Pernicious Anaemia Society
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If B12 cannot be boosted by diet, can folate tablets be absorbed by the body?

I have B12 def and it is believed to be caused by long term use of metformin. It seems my body cannot get the required B12 from diet, so I have injections. But I've seen on forums that B12 is not effective without folate or folic acid. I have no prescription for these. If I buy and swallow tablets, how do I know if my body can absorb these if it cannot get B12 from diet or tablets?

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It seems that metformin disrupts B12 absorption by interfering with the supply of calcium needed for the absorption of the IF-B12 complex academic.oup.com/ageing/art... and can be rectified by taking calcium supplements.

I don't believe that folate absorption is reliant on calcium and that absorption should be unaffected by metformin.

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Thank you - that helps me - I didn't want to be swallowing folate pills if they couldn't be absorbed. Now I'll have to buy some calcium pills as well!

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Many thanks for the link to the article, fbirder :) I'm also on Metformin (and Ranitidine) and it seems my GP has absolutely no idea of the implications re Vit B12 deficiency!!!

I will be showing my GP a copy of this article when I see him next week, along with some other articles, of course ... ;) It would be great if he read and digested but I won't hold my breath ;)

Maybe I should be taking Calcium supplements???

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Aren't these things that doctors should be checking? Seems more and more, we the patients are the ones bringing this stuff to their attention and when their egos get bruised, they tell us to stay off the internet.

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in addition to the explanation provided by fbirder, the mechanism for absorbing the vaste majority of B12 from your food is very specialised to the ileum whereas folate will be absorbed throughout the gut.

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Thank you. I think that when doctors prescribe B12 injections they should also offer folate and calcium or at least TALK to the patient about it!

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should talk to patients about a lot of things but ... :)

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I had terrible problems on b12 until i started to take metafolin! Folic acid made me worse, i always take the two together now, take the metafolin first then the b12,

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moonbeamX

I, too, take Metformin, plus Ranitidine, and B12 deficient (now self-injecting). However, my Folate level was actually out-range-high - GP said I was eating too many cabbages :(

I wasn't on any supplement, except MultiVit tablets, but do eat healthy portions of vegs so I don't feel absorption of Folate/Folic Acid is likely to be an issue, to be honest and agree with fbirder :)

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I took metformin for 6 months and had to give it up. Nothing to do with B12 but because the diarrhoea was unbearable (no fun waking at 04:00 every morning). I wonder if my gastric atrophy had any bearing on it.

Fortunately, after those 6 months of dieting (no doubt helped by the side-effects) my HbA1c was down to reasonable levels and has stayed there for the last 9 months.

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I have same problem,I asked my doctor about b12 and answer the test For b12 will never be done only folic and that a blind test folic come back normal or better do not mean b12is.Our intrinsic factor is ok.I gather it postal lottery my area not chance of getting it but up north you may.Doctor stands good chance getting into trouble doing b12 only.

I am trying also to get it

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Away from home,not on PC,so cannot check sources,but if anyone is going to take calcium please check out bit k, so calcium is routed to bones and not heart. Should read Vit K. Another thing docs don't tell us?

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