Posts Tagged ‘vitamin B12’

Vitamin B12 is often deficient with type 2 diabetes even without taking Metformin

Monday, February 8th, 2010

Endocrine PracticeAn important study was just published in the journal Endocrine Practice (the journal of the American Association of Clinical Endocrinologists) that set out to determine if undiagnosed Vitamin B12 deficiency is common among people with type 2 diabetes, even when not taking Metformin (which itself causes B12 deficiency). Their findings: “Almost one-half of type 2 diabetes subjects not taking Metformin had biochemically proven vitamin B12 deficiency.” (And they used a very low benchmark, <200 microgram/dL, to qualify as “low”, which we would call severe deficiency.) Their important conclusion that needs to be more widely communicated: “We conclude that Vitamin B12 deficiency is common amongst type 2 diabetes subjects and is nutritional in nature…This indeed is an important finding, as taking oral Vitamin B12 supplementation is easy, convenient and readily accepted by patients. This is a novel finding and stresses the need for aggressive and early diagnosis and treatment to avoid complications of Vitamin B12 deficiency.” Why wait for type 2 diabetes to develop? Take care of any deficiency, a potential contributing cause, earlier at a preventive stage.

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Schizophrenia and Vitamin B12

Monday, November 23rd, 2009

As you know, vitamin B12 is a critical nutrient for brain and nervous system health. Deficiencies commonly occur due to diet or poor assimilation. Here is a report published in the journal General Hospital Psychiatry describing a psychotic episode resulting from cobalamin (vitamin B12) deficiency. Interestingly, this occurred without any hematologic (blood) symptoms or preceding neurological manifestations. I have personally seen a case like the one described here.

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Vitamin B12 and brain shrinkage

Monday, November 23rd, 2009

Do keep in mind that Vitamin B12 is so important for the nervous system that low levels accelerate neurodegeneration to the degree that the brain shrinks markedly, as described in this paper published in the journal Neurology. [A cautionary note for any doctors reading this post: brain volume loss was, surprisingly, not associated with high levels of methylmalonic acid or homocysteine. The association was with serum B12 <308 pmol/L, low levels of holotranscobalamin and transcobalamin saturation.]

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Taking Metformin? Make sure you have Vitamin B12

Monday, November 2nd, 2009

There is abundant evidence that metformin, a medication commonly used for type 2 diabetes, impairs the absorption of Vitamin B12 (even by broad pathological reference standards, not to mention the more sensitive functional reference ranges). Few patients seem to be told about this even though it has been well known for a long time:

  1. Use of Metformin Is a Cause of Vitamin B12 Deficiency
  2. Risk Factors of Vitamin B112 Deficiency in Patients Receiving Metformin
  3. Metformin-related vitamin B12 deficiency
  4. Metformin increases total serum homocysteine levels in non-diabetic male patients
  5. Malabsorption of vitamin B12 during biguanide therapy
  6. Association of metformin, elevated homocysteine and methylmalonic acid

For vitamin B12 I recommend the sublingual methylcobalamin form.

(Metformin is a type of biguanide. Homocysteine and methylmalonic acid levels go up with B12 deficiency.)

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