A widely used drug causes deficiency of a vitamin you desperately need

Should Have Seen This One Coming

The most serious danger to type 2 diabetics might not be sugar at all. It might be your medication.

The problem is metformin, a drug that’s been around for decades and used by millions.

By the time the FDA finally approved metformin for use in the U.S. in 1994, researchers were already aware the drug was linked to poor absorption of vitamin B12. Further research suggested that metformin might actually cause B12 deficiency.

And now there’s important new research from the Netherlands.

After a four-year intervention, diabetic subjects who used metformin ended up with B12 levels that were nearly 20 percent lower than the placebo group on average. Subjects in the metformin group were also at higher risk of developing a full-blown deficiency of this very important vitamin.

So what makes B12 so important?

Let’s start with homocysteine. A high level of this amino acid has been linked to increased risk of dementia, Alzheimer’s disease, heart attack, stroke, and Parkinson’s disease. But B12 is one of the key vitamins that helps metabolize homocysteine, which drives your level down.

In the Netherlands study, homocysteine increased by an average of 5 percent in subjects who took metformin.

B12 also plays a role in keeping your bones healthy. A University of California study found that women with the lowest levels of B12 had a significantly higher risk of bone loss and fractures compared to women with the highest levels.

Course correction

Unfortunately, the Netherlands study didn’t determine if B12 supplementation would correct the deficiency. But let’s assume that supplements would be helpful, at the very least, and go forward from there.

Dr. Spreen recommends 1,000 micrograms of B12 daily, taken in sublingual form (dissolved under the tongue). And he notes that of the three B12 forms, methylcobalamin is by far the best.

But he adds an important note that B12 needs other nutrients in order to be most effective.

His recommendations:

• Folate – 1.6 mg daily
• Vitamin B6 – 100 mg daily
• Magnesium – 400 to 500 mg daily

Your best dietary sources of B12 are primarily meat, fish and eggs (so vegetarians and vegans will definitely want to supplement). Folate and B6 are found in asparagus, lentils, chickpeas, most varieties of beans, and especially spinach and other leafy green vegetables. For magnesium, you want to eat plenty of avocados, nuts, seeds, whole grains, and (again) leafy green veggies.

To Your Good Health,

Jenny Thompson

Sources:
“Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial” BMJ, Published online ahead of print 5/20/10, bmj.com
“Low Plasma Vitamin B12 is Associated With Lower BMD: The Framingham Osteoporosis Study” Journal of Bone & Mineral Research, Vol. 20, No. 1, January 2005, jbmr-online.org