Metformin and vitamin B12 deficiency

Vitamin B12 Deficiency and Diabetes

Vitamin B12 Deficiency Among Diabetic PATIENTS

As you probably already know, one of the side effects of metformin is that it prevents proper nutrient absorption from food in your intestinal tract. Vitally important vitamins and minerals pass through your system not absorbed, leaving your body deficient in the elements it needs to rebuild and heal itself. As you can understand, it’s a dangerous side effect, in that it can further exacerbate your condition and weaken your body even more, although all you are trying to do is to actually help it fight the disease.

The solution to this side effect is to start supplementing your diet with vitamins and minerals to maintain the proper balance in your body and to help your body acquire those building blocks that it needs for its perfect performance. I definitely recommend speaking to your doctor about supplementation. It is possible that they will have you do some tests to see what you may already be deficient in and recommend certain supplements to support you.

Although supplements have been thoroughly researched and a multitude of studies have proved them effective and safe, a lot of people are still skeptical about the idea of nutritionally supplementing their diet, whether they are diagnosed with Type 2 diabetes or not. You may think you are already eating a healthy and balanced diet. Why would you need to supplement?

A harsh truth is that only a few of us come close to eating a truly healthy and balanced diet, even those that aren’t on metformin. The type of lifestyle people live today contributes to the decreasing quality of the food we eat. Our soil is depleted of nutrients due to constant overuse. Our meat, instead of being grass-fed, is often fed grains and other foods that aren’t nutritionally rich, and so we can’t get the nutrition we should be able to get from meats. In addition to that, most people simply don’t have a diverse and rich enough diet to really enjoy the nutritional variety that we need to thrive. A lot of us eat out in fast foods restaurants almost daily, and even if you eat at home, it is possible that most of your food is nutritionally poor processed food. These type of foods undoubtedly lack in nutrients needed by the body for proper function and performance.

Another misconception is the idea that supplements are really not that beneficial and are only a waste of money. This could not be farther from the truth! You will be surprised how much difference even a single supplement can make in your everyday life. I can attest to a major improvement in my health state after I began taking vitamins B6, B12, vitamin D, and iron. For my particular case, those were an absolute game changer. It is always a great idea to check your vitamin and mineral levels professionally to get a better picture of how your body is doing, especially if you are on such harsh medication as metformin. Further in this article, I will concentrate more on Vitamin B12 in particular as one of the most vitally important vitamins for your body to thrive.


Vitamin B12 is one of the water-soluble vitamins that provides the following benefits:

  • Effective metabolism of protein, carbohydrates, and fat
  • Improves the function of iron in the body
  • Supports proper maintenance of a healthy central nervous system
  • Supports healthy folate activity and calcium absorption
  • Helps increase your energy
  • Helps in healthy formation and regeneration of red blood cells.

Here is some of my personal history with vitamin B12. At a certain point, I noticed that I started forgetting words, and it took me a while to remember them while speaking. I also noticed I became mentally slow. I talked slowly, I constantly stammered and couldn’t find words for even the simplest concepts. I couldn’t even think fast. I lived in a nearly constant state of mental fog. Then I found out I was deficient in Vitamin B12.

I started taking supplements, just one tablet a day, and the results have been short of amazing. I noticed that I am much less tired. I think and speak faster and make decisions with greater ease. I have much more energy. And that’s just what I see on the surface. I am sure if I did some tests, I would see some great results in the internal systems of my body as well. This is why I highly recommend supplementing with B12, especially if you are on metformin which tends to exacerbate malabsorption of nutrients and may wreak havoc in multiple systems of your body unless you help support yourself.

Through diet, Vitamin B12 can be obtained by consuming tuna, salmon, chicken, milk, and eggs, and also vegan burger patties fortified with Vitamin B12. You can see that most of the sources of B12 are of animal origin, so if you are a vegetarian or especially vegan, you are almost 100% guaranteed to be lacking in vitamin B12.

