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How to safely use metformin to manage type 2 diabetes

Diabetes results in nerve and blood vessel damage. Too little vitamin B12 results in nerve damage and vascular complications. Metformin chews vit B12. Coincidence ?

When sugar levels go awry – meds are often prescribed.  The anti-diabetic drug which is widely prescribed, is metformin.  This is the active ingredient in the pill, but will not be the name that you see on the pill box.

To help you figure out, if the pill you’re taking has metformin inside, I’ve listed some of the common trade names of metformin.

• Glucophage
• Carbophage
• Riomet
• Fortamet
• Glumetza
• Obimet
• Gluformin
• Dianben
• Diabex
• Diaformin
• Siofor
• Metfogamma
• Glifor

Metformin mechanism of action

Metformin works it’s magic, by decreasing glucose production  –  the overall result, it helps keep sugar levels in check. Protecting the diabetic from the dire consequences of elevated sugar levels.

Unfortunately, it also does a few things that are not quite as helpful.

This is the problem with drugs – there are always risks along with the benefits.

Metformin chews up vitamin B12

Numerous studies have demonstrated, that diabetic patients taking metformin on a regular basis, end up with lower vitamin B12 levels.

Low, not necessarily NONE.

But, low enough to be “worrisome”.

Yup.

NOTE : Vitamin B12, which sometimes also referred to as cobalamin.   The reason for this is because right in the middle is an atom of cobalt.

Metformin as a co-factor

You see, Vitamin B12, is an important cofactor i.e. an enzyme helper.  It helps 2 enzymes.

One of the enzymes it helps, is involved in methylation pathways and the other, in energy metabolism, so  when it is missing in action, a whole range of problems can arise.   Among them permanent nerve damage, megaloblastic anaemia and vascular complications.

Nerve damage and vascular complications.

Mmmmmmmmmmmmmmm……  these are two big problems facing someone with diabetes.   They have fancy names, neuropathy, retinopathy, macroangiopathy – but when all is said and done, the complications of diabetes, revolve around nerve damage and blood vessel damage.

High sugar levels are usually blamed for this damage.

The priority in diabetes

This is why priority number one in diabetes, is to keep those sugar levels within a normal range.

Something metformin is good at doing.

But…………

At a price ?

Remember, diabetes is not something you’re CURED OF.  It is more about management.  Sadly, even when sugar levels are managed well…………….complications can arise.

Specifically nerve damage and vascular complications.

Could metformin, our hero, be part of the problem ?

Maybe.

An unrecognized vitamin B12 deficiency, is going to impact.

But, it doesn’t have to be……

Make a plan

So metformin chews vitamin B12, how it does it, is still not clear, but it does, so if you been taking metformin for 6 months or more,  you need to make a plan, TO GET A LITTLE EXTRA vitamin B12.

Your body cannot make it.

Plants can’t either. Some bacteria can make it, most don’t, they steal it from you or their neighbours.

The only natural source of vitamin B12

To get enough you need to consume animal products.

• 100 g of liver will contain 26-58 ug of the stuff.
• 100 g steak or a pork chop,  gives you 1-3 ug
• anegg yolk , will give you 1-2.5 ug

If you’re a strict vegetarian, you’re GOING TO BE short changed.

AND NEED TO SUPPLEMENT !

Unfortunately, even if you’re eating enough, it does not always mean, you’re getting enough….

Getting it in, is a process

The body uses a rather sophisticated process, to get vitamin B12 from the gut, and into the cells that need it.

15 different proteins are involved.

That means, there are 15 different points, were things can GO WRONG.

And they often do.  Vitamin B12 is often a nutrient in short supply.

Eating it is not a guarantee you’re getting it

How much vitamin B12 you’re getting, depends on how well this pathway is working,  the efficiency of this pathway depends on your genetics, as well as your body chemistry…….

If you’re taking metformin – the pathway is compromised.

So while eating more, will help, it might not always be enough………………

Supply is depleted to over time

Our bodies store vitamin B12 – on paper, you should have more than enough to meet your needs.

But years of metformin use………….could leave you with low levels, even if you’re eating “enough”.

This  ALSO means, simply swallowing a vitamin pill full, of vitamin B12, might not always,  fix the problem.

You need to bypass the sophisticated absorption system, which is being “sabotaged” by metformin.

Topping up the vitamin B12 supply

There are two ways to do this

• You can use a sublingual formulation, this is a formulation you put under your tongue
• You can be brave and get a shot.

Mitigate the metformin risk

If you’re managing your diabetes with metformin, make sure you’re keeping your vitamin B12 levels topped up.

Further reading

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