“New” research presented at an annual meeting of Type II diabetes experts links the drug metformin with an increased risk of developing a vitamin B12 deficiency. That finding is a concern because low B12 can contribute to the development of clinically significant peripheral neuropathy (damage to the nerves in your hands and feet) just as uncontrolled diabetes itself can.
Now, as you know, I always recommend metformin as the first-line treatment for blood sugar control. First of all, the drug derives from an ancient herbal remedy called French lilac. Second, it has been on the market — and safely used by hundreds of millions of people — for decades. In fact, doctors write 100 million prescriptions for it worldwide each year. Third, it’s the only treatment proven to reduce the common dangerous complications of Type II diabetes. And as a “side effect,” it also dramatically reduces the risk of pancreatic and other cancers.
And — yes — metformin depletes your supply of vitamin B12. But I’ve been talking about this very concern for several years in my Daily Dispatch. So it shouldn’t come as “news” to you. Plus, I’ve been recommending a simple fix for everyone, especially those who take metformin: Take a high-quality B vitamin complex supplement daily.
But apparently, for mainstream medicine, this whole concept is a bit hard to grasp…
The easy, effective, inexpensive way to head metformin’s only problem off at the pass
You see, when there is persistent high blood sugar, there is damage to small blood vessels that supply the peripheral nerves (as well as the eyes, heart and kidneys). And controlling high blood sugar should, in theory, control peripheral nerve damage, a common Type II diabetes complication. Likewise — controlling high blood sugar with metformin should, in theory, prevent peripheral neuropathy as well. But instead, metformin can contribute to peripheral neuropathy because of the problem with vitamin B12, as this study showed.
For this study, researchers followed 390 insulin-treated patients with Type II diabetes who were given 850 mg metformin or placebo for 4 to 5 years. They also measured a very specific marker for vitamin B12 deficiency in tissues called methylmalonic acid (MMA).
Overall, they found long-term treatment with metformin resulted in a 19 percent increased risk of developing a vitamin B12 deficiency, which resulted in a 5 percent increase in homocysteine levels. (For all the details about how to reduce and control homocysteine through diet, and B vitamins, please see the November 2015 issue of my Insiders’ Cures newsletter.)
The study’s authors recommend doctors screen for vitamin B12 deficiency in patients who take metformin. Or, doctors could simply prescribe B vitamin supplements to these patients. Truly, a B vitamin deficiency is easy to diagnose and treatment is easy, effective, and inexpensive — if doctors pay attention. And that’s a big “if.”
Mainstream doctors miss the obvious, then claim it as “evidence”
In fact, some doctors at the meeting expressed skepticism, claiming they didn’t personally observe high rates of vitamin B12 deficiency in their own patients treated with metformin for Type II diabetes. Even the supposedly objective moderator of the session claimed he hadn’t seen enough cases in his own practice.
Normally, doctors call for evidence from clinical trials rather than just rely on their own clinical, anecdotal observations. But in this case, personal anecdotes were more important than the clinical trial evidence for which they clamor — especially when it comes to the side effects of a favorite drug and the benefits of vitamin supplementation.
Why are they so worried about simple B vitamin supplementation?
The “side effects” of B vitamin supplementation are a whole host of other health benefits, besides preventing and even reversing peripheral neuropathy.
What about all the clinical anecdotes from practitioners of natural and nutritional medicine who have observed miraculous results without drugs in thousands of patients over many years? You won’t hear about them at these meetings of mainstream medical minds.
Everyone needs more B
The B vitamins are very important for brain and nerve health. In Europe, they call them “neuro-vitamins.” But it can be hard to achieve and maintain optimal levels, even if you don’t take metformin. Poor, restricted and unbalanced diets — including ones considered “healthy” by many people, such as a vegan diet — can lead to low levels of B vitamins.
The study’s authors suggested drug manufacturers offer a combination metformin-vitamin B12 pill. But that’s like suggesting statin-makers offer a statin-CoQ10 combination, which would help counter the disastrous side effects of these drugs. In fact, drug-maker Merck even took out a patent on a combination statin-CoQ10 drug. But they never made for available for sale.
When we asked them why, they would not comment. Perhaps they didn’t want to make a tacit admission about the terrible side effects of statin drugs and the inherent need for counter-measures. And as it turns out, scientists now know big pharma manipulated the data for statin drug benefits and side effects. Or perhaps the FDA would have made them repeat millions of dollars of studies on the combination, each of whose components were already independently approved and under regulation.
Clearly, not all doctors appear willing to pay much serious attention to the potential of metformin causing vitamin B12 deficiency. And you have to wonder whether this “news” about metformin is simply an effort to get more doctors to prescribe newer, more expensive, more dangerous diabetes drugs instead of the old stand-by.
So you should simply follow my oft-repeated advice: Make sure to take a high-quality daily B vitamin complex with 12 mcg vitamin B12 (as methylcobalamin), especially if you take metformin.
“Metformin Link to Vitamin B12 Deficiency, Neuropathy in Diabetes,” Medscape (www.medscape.com) 9/25/2015