PA and Metformin: Hi Brains Trust! As... - Pernicious Anaemi...

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PA and Metformin

Suzibelle profile image
34 Replies

Hi Brains Trust!

As of a visit to my GP this morning, I'm staring down the barrel of Type 2 diabetes and, whilst having already begun to implement a diet/exercise regime, I was wondering what effect metformin might have on my B12 levels as I'm already SI every 2-3 weeks, depending on symptoms. I know metformin will induce B12 deficiency but I can't find any research on whether or how much of an effect it has on those of us already supplementing.

I've found a couple of recent articles on it causing B12 deficiency, which I will take in to him next time I see him (because he asked!!!) but if anyone has a link to one relating to my question I would love it if you could post it.

Thank you.

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Suzibelle profile image
Suzibelle
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34 Replies
Sleepybunny profile image
Sleepybunny

Hi,

"I know metformin will induce B12 deficiency but I can't find any research on whether or how much of an effect it has on those of us already supplementing."

I've also come across articles suggesting a link between metformin and B12 deficiency.

I wondered if PAS would have any info.

pernicious-anaemia-society....

PAS members can use the PAS helpline.

pernicious-anaemia-society....

Articles about Metformin and B12 deficiency

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

nhs.uk/medicines/metformin/...

Trisp profile image
Trisp in reply toSleepybunny

Pins and needles are a side effect of metformin. I had that so I reduced my dose and take Berberine as well. It hasn't really affected my levels but greatly reduced the B12 symptoms. I get monthly injections of B12.

Suzibelle profile image
Suzibelle in reply toTrisp

Bilateral numbness/pins and needles in both arms (ring and pinkie fingers) was a major symptom when I was diagnosed with PA so thanks for the heads-up to keep an eye on it in case I do end up on Metformin. I also came across Berberine last night during my initial research so it's interesting to know of someone using it!

Rexz profile image
Rexz in reply toSuzibelle

Suzibelle, I take Berberine along with Metformin. I would do the entirely natural route first as you are doing and see if that works.

Rexz

Suzibelle profile image
Suzibelle in reply toSleepybunny

Thanks Sleepybunny. I did check the PAS site but couldn't find anything about metformin when you're already supplementing B12. I have every intention of avoiding crossing over the line into diabetes if I can but the doc did mention metformin and asked me to get some info re metformin/PA (!) but it then made me think... hopefully I'm barking up the wrong tree and don't need to be concerned 😊

Jillymo profile image
Jillymo

Hi,

I just found this on line which maybe of some guidance.

Can you take metformin if you have B12 deficiency?

you can keep taking metformin while vitamin B12 levels are being corrected. do not stop your treatment without first discussing this with your doctor.20 Jun 2022

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

Best wishes.

Suzibelle profile image
Suzibelle in reply toJillymo

Thanks Jillymo. If I do end up on it (hope not) it looks like I'll need to keep an eye on a PA symptoms flare.

charks profile image
charks

You don't have to take the metformin. I refused it and controlled my sugar levels using diet/exercise. My sugar levels were off the scale but within 3 weeks they had come right down and within 2 months they were normal. And have remained normal for the last 3 years. Mind you I haven't eaten any sweets since! The biggest aid was intermittent fasting. Which I still do now.

Suzibelle profile image
Suzibelle in reply tocharks

Thanks charks. Good to know as I've got three months to get my levels down using diet and exercise - I used to be good at it but have been working from home for the past couple of years and very, very sedentary, which I think is a large part of it (as well as genetics - my mum developed type 2). I'll try the intermittent fasting again - tried it a while ago but now I've got the incentive to stick with it!

charks profile image
charks in reply toSuzibelle

And the best thing about intermittent fasting is that you can eat what you want during the eating period. Apart from sugary things.

EiCa profile image
EiCa in reply tocharks

I have been “borderline diabetic” for at least 15 years. I have never used medicine to control it. My A1C has never gone above 6.3 and has been as low as 5.5. My fasting glucose has remained the same at 100. I watch sugar/carb intake carefully. It is possible. If I eat something I shouldn’t my blood sugar soars si I haven’t cured myself but I have controlled it. I do very poorly with medication and side effects.

if you use a glucometer you can learn how and what to eat and use readings to learn. You would have to test a lot at the beginning but eventually you learn which foods cause blood sugar spikes. Sometimes it is very surprising how high blood sugar can go with the wrong amount of a certain food.

