Metformin & B12

As a type II diabetic I recently had a blood test. VA called to say I am low on B12 and should take a supplement. My Multi gives 417% and I take 2 a day for 834%. I understand Metformin/gloucofage causes the loss of B12. Other than seperating the intake of B12 from the Metformin, has any one had any experience with this?

No experience but I would recommend sublingual b12. You have several good options. Source naturals makes a good one. Mercola makes a good spray too although it’s a bit more expensive comparatively.

I’d ask for a prescription nasal spray or injection if you dont see improvement…

[quote]Mouldsie wrote:
I’d ask for a prescription nasal spray or injection if you dont see improvement…[/quote]

Good idea. I had forgotten that Osteopaths used to give B 12 injections to 50 year + patients. After the Osteopaths started working with MD, they sorta got bs’d away from the vitamins. Tomorrow morning I will press for the B12 shot if they have it on hand. I have no idea how long they last.

[quote]philipj wrote:

[quote]Mouldsie wrote:
I’d ask for a prescription nasal spray or injection if you dont see improvement…[/quote]

Good idea. I had forgotten that Osteopaths used to give B 12 injections to 50 year + patients. After the Osteopaths started working with MD, they sorta got bs’d away from the vitamins. Tomorrow morning I will press for the B12 shot if they have it on hand. I have no idea how long they last.[/quote]

8 19 2010 thursdaqy
Today the VA gave me an IM of B12, plus syringes and B12 for the nest 12 weeks. On top of that this can be renewed two more times.

Consider joining an Armed Force full time for 4 to 6 years. Having a Veterans Administration Hospital Care is a great benefit if you ever need it.

Yea my doc prob would have made me fight and claw for something like that lol… but they will freely give me vaccines

It’s cool that you got the shots, but sublingual or other high dose oral B12 is way less invasive, would probably work just as well, and is much easier to put a little sweet tab under your tounge. Your choice though.

[quote]BulletproofTiger wrote:
It’s cool that you got the shots, but sublingual or other high dose oral B12 is way less invasive, would probably work just as well, and is much easier to put a little sweet tab under your tounge. Your choice though.[/quote]

I believe that the sublingual tabs were not available. Since I had been taking 847% more B12 than I needed I do not know how much more in pill form I would have to take. It appears that the longer a Diabetic takes Metformin, the worse this condition gets. So once a week a needle in the butt…

[quote]philipj wrote:

[quote]BulletproofTiger wrote:
It’s cool that you got the shots, but sublingual or other high dose oral B12 is way less invasive, would probably work just as well, and is much easier to put a little sweet tab under your tounge. Your choice though.[/quote]

I believe that the sublingual tabs were not available. Since I had been taking 847% more B12 than I needed I do not know how much more in pill form I would have to take. It appears that the longer a Diabetic takes Metformin, the worse this condition gets. So once a week a needle in the butt…
[/quote]

847% is clearly, simply not enough then. B12 and many of the other B vitamins have a very low toxicity and it is very common to see dosages in supplements for certain B vitamins of 10,000+%. For example, “Source Naturals Sublingual MethylCobalamin Vitamin B12 Cherry – 1 mg” is 16,670% of the RDI, yet it is still a safe product since B12 has a very low toxicity and is not stored in the body (The unused portion is simply pissed out while whatever you do need is used).

I’m not saying the injections are inherently dangerous or not as effective. I’d use them since you have access and already went to the trouble to get them, but a simple bottle of high dose B12 (which is almost all B12 supplements) will do the trick IMO.

FWIW, you should consider just getting a high dose B vitamin complex because there really is no harm and it would also provide ample B12 as well as any other B vit you were deficient in. Also you could consider getting a multi with a higher amount as well. I use Life Extension Two a Days and they have 300mcg B12, which is 5,000%.

I did some research on B12 previously.
It may not be that simple for the OP depending on metformin’s action of B12 deficiency… does it induce malabsoprtion? How? Does is cause increased loss? etc

B12 supplements are large molecule that are not well absorbed by the receptors in the mouth (prob why they use 16,000% in tabs) or the stomach. The B12 that gets through the stomach is absorbed in the small intestine through a complex process. From there your body is normally efficient at recycling it and storing large levels of it so normal people do not need much supplementation until they age and lose ability to absorb it as well (loss of intrinsic factor?). There could also be a B12 deficiency if metformin is causing some step in the process to making b-12 into the proper form of adenosylcobalamin.