A study that involved 46 individuals diagnosed with Type 2 Diabetes and taking either Metformin or Phenformin or both, showed that thirty percent of patients had vitamin strong B12 malabsorption. This meant that their bodies had difficulties in absorbing the vitamin, which resulted in the deficiency that continued even when the intake of medications was stopped. This is quite a large percentage of such a small representative group. In reality, almost anyone should supplement with vitamin B12, even if they aren’t on metformin.

Symptoms of vitamin B12 deficiency

How can you tell if you are vitamin B12 deficient?  The best way is to do medical tests to find out. However, some of the signs of vitamin B12 deficiency include the following:

  • weakness and/or soreness in arms and legs
  • slow sensory perception and reflexes
  • stammering and nervousness
  • jerking in limbs and difficulty walking
  • inflammation of the nerves
  • memory loss and mental slowness
  • mood disorders (irritability, depression, anger, etc..)
  • unpleasant body odor

Your health care provider can easily monitor your vitamin B12 levels through a blood test. In the case of severe deficiency, your doctor can administer vitamin B12 injections under the tongue or by using a patch that can quickly deliver the vitamin to the body. Once your levels are stabilized, you can maintain healthy levels of daily Vitamin B12 supplementation.

Disclaimer of Medical Liability

This site is not designed to, and does not: provide medical advice, professional diagnosis, opinion, treatment, or services to you or to any other individual. Through this site and links to other sites, Metformin Facts provides general information for educational purposes only.

The information provided in this site, or through links to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call, consultation or the advice of your physician or another healthcare provider. Metformin Facts is not liable or responsible for any advice, course of treatment, diagnosis or any other information, services, or product you obtain through this site.

Metformin, diabetes and food interactions

Metformin Food Interactions

How Does Metformin And Other Anti Diabetic Drugs Interact With Food?

When you are taking any medication, it’s important to know what other life factors can affect that medication’s absorption and functioning in your body. Food is one of the most important factors to take into consideration. Consumption of alcohol is another.

Many types of foods, especially those that originate from plants, have various chemical compounds that interact with the enzymes present in the liver. These enzymes are also used by the liver to destroy and detoxify active chemicals that are present in the medications you take to control diabetes.

It is important to know how the type of food you consume will affect your liver’s ability to recycle the active ingredients present in diabetes medications, as well as which type of foods can slow this process down as these will affect the rise and the dip of blood sugar levels.

How foods affect diabetic drug processing

How the food you eat will affect the diabetes medication you take will depend on what enzyme is used by your liver to break down those medications. This is an overview of how several known diabetic drugs are processed in the liver and how they are affected by the foods you eat.


Also known as Glucophage, metformin is one medication that does not get processed by the liver. This means the use of Metformin cannot be affected by the food you eat.

However, consumption of alcohol does affect metformin metabolism. Excessive alcohol in your system will lead to metformin breaking down too much lactate which can cause one of the metformin side effects known as lactic acidosis.

Lactic Acidosis a serious condition that is characterised by an increased amount of lactate in the body and can cause multiple negative symptoms such as trouble breathing, weakness, diarrhea, vomiting, abdominal pain, muscle pain, and tiredness. In severe cases, lactic acidosis can be lethal. To avoid any negative symptoms, it is best to avoid alcohol or limit it to very small amounts ( 1 drink a day maximum for women and 1-2 for men) while medicating with metformin.

You will be even better off speaking to your doctor about risks of consuming alcohol in your particular case as well.


Also known as Galvus, vildagliptin is a diabetes medication that is processed by the liver with cytochrome P450. However, the processing is very limited. Through consuming licorice, grapefruit, ginger, or hot peppers, you can increase the ability of this medication to decrease blood sugar levels in the body.


Also known as Januvia, sitagliptin gets processed in the liver with the CYP2C8 and CYP3A4 enzymes. Avoid eating too much fruit and drinking fruit juices as these will interfere with the enzymes and increase the possibility of more severe side effects caused by the medication.