Metformin is indeed a miracle drug and will likely help you but more and more info is coming out about side effects particularly kidney harm. I am not telling you not to take it. It really depends on how high your numbers are. Uncontrolled diabetes is very dangerous. It is not easy to control without it but eating right and exercise can indeed do so (or has for me at least)

EiCa profile image
EiCa in reply toEiCa

One more thing…my weight is not an issue in fact I am underweight but that is because of muscle loss from spinal/bone issues. I would encourage you to read about it. There are two sides to the issues; good and bad effects.

Suzibelle profile image
Suzibelle in reply toEiCa

I'm going to take myself off to a dietician shortly and I'll be loaded with a lot of questions thanks to everyone here!

charks profile image
charks in reply toEiCa

I think you replied to the wrong person. I don't use metformin.

palmier profile image
palmier

Apparently metformin somehow interferes with calcium which is needed for b12 absorption. A calcium supplement may reduce or counteract this effect.

Increased intake of calcium reverses vitamin B12 malabsorption

pubmed.ncbi.nlm.nih.gov/109...

Suzibelle profile image
Suzibelle in reply topalmier

Interesting, thanks!

Rexz profile image
Rexz

If you are SI B12 then Metformin will have ZERO impact on your B12 levels. To clarify, the prolonged use of Metformin is known to cause B12 absorption issues, but when SI you are bypassing that absorption process anyway.

I've been on Metformin since JAN 2020 when I was diagnosed with PA with no issues.

Best wishes, Rexz

Suzibelle profile image
Suzibelle in reply toRexz

That is excellent news, thanks Rexz. I was coming to that conclusion but it's useful to have someone with real experience say it ☺️

Rexz profile image
Rexz in reply toSuzibelle

I would add, maybe a very important benefit of Metformin is it reduces your risk of cancer. It's a known cancer prevention aid. That comes in handy as those with PA are at an increase risk of gastric cancer. It was a 3-fold increase risk, but more recent studies put it at 10 to 13-fold increase risk. That 13-fold equates to 1,300%. Personally I'm one of the lucky ones that had stomach cancer so I know a little bit.

It also helps control weight.

I would take it.

Rexz

Suzibelle profile image
Suzibelle in reply toRexz

That is interesting to know. I've had a couple of colonoscopies and endoscopies because of the PA but they haven't found anything yet. So if the next three months do little to help the blood sugar and weight and I do end up with a metformin script at least I'll know there are benefits apart from what it's aimed at. Thanks again and I hope you're keeping well.

yorkshiregirl4 profile image
yorkshiregirl4

Hello Suzibelle, I was diagnosed with type II diabetes over twenty years ago and was only taking Metformin for a short time as I could not control the stomach upsets and diarrhoea. I do not know the impact upon taking Metformin at the same time as injecting B12 but Rexz has given some very sound advice on this. The other aspect about this is I understand Metformin is the first medication used by the NHS for type II diabetes because it is by far the cheapest. I do not know the impact of other medications for diabetes.

I adjusted my diet quite significantly and brought about considerable improvement. I subsequently read Dr Michael Mosley's book the 8-week blood sugar diet and found it really useful. I now just eat breakfast at 9-10am and a main meal mid-afternoon and try to not eat anything after 6pm. It might sound drastic but I can do this more easily than 2 days a week very low calorie intake. I am used to this now and my body has adjusted to this regime.

You need to investigate all alternatives and make the best decision for you, your lifestyle and your family because we are all different and in different circumstances. Good luck.

