It’s the most prescribed drug for type 2 diabetes in the world.

Doctors say it’s safe, affordable, and standard practice.

But mounting research suggests it may quietly drain one nutrient your brain cannot function without.

And that could put you on the fast track to cognitive decline…memory loss…and, yes, Alzheimer’s disease.

We’re talking about metformin…. and millions of seniors aren’t being warned about the risks.

But we’re going to share everything you need to know to keep yourself and the people you live safe.

Earlier this month, a study published in Cureus found that patients with type 2 diabetes, especially those on long-term metformin therapy, frequently develop vitamin B12 deficiency.

In fact, those on metformin for over five years had nearly 3 times the risk of vitamin B12 deficiency.

And that could have them rocketing toward an Alzheimer’s diagnoses.

You see, B12 plays a critical role in:

  • Nerve health
  • DNA repair
  • Red blood cell formation

Without enough B12, the nervous system begins to suffer.

But more importantly, brain function drops.

To prove it…

Another study published in the International Psychogeriatrics journal found that low serum vitamin B12 levels are associated with Alzheimer’s disease, vascular dementia, and Parkinson’s disease.

And here’s the disturbing part.

B12 deficiency can even mimic early dementia.

And in some cases, the damage becomes irreversible if not caught early.

Here’s what happens:

Metformin is known to interfere with B12 absorption in the gut.

So even if you’re eating the right foods, your body can’t access the nutrients it needs.

The longer someone takes it, the greater the risk.

Yet routine B12 monitoring isn’t always emphasized in clinical practice. It’s not even on the standard blood panel. You have to ask for it.

So millions of Americans may be taking a medication that helps control blood sugar…

While unknowingly increasing their risk of a deficiency linked to cognitive decline.

On top of that, diabetes alone already increases your risk of Alzheimer’s disease.

Scientists have even called the connection between these two diseases Type 3 diabetes.

Once you’re diabetic, you already have a 56% higher risk of developing Alzheimer’s disease.

Add metformin on top of that, and you’re playing with fire.

If you or someone you love takes metformin:

  • Ask your doctor to check serum B12 levels annually
  • Watch for neurological symptoms: brain fog, memory lag, fatigue, poor balance
  • And discuss supplementation if levels are low. You may have to try a sublingual (under the tongue) B12 to bypass your digestive system and any absorption problems.

Protecting your blood sugar shouldn’t come at the expense of protecting your brain.

Remember, B12 testing is simple. Correction is inexpensive. And early detection can prevent long-term damage.

Sometimes the real danger isn’t just the drug itself…

It’s the silent nutrient depletion that comes with it.

And when it comes to your brain, silent is the last thing you want.

Preventing the brain drain,

Ray Thatcher
Research Director, Health Sciences Institute

Sources:

  • Rangare V, Nagwanshi J, Raghuwanshi K (February 07, 2026) Prevalence of Vitamin B12 Deficiency Among Patients With Type 2 Diabetes Mellitus on Long-Term Metformin Therapy. Cureus 18(2): e103178. doi:10.7759/cureus.103178
  • Moore, E., Mander, A., Ames, D., Carne, R., Sanders, K., & Watters, D. (2012). Cognitive impairment and vitamin B12: A review. International Psychogeriatrics, 24(4), 541–556. https://doi.org/10.1017/S1041610211002511
  • Cholerton B, Baker LD, Montine TJ, Craft S. Type 2 Diabetes, Cognition, and Dementia in Older Adults: Toward a Precision Health Approach. Diabetes Spectr. 2016 Nov;29(4):210-219. doi: 10.2337/ds16-0041. PMID: 27899872; PMCID: PMC5111529.
  • Tsiknia, A. A., Tennant, V. R., Lee, N., Hall, B. J., Vintimilla, R., Hazra, N., Kothapalli, D., Toga, A. W., O’Bryant, S. E., Nandy, R. R., Clark, A. L., Petersen, M., Yaffe, K., & Braskie, M. N. (2025). Diabetes and cortical thickness in ethnically diverse cognitively normal older adultsAlzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, 17(2), e70088. https://doi.org/10.1002/dad2.70088
  • Katella, K. (2024, June 26). Are you getting enough vitamin B12? What you need to know. Yale Medicine. https://www.yalemedicine.org/news/are-you-getting-enough-vitamin-b12


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Allan Spreen, M.D.
Dr. Allan Spreen, Chief Medical Advisor

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