When using Sitagliptin, you should particularly avoid consumption of mangoes, oranges, dragon fruits, rambutans, passion fruits, pawpaws, wild grapes, pomegranates, wild mulberries, and kiwis.


This medication is also known as Actos and is processed with the CYP2C8 enzyme. All of the fruits mentioned above (mangoes, oranges, dragon fruits, rambutans, passion fruits, pawpaws, wild grapes, pomegranates, wild mulberries, and kiwis) will also affect this medication so it is important to avoid them especially pomegranate juice.


The CYP2C8 enzyme also processes Rosiglitazone, also known as Avandia, so it is also advised to avoid the fruits mentioned earlier. The intake of pomegranate juice will also cause this medication to produce greater side effects so stay away from the fruit juice as much as possible.

Food is very important when it comes to maintaining your body’s ideal health and well-being. Maintaining a correct diet and supplementing vitamins and minerals, as well as watching foods that can affect your medications should be high on your list of priorities in your quest to feel better.

Another important factor is following a healthy lifestyle, which includes: eating the right amount of healthy foods, maintaining regular physical activity and reducing stress.

Disclaimer of Medical Liability

This site is not designed to, and does not: provide medical advice, professional diagnosis, opinion, treatment, or services to you or to any other individual. Through this site and links to other sites, Metformin Facts provides general information for educational purposes only.

The information provided in this site, or through links to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call, consultation or the advice of your physician or another healthcare provider. Metformin Facts is not liable or responsible for any advice, course of treatment, diagnosis or any other information, services, or product you obtain through this site.


Before You Start Taking Metformin

Overview of metformin

Metformin is an orally-administered medicine intended to treat diabetes by controlling sugar levels in the blood. It is a drug for patients with type 2, non-insulin dependent diabetes. It is occasionally administered in conjunction with insulin or other medicines. Metformin is not intended to treat type 1 diabetes.

This drug is now regarded as the most recommended anti-diabetic prescription medicine in the world. In 2010, almost 50 million metformin prescriptions were issued in the United States alone.

Metformin may serve other purposes not found in this medication guide.

What to pay attention to before taking metformin


It is important that any medicine you take does not do more harm than good. (Ideally, no harm!) Always let your physician know if you have any allergies to other medications, foods, additives etc, before taking metformin. If you find that you develop an allergic reaction to metformin, stop taking it immediately and consult with your doctor.


If your diabetes is in ketoacidosis state, insulin treatment is necessary.

Former history

It’s important to notify your doctor if you have any liver conditions or heart disease history before you take Metformin.

Lactic acidosis

Lactic acidosis is a dangerous side effect that may occur while taking Metformin. The condition can be life-threatening if symptoms are not remedied in due time. Seek medical attention if you have symptoms such as numbness, dizziness and vomiting, unstable blood pressure, stress, stomach and muscle pains and difficulty breathing.

Metformin and children

Metformin has been proved to be a safe and effective drug in treating children with diabetes as well as adults. However, a consultation with a doctor is always necessary, as well as the right dosage.

Metformin and the elderly

There haven’t been specific studies to determine metformin affects in the geriatric population. However, it is generally believed that metformin is safe for the elderly and can be used just as with any other age group.

Having said that, a large percentage of the elderly population may have kidney, liver and heart issues and that has to be taken into account when metformin is prescribed.

Pregnant women and metformin

Metformin is considered safe for women at any stage of pregnancy and during breastfeeding.


Always pay attention to your doctor’s exact prescription and dosage and follow their advice as to how to take metformin, when and under which conditions. Generally, it is recommended that metformin is taken with food to soften its effect on GI tract and bowels, which can be particularly strong in the first few weeks of meditating. Swallow the tablets whole with some water.

