mess with vitamin B12

Keeping track of the nutritional consequences of medications can be tricky. Doctors don’t always ask about possible problems; nor do pharmacists necessarily take these into account. But there are some medications that may mess with vitamin B12 and lead to deficiency. It is worthwhile knowing which ones they are.

Metformin May Mess with Vitamin B12:

Q. I have been taking metformin for type 2 diabetes. It gives me gas and a bellyache.

As a result, I have also been taking omeprazole for a long time. When I realized that these drugs could deplete vitamin B12, I began taking a supplement. The tingling and nerve pain have improved a lot.

I wonder how many people know that metformin can affect nerves through its impact on vitamin B12. They may be going through life with more pain than need be. My own doctor never mentioned that my medications could reduce vitamin B12 and I was never tested.

PPIs Can Mess with Vitamin B12:

A. The diabetes drug metformin and all the proton pump inhibitors (PPIs) such as omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid) and pantoprazole (Protonix) can interfere with vitamin B12 absorption. When levels of this crucial vitamin drop too low, the symptoms may include numbness and tingling in the hands and feet as well as weakness, fatigue, constipation and loss of appetite. People with too little vitamin B12 may also feel depressed, confused or unsteady. In some cases, memory deteriorates to the point that they might be misdiagnosed with dementia.

We commend you for being alert to the potential side effects of your medications. Taking a supplement is a good way to deal with vitamin depletion caused by such medications. In many instances, a high-dose oral vitamin B12 supplement, such as 1,000 mcg (1 mg), provides enough of this vitamin that injections are not necessary.

Treating Diabetes:

Metformin is a good treatment for diabetes. There are other options for controlling blood sugar, however. You can learn more about them in our Guide to Managing Diabetes.

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  1. Nuni
    Reply

    I was recently diagnosed with Type 2 diabetes. Metformin was prescribed but I wanted to try diet and exercise first. I lost 35 lbs. and am no longer diabetic. This is fortunate, as I discovered that Metformin breaks down into sulphur compounds which I am very allergic to. My Dr. was unaware of that.

  2. Dawn
    Texas
    Reply

    I enjoyed your article. I have pernicious anemia and do take B12 plus injections once a week (it changes according to my blood work). I also take Carfate and wonder if that interferes with B12 absorption? I have had this for about 20+ years and never thought about medicines I take interfering with absorption. I love reading all your emails because it gives incite to things I have never thought of before reading the articles. Thank you.

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