New studies (2025) reveal that long-term Metformin use increases the risk of Vitamin B12 deficiency by up to 35%
And the risks? They’re not just minor…
Mechanism Behind It:
- Disrupts gut microbiota - ↓ intrinsic factor function
- Alters IF-Cubam receptor - ↓ B12 absorption
- Higher risk in elderly, vegetarians, or those with GI issues
Stages of Risk:
- Early Signs: Fatigue, brain fog, mild neuropathy
- Advanced: Irreversible nerve damage, ↑ dementia risk (up to 50%!)
What Do 2025 Guidelines Recommend?
- B12 testing every 6 months for all Metformin users
- Supplementation: 1,000 mcg/day oral B12 or quarterly IM injections
- MMA + Homocysteine = Now Gold Standard testing