Do not break the tablets. The correct dosage of metformin will be defined by the physician for your particular case after taking into account your health state, your history with other medications, your lifestyle and your health goals. Generally, adults are recommended 500 mg to 1000 mg per day depending on metformin formulation.

Dosage for children is always determined strictly by the doctor.

If I Missed A Dose of Metformin, What Should I Do?

If you missed a dose in medication’s schedule, take it as soon as possible if it’s still a long time until your next dose. However, if it’s almost the time for your next dose, don’t take the missed dose and go on with the standard schedule. Never take two doses of metformin at the same time!

Storing Metformin

The medicine should be kept in a dry place at room temperature. Keep the drug in an airtight bottle. Keep the drug and other medicines beyond children’s and pets’ reach.



Metformin and Hair Loss – Are They Related?

Is Hair Loss a Side Effect of Metformin?

Although Metformin has a few potential side effects, some of which are quite considerable, it is very unlikely that hair loss would be one of them. According to lab tests conducted prior to metformin’s approval as a drug by FDA, hair loss was not found to be a common side effect of metformin.

Hair loss is likely probable to occur in women with Polycystic Ovary Syndrome (PCOS) who are taking Metformin, though it is not caused by taking Metformin but by the disorder itself.

In the case of diabetes, a lot of diabetic patients report minimal to moderate to sometimes severe hair loss, and a lot of them are on metformin. Although that still doesn’t mean that metformin is the direct cause, it can very well be an indirect cause.

When a drug is just being developed, multiple lab experiments are often held to examine its potential adverse effects. However, often it is after it is approved and more and more people take the drug long-term, that it is possible to discover more side effects. 

Thus, it’s not always possible to confidently assert that a specific effect is not caused by a medicine, even though the side effect was not found during the tests.

If you notice a change in your hair growth while on metformin, do consult your doctor. Your medical practitioner will have a few options to offer you depending on how grave your hair loss is. If the symptoms keep bothering you and your doctor confirms that Metformin is at the root, he or she might prescribe you with another medication for your treatment.

Why metformin can cause hair loss

Metformin is known to hinder mineral and nutrient absorption in the human body. It often leads to depletion of various important nutrients, vitamins, and minerals, which by itself can cause a whole range of unpleasant symptoms and conditions. Hair loss may very well be one of them.

Two nutrients, in particular, are very beneficial for maintaining good hair health.

Vitamin D

Vitamin D has been proven to positively affect the growth of hair follicles and support the health of your hair throughout its life. You can be deficient in Vitamin D if you live in a northern climate and do not have a regular sun exposure. In this case, you can supplement vitamin D for better health of your hair.


According to one study, low levels of iron may inhibit an enzyme that is vitally important for hair health. You may have low iron and not be aware of it whether you are on metformin or not. Women are particularly at risk of low iron or even anaemia.

If you are frequently cold, tired, weak, have pale skin and tremor in your limbs, cold hands, and feet, you might be low on iron.  Iron is vitally important for many different functions of your body, not just your hair health. Consult with your doctor.

They might advise you to do some tests to see your iron levels and prescribe you a supplement. If you are on metformin, it is especially important to supplement iron (and other minerals and vitamins) because of the ability of metformin to block proper mineral absorption, even if you get enough iron with your food.

Other vitamins and nutrients that are important for optimal hair health are:

Biotin (Vitamin H)  – a vitamin that helps strengthen the protein structure in the hair
Vitamin A
Vitamin C
Flax Seed Oil
Folic Acid

Some of these you can easily add to your system by supplementing without many risks. (Such as Vitamin A, Vitamin C, Flax Seed and Folic Acid.) With some others, a bit more caution is required. Do not start supplementing Selenium or Zinc without first consulting a professional.

Another possibility is that you are experiencing a so-called psychological hair loss. This is because you might have been stressed out of the past while, dealing with your disease and medications, and adjusting to the new lifestyle. Try not to panic if you notice signs of hair loss.

