformin impairs the absorption of vitamin B12 in the ileum. In addition, as part of the DDPOS study, it was shown that against the background of taking this drug, the level of homocysteine, a marker of cardiovascular risk, increases. Other studies have demonstrated that even 3 months of metformin use can affect the concentration of cyanocobalamin in the body. The authors of the systematic review and meta-analysis focused on patients taking this drug with type 2 diabetes mellitus and women with polycystic ovary syndrome. It turned out that the severity of vitamin B12 deficiency depends on the dose of metformin, and this effect is observed both with long-term (3 years or more) and with short-term (up to 3 years) administration of the drug.

Usually, women suffering from polycystic ovary syndrome are prescribed from 1500 to 2000 mg of metformin per day. As a rule, such patients take the drug for a long time, which increases the risk of cyanocobalamin deficiency.

The Importance of Vitamin B12

Water-soluble vitamin B12 is necessary for conducting nerve signals, providing mental functions, DNA synthesis and the production of red blood cells. Most of this vitamin is found in animal products. Those who adhere to a vegetarian diet should introduce supplements containing B12 into their diet. The recommended daily dose of this vitamin for adults is 2.4 mcg.

Symptoms of cyanocobalamin deficiency include anemia, neuropathy (nerve damage), chronic fatigue, memory disorders, confusion, and even dementia. Cyanocobalamin deficiency is a serious condition that affects mood and the amount of energy. It can also lead to permanent irreversible nerve damage. Sometimes taking multivitamins containing B12 against the background of metformin use is still accompanied by cyanocobalamin hypovitaminosis. Therefore, people taking this drug should annually check the level of B12 in the body and, if necessary, make changes to the diet. Methylcobalamin, a form of vitamin B12 taken sublingually (the tablet needs to be absorbed under the tongue), is absorbed best.

How can vitamin B12 deficiency be diagnosed?

The level of cyanocobalamin in the body can be judged by a blood sample. There is an opinion that the reference values of vitamin B12 used in laboratories are underestimated, and symptoms of hypovitaminosis may manifest when the B12 level drops below 400 pg/ml. The study of the level of methylmalonic acid is a more accurate test that allows you to estimate the amount of cyanocobalamin in the body.

If you are taking metformin, ask your doctor to check the level of vitamin B12 in the body once a year, and if necessary, prescribe supplements to make up for the deficiency of this vitamin. This will help you avoid complications associated with hypovitaminosis.

Portal "Eternal youth" http://vechnayamolodost.ru  04.04.2017