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Antidiabetic medications - biguanides


Medications
Depletions
 
Editorial Note
Supporting Research

Medications

  • Metformin
    • Glucophage
    • Glucophage XR

Depletions

Vitamin B9 (Folic Acid)

Low levels of folic acid have been linked to anemia, heart disease, and birth defects.

Vitamin B12 (Cobalamin)

Obvious symptoms of vitamin B12 deficiency are rare because it takes years to develop complications associated with long term depletion of this nutrient. Irritability, weakness, numbness, anemia, loss of appetite, headache, personality changes, and confusion are some of the signs and symptoms associated with vitamin B12 depletion. Low levels of this vitamin may also be associated with an increased risk of colon cancer, heart disease, brain disorders, and birth defects.

Editorial Note

The selected depletions information presented here identifies some of the nutrients that may be depleted by certain medications. The signs and symptoms associated with nutrient deficiency may also indicate conditions other than nutrient deficiency. If you are experiencing any of the signs or symptoms mentioned, it does not necessarily mean that you are nutrient deficient. Nutrient depletion depends upon a number of factors, including your medical history, diet, and lifestyle, as well as the length of time you have been taking the medication. Please consult your health care provider; he or she can best assess and address your individual health care needs and determine if you are at risk for nutrient depletions from these medications, as well as others not listed here.

Supporting Research

Adams JF, Clark JS, Ireland JT, et al. Malabsorption of vitamin B12 and intrinsic factor secretion during biguanide therapy. Diabetologia. 1983;24(1):16-18.

Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY Acad Sci. 2000;889:87-106.

Andrès E, Federici L. Vitamin B12 deficiency in patients receiving metformin: clinical data. Arch Intern Med. 2007;167(7):729; author reply 730-1.

Berger W. Incidence of severe side effects during therapy with sulfonylureas and biguanides. Horm MetabRes Suppl. 1985;15:111-115.

Buvat DR. Use of metformin is a cause of vitamin B12 deficiency. Am Fam Physician. 2004;69(2):264; author reply 264, 266.

Carlsen SM, Folling I, Grill V, et al. Metformin increases total and serum homocysteine levels in non-diabetic male patients with coronary heart disease. Scand J Clin Lab Invest. 1997;57(6):521-527.

Carpentier JL, Bury J, Luyckx A, Lefebvre P. Vitamin B12 and folic acid serum levels in diabetics under various therapeutic regimens. Diabetes Metab. 1976;2(4):187-190.

Dali-Yousef N, Andres E. An update on cobalamin deficiency in adults. QJM. 2009;102(1):17-28.

Fisman Ez, Motro M, Tenenbaum A. Non-insulin antidiabetic therapy in cardiac patients: current problems and future prospects. Adv. Cardiol. 2008;45:154-70.

Fitzgerald MA. Drug-induced vitamin B12 deficiency. Nurse Pract. 2007;32(9):6-7.

Hvas AM, Nexo E. Diagnosis and treatment of vitamin B12 deficiency -- an update. Haematologica. 2006;91(11):1506-12.

Liu KW, Dai LK, Jean W. Metformin-related vitamin B12 deficiency. Age Ageing. 2006;35(2):200-1.

Moretti R, Torre P, Antonello RM, Cazzato G, Cattaruzza T, Scapicchio PL. Vitamin B12 and folate depletion: clinical evidence in a neurological population. Neurologist. 2004;10(6):338-43.

Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH:LexiComp, Inc.;2001:409-410.

Reynolds E. Vitamin B12, folic acid, and the nervous system. Lancet Neurol. 2006;5(11):949-60.

Svenson J. Neurologic disease and vitamin B12 deficiency. Am J Emerg Med. 2007;25(8):987.e3-4.


Review Date: 5/10/2010
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network.
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