For one, if it is psychological and stress-related, you won’t lose much hair. The conditions will very likely stabilise in a few weeks. Also, the more you stress, the worse it will be. If you learn to relax and keep stress at bay, you might notice your hair state improve.

Of course, it’s understandable that hair loss can cause a lot of stress by itself, both for male and female patients. If you have been watching your hair for a while and haven’t noticed any improvement, it might be time to consult with your doctor. You don’t want your difficulties with your hair lead to anxiety and lost self-confidence, or worse, depression.

Treatments are available to help deal with hair loss. Whether your original diagnosis was diabetes or PCOS, see your doctor and ask what alternative is best for you in terms of supporting your hair health.

Side Effects of Metformin

Metformin (also known by generic name Glucophage) is an oral hypoglycemic medication used to control high blood sugar. It is used in managing Type II diabetes, in the cases when the body’s high blood sugar levels cannot be properly controlled through exercise, diet and weight management alone. In some cases, patients use Metformin along with other anti-diabetic drugs like glyburide and insulin.

Metformin is the only drug of biguanide type (blood sugar controlling drugs) that has been allowed by US FDA and has been widely used as a to-go medication for Diabetes, as well as some other conditions (such as polycystic ovary syndrome, gestational diabetes, and others).

Metformin helps by reducing the amount of sugar, or glucose that is produced by the liver and also helps release the glucose from the liver into the body. The drug also helps to increase sensitivity to insulin by decreasing blood sugar production, reducing hyperglycemia, reducing triglycerides, improving transport of insulin and helping in weight management. In combination, all those factors lead to much-improved insulin sensitivity, which is especially helpful in cases of insulin resistance.

Another way metformin is helpful to diabetic and pre-diabetic patients is that is has been shown to slow down and reduce the absorption of carbohydrates through intestines, which further helps control blood sugar levels. It also increases the ability of muscles to absorb glucose so that the body can use it more productively. Metformin is particularly useful at keeping night-time glucose levels in check, although it helps maintain the levels all throughout the day as well.

Although metformin is often the go-to drug for diabetics and pre-diabetics, there are things you need to pay attention to when starting medicating with metformin. There are a few metformin side effects that some patients have experienced. Although generally very well-tolerated, different patients’ response to metformin may vary from one individual to another due to differences in body factors.

Most of the metformin side effects are the result of metformin preventing nutrient absorption in the GI tract, which by itself can cause a whole host of symptoms. This is why it is very important to watch your general state on metformin, consult with your doctor if anything is off, and take supplements to support and maintain your overall body health. A lot of metformin side effects can be curbed with proper supplementation as well as good diet.

Abnormal stools

This is one of the most common metformin side effects that a lot of people tend to experience when medicating with metformin. Generally, it is expressed in chronic diarrhea. It is believed to be related to that fact that metformin prevents enterocytes (cells in your digestive tract) from absorbing certain nutrients, particularly carbohydrates, which results in upset GI tract. 53% of the patients medicating with metformin experience diarrhea.

Changes in taste and smell

These common metformin side effects also happen because metformin alters your digestive process and your nutrient absorption. Some foods/products may start tasting and smelling better to you, while others may gain an unfamiliar/unpleasant smell/taste. Patients often report a heightened sense of smell on metformin, as well as metallic taste in the mouth and while consuming certain foods. 1-5% of the patients experience taste and smell disturbances while medicating with metformin.

Lactic Acidosis

Metformin can have an effect on the accumulation of lactates in your system, which results in a lower pH of your body. The symptoms of lactic acidosis may include general weakness, trouble breathing, abdominal pain, diarrhea, vomiting, muscle pain, and tiredness. About 3 out of 100 000 patients suffer from lactic acidosis while medicating with metformin.

The symptoms of lactic acidosis will be exacerbated in patients with excessive alcohol intake, heart issues, kidney issues, liver dysfunction. If you experience severe symptoms of lactic acidosis, it is recommended to stop taking metformin and talk to your physician.