Suzibelle profile image
Suzibelle in reply toyorkshiregirl4

Hi yorkshiregirl4. That is excellent feedback, thank you. I don't want to touch metformin to start with and the more I hear about it the stronger that feeling is. I don't have a particularly bad diet but have already started to modify it and get off my rear end every day to get back into exercise but I'll also look into intermittent fasting/restricted eating as well to see if I can build something in - I work from home but home is a farm so there's all that to do after the normal work day but I'll shift the evening meal as far forward as I can to extend the fasting period (we already do a 9-10am breakfast). Appreciate the input.

yorkshiregirl4 profile image
yorkshiregirl4

Just a further thought, Suzibelle, I still check my blood glucose levels occasionally to ensure I know where it's at. In the earlier days I found it particularly useful to do so having kept a food diary and then appreciating which foods raised the blood glucose levels more than others. It really is a very useful tool to take charge of this yourself if that's at all possible.

Suzibelle profile image
Suzibelle in reply toyorkshiregirl4

I've started the diary and intend to get some reference material for GI content and GI loading but you're right, it may be an idea to start looking at blood glucose monitors as well, I hadn't thought of that. Thanks!

EiCa profile image
EiCa in reply toSuzibelle

The glucose monitors are immensely helpful when learning about your own blood sugar findings. Here in the US they are covered if you have a type 2 diagnosis. The strips can be pricey and I test a lot, especially when I feel unwell and/or I try a new food. Testing at the 2 hours after eating time is recommended but I find my blood sugar doesn’t stabilize for 3 hours but if I am over 140 at two hours I shouldn’t be eating that food or I need to reduce the portion or eat with protein/fat.

Suzibelle profile image
Suzibelle in reply toEiCa

Thanks for the info, EiCa, I'll start looking into it here in Australia.

I was on metformin when I was first diagnosed with type 2...the side effects were horrendous [nausea, vomiting, diarrhoea, severe wind - it hurt to burp or fart], and it wasn't lowering my mmol.

I checked the leaflet (this would have been 2009~2009) and it said that 1 in of patients suffer from 'a debilitating malaise'.

A few years later they update the leaflet and called the malaise something else (I forget what)

Then sometime in the mid 2010s they were calling it B12 deficiency.

Seems people were dying from that "mystery malaise" side effect,

I'm now on something else, but still have low B12. Also I don't follow any sort of diet/exercise regime - but then I'm pretty sure I have Cushing's Syndrome - hyperglycaemia is one symptom/sign of it.

Suzibelle profile image
Suzibelle in reply to

Wow, that sounds horrific and yet another reason to keep away from the metformin. I was reading some papers last night on the B12 deficiency side affect and it was mildly depressing to realise that it took them so incredibly long to understand what was going on - we all know an awful lot of doctors have no idea about nutrition or vitamin deficiencies but that was borderline negligent...

in reply toSuzibelle

I was begging the GP to take me off that tablet, and she kept refusing. The chemist gave me an alternative one month as he couldn't get the usual one, the alternative didn't give me the vomiting etc, but it gave m terrible brain fog!

I asked the GP agian and she said "you just have to get used to it!" blythe as you llike. I said I'd been on it for 6 years, "how long does it take to get used to??"

I only got something else when I had a raging UTI that wouldn't go away and my blood sugars were out of control to the point that either the UTI or the hyperglycaemia was going to kill me, I demanded a second opinion and was put on a brand new tablet that brought my blood sugars crashing down and as a result the UTI cleared up!

Suzibelle profile image
Suzibelle in reply to

You've been on quite a journey! I trust you're mostly sorted now 😊

in reply toSuzibelle

I'm nearly 60 and my health issues are lifelong.

(TW)

It started when my mother poisoned me. She lied her ass off to doctors for 40 years so no one will listen to me, so she wouldn't have to go to prison.

She was also poisoning my dad.

Bellabab profile image
Bellabab

I reversed the diagnosis of type 2 diabetes using the Newcastle diet. GP checks my Hba1C blood levels annually and its still fine 10 years later.

freedieting.com/newcastle-diet

charks profile image
charks in reply toBellabab

The Newcastle diet sounds terrible, I could never do that. I much prefer intermittent fasting as you can eat much more than 800 calories a day and still reverse your fatty liver by metabolic switching. And eat a normal diet.

Suzibelle profile image
Suzibelle in reply toBellabab

Hi Bellabab. I've tried something very similar about ten years ago (to lose weight) and it didn't do much but that was pre menopause so I might revisit it. Thanks for the reminder.

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