Then there is the type, cyanocobalamin is less effective and prob in his multi…

So using a methyl b-12 may help, it may not. I do not know how metformin interacts… but the b-12 shot will solve the problem either way

In the June issue of Health & Healing Dr Julian Whitaker MD reported on Metformin impairing B12 absorption and leads to deficiencies in 30% of patients who use Metformin. Further the lack of B12 can cause nerve damage.

I gave a copy of this to my VA Diabetic counselor and she ordered B12 to be tested at my next blood draw. That was on a Friday. The next Tuesday they called about being short of B12, and on Thursday set me up with B12 IM for the next 3 months.

One of the problems for the diabetic was the frequent urination. I will take the IM shots until they run out. I have worked at dropping 19 of 30 lbs and will continue the workouts, weights and eliptical trainer. I will take the Metformin at breakfast and supper along with fish oil(to lower the glycemic index of the meal). Any other supplements will be at least 2 hours away from Metformin. That is about the best sceme I can come up with.

I’m glad you were proactive and got tested because from what I’ve read such screening is not routine, although it seems that it absolutely should be.

@ Mouldsie - I agree that sublingualy, B12 might not be very effective, but then again whatever isn’t is otherwise sent to the intestines, where I haven’t read anything about absorption issues being common. This website doesn’t differentiate between effectiveness of oral, injectable, or inhaled forms: Metformin and Risk For Vitamin B12 Deficiency - DSM although it does indicate that vegetarians and the elderly might need additional B12, indicating that those groups could have absorption issues (well vegetarians obviously just don’t get enough in their diets).

Guys thank you for all the useful thoughts and information. With as many diabetics as we have, I am sure that the quiet ones are readig your information and thinking. For the same reasons I have often wondered by there is not a thread for the diabetic Type 1 and II people.

There are studies that show high dose oral is as good as injectable B12. You need to use 1000 mcg (1 mg) per day. Recheck in a few months. I use this in my b12 deficient patients, and the vast majority do very well.

Never thought we dould have a sighal North of Newberry Michigan on the Lake Superior shoreline, but we do.
Teratos, can you tell us a little about your profession and the recomended amount of B12? Would this be a capsule to swollow, or a sublingual? I am more than a little ingtrigued.

Never thought we dould have a sighal North of Newberry Michigan on the Lake Superior shoreline, but we do.
Teratos, can you tell us a little about your profession and the recomended amount of B12? Would this be a capsule to swollow, or a sublingual? I am more than a little ingtrigued.

Never thought we dould have a sighal North of Newberry Michigan on the Lake Superior shoreline, but we do.
Teratos, can you tell us a little about your profession and the recomended amount of B12? Would this be a capsule to swollow, or a sublingual? I am more than a little ingtrigued.

Never thought we dould have a sighal North of Newberry Michigan on the Lake Superior shoreline, but we do.
Teratos, can you tell us a little about your profession and the recomended amount of B12? Would this be a capsule to swollow, or a sublingual? I am more than a little ingtrigued.

[quote]philipj wrote:
Guys thank you for all the useful thoughts and information. With as many diabetics as we have, I am sure that the quiet ones are readig your information and thinking. For the same reasons I have often wondered by there is not a thread for the diabetic Type 1 and II people.[/quote]

I’m Type 2 as well and taking Metformin and Glucophage. Just wondering your original post mentioned “VA” - what is that? And how were you able to measure the content of B12? I’ll be sure to check this as well. I’ve been on Metformin since 2005 and added Glucophage last year.

[quote]BulletproofTiger wrote:
I’m glad you were proactive and got tested because from what I’ve read such screening is not routine, although it seems that it absolutely should be.

@ Mouldsie - I agree that sublingualy, B12 might not be very effective, but then again whatever isn’t is otherwise sent to the intestines, where I haven’t read anything about absorption issues being common. This website doesn’t differentiate between effectiveness of oral, injectable, or inhaled forms: Metformin and Risk For Vitamin B12 Deficiency - DSM although it does indicate that vegetarians and the elderly might need additional B12, indicating that those groups could have absorption issues (well vegetarians obviously just don’t get enough in their diets).[/quote]

Thanks BulletProofTiger for the link. I am bit concerned now.

Does anyone have a link or suggestion on the daily recommended dosage of VitB12? Thank you.