B12 deficiency and Metformin

[WiscGuy]

The following is likely of interest to people on Metformin

gov.uk/drug-safety-update/m...

Of special interest is the following excerpt:

* administer corrective treatment for vitamin B12 deficiency in line with current clinical guidelines; continue metformin therapy for as long as it is tolerated and not contraindicated

Of special interest due to it's nonsensical nature is the following excerpt:

* test vitamin B12 serum levels if deficiency is suspected (for example, in patients presenting with megaloblastic anaemia or new-onset neuropathy) and follow current clinical guidelines on investigation and management of vitamin B12 deficiency (for example, see Clinical Knowledge Summary from NICE)

I say the preceding is nonsensical because (unless B12 deficiency resulting from Metformin is its own special case) it is well-known that B12 deficiency patients with neurological symptoms often have blood test results within the reference range.

[wedgewood]

Thank you for useful information WiscGuy .

[JayceeJC]

thank you for that. I think I understood the content. I’ve been on Metformin for 11 years and this is the first time I’ve been told I’ve had B12 deficiency. I’m hoping a quick boost of B12 will he enough to set my level within ranges and that I get some quality of life back.

Thank you again and take care.

[ktwing]

The other nonsensical aspect might be that new-onset neuropathy in someone with type 2 diabetes will almost certainly be put down to the diabetes by medics - this is what happened to my late father, on Metformin for 30 years, eventually B12 only considered when his memory failure developed to quite a bad level, and then only when I pushed it after a nurse pointed out that his B12 was quite low after my mum begging for someone to look into his poor memory. But by then it was obviously too late and the treatment wasn't adequate.

There were other complications, such as that he seemed unable/unwilling to address the diabetes in any other way for those 30 years, so Metformin was the obvious solution, but I wish someone had pointed out or looked for the B12 angle earlier.

[WiscGuy in reply to ktwing]

So sorry to hear about what happened to your father.