Metformin side effects


Because nutrient absorption is hindered on metformin, you may develop deficiencies in such vital nutrients as Folic Acid, B12, CoQ10 and others, which can lead to tiredness, somnolence and possibly even anaemia. It is very important to keep your nutrients in check while on metformin. Consult with your doctor about supplementation.

Neuropathy (tingling or loss of feeling in limbs)

Metformin prevents vitamin B12 absorption which can cause symptoms of neuropathy such as tingling or loss of feeling in arms or legs. (Vitamin B12 helps support your body’s nervous system).

Memory issues and brain fog

This one is also a result of nutrient deficiency, particularly vitamin B12. Poorer vitamin B12 absorption may lead to loss of memory, difficulty in concentrating, brain fog, tiredness, etc. Some mood changes are also possible, such as moodiness, irritability, depression, anger, agitation and general instability.

To prevent these symptoms, try supplementing vitamin B12 on a regular basis. Dealing with a disease can be a stressful time. But do not discard mood or cognitive issues as it’s just as much an important part of your health as the rest of your body!

Muscle pain

Metformin can hinder COQ10 production in the body. CoQ1O is a coenzyme that is crucially important for muscle health (and energy production). Depriving your body of CoQ10 and other nutrients can cause muscle stiffness, pain, and cramping.

Nausea and vomiting

Metformin causes general GI tract upset and nausea and vomiting is a part of it. Unfortunately, as many as 26% of patients report nausea and vomiting as two of metformin side effects. To help curb nausea, try to take metformin with your largest meal of the day and try to include some protein with that meal.

If you feel like you can’t eat a thing and just really feel too sick, still try to eat something, maybe something small – you will very likely feel better. If you can’t seem to curb the symptoms, talk to your physician. Some patients report better tolerance of Glumetza brand of metformin which is a little more expensive and has a different formulation that is often better tolerated.

Skin and hair issues

Depletion of nutrients such as vitamins B12, B9, B6, Folic Acid, and others may lead to a worsened condition of your hair and nails. Your doctor may recommend the nutrients that are best to supplement to avoid further aggravation of the condition and improve your overall state.

Difficulty breathing 

1-5% of patients experience shortness of breathing on metformin. It is recommended to talk to your physician if you have this symptom.

Flu-like symptoms such as muscle pain, fever, chills, and weakness

All of these can be symptoms of lactic acidosis and it is highly recommended to pause medicating with metformin and address the concern to your doctor if you have these symptoms.

Other metformin side effects may include the following:

Chest discomfort

Heart palpitations

Lightheadedness or dizziness

Nail problems

Feelings of a rapidly or forcefully beating heart (heart palpitations).

Flushing (a skin reddening, commonly on the face)

Increased sweating

Increased thirst

Metformin Side Effects

A few other complications while taking metformin can be:

Signs of allergic reaction, including unexplained skin itching, rash, wheezing, or difficulty in breathing, hives, or unexplained swelling.

Lactic acidosis in patients with kidney problems. Lactic Acidosis can be sudden and severe, especially in patients with kidney issues. Lactic acidosis takes place when there is an increased level of lactic acid in the body of the diabetes patient.

While the drug is used in inhibiting the process of hepatic gluconeogenesis (the process that produces glucose), it also reduces the intake of lactate by the liver.

The problem often arises in individuals with impaired renal functions taking metformin. The drug and lactate will then build up to cause lactic acidosis. Although the incidence is just 10 in every 100,000 people, you should still consult your doctor about using metformin if you have a known kidney condition.

Metformin may cause severe Vitamin B12 deficiency. Around 7 out of 100 patients are likely to experience a largely reduced level of Vitamin B12 while medicating with metformin. Luckily it’s relatively easy to monitor the levels of B12 to know whether or not Vitamin B12 injections would be necessary.

Metformin can also cause impaired kidney and liver functions. This can happen if a patient takes an overly large dose of the drug, which can make it hard for the liver to process it. Kidneys will also be affected. In extreme cases, it is possible for the kidney and liver to fail completely, leading to a lot of complications in the patient. Be very careful about dosage when it comes to metformin.

Metformin is capable of affecting the level of certain hormones in the body, especially in large doses. For instance, an overdose may lead to a reduction in the blood levels of thyroid-stimulating hormones, especially if the individual has a history of suffering from hypothyroidism. It can also cause a reduction of the blood level in testosterone and luteinizing hormones found in men.

Metformin side effects in womenApart from diabetes, metformin is also used to treat (PCOS) or Polycystic ovary syndrome.

According to FDA, metformin is safe for pregnant women. There is no evidence of an increase of human fetal abnormalities as a result of metformin use during gestation. For instance, in women, Metformin has been used to treat non-insulin-dependent diabetes, with no increase in the occurrence of major congenital anomalies.

However, do make sure to consult your physician and/or obstetrician before going on with metformin. It is crucial to receive qualified medical advice which will take into account your general health state, your previous concerns and all the other factors which may play a role in your baby’s successful development.

In the case of infertile women suffering from Polycystic Ovary Syndrome (PCOS), the drug should be used after the doctor has carried out a careful analysis and synthesis of the information obtained from a detailed physical examination, history and the results of series of investigations undergone by the couple.

The type of infertility (primary or secondary) should be taken into account, the duration of infertility, menstrual history (dyspareunia, dysmenorrhoea, discharge), medical and surgical history, sexual history (coital frequency), social history and drug history (smoking, alcohol, occupation).

One of the most common Metformin side effects is weight loss. Metformin can lead to a loss of appetite in patients, thus making the weight loss goal a reality for the patient. (A major goal of diabetic patients is a weight loss since the major symptom of Type II diabetes is excess weight.)

The weight loss aspect of Metformin does not mean that the drug should be taken by everyone who wants to lose a few pounds. The drug will also not be effective if the patient continues consuming foods that cause an increase in blood glucose level since such rapid increase forces the body to create insulin before the drug can have any effect.

If at any point in your journey the side effects of metformin become too much to live with, do consult your doctor to get professional medical help and advice. They might review your dosage and potentially decrease it to curb some of the symptoms. Your doctor may also prescribe you a different formulation of the drug, maybe a slower-releasing for of it, to help stabilise your symptoms.

To help with some of the symptoms, try taking your metformin with a larger meal containing protein. Do not take metformin on an empty stomach. If you take metformin once a day, the best time would be at dinner time as it’s close to the night -time when you can sleep through the worst of the symptoms.

Don’t give up on your medical plan if you need metformin. You will be able to feel better with time when you know more about your individual tolerance and develop your own ways of taking the medication with the best results.

Talk to your doctor about supplements. Metformin does hinder absorption of many vital nutrients in your body, which can lead to a whole host of symptoms that can be hard to deal with. This can be corrected with proper diet and a good supplementation plan.

You will likely have to supplement such nutrients as vitamin B12, B9, CoQ10, and Folic acid. Your doctor will advise you on what else you can do to improve your overall health while tackling your diabetes.

Regardless of the side effects of Metformin, it’s still a widely used, effective and a leading anti-diabetic drug. If you are concerned about these side effects or they became more severe over time make sure to discuss it with your doctor. Also, remember not to lower or increase your Metformin dosage as a result without consulting your doctor first.

This site is not designed to, and does not: provide medical advice, professional diagnosis, opinion, treatment, or services to you or to any other individual. Through this site and links to other sites, Metformin Facts provides general information for educational purposes only.

The information provided in this site, or through links to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call, consultation or the advice of your physician or other healthcare provider. Metformin Facts is not liable or responsible for any advice, course of treatment, diagnosis or any other information, services, or product you obtain through this site.


Metformin and Alcohol – Know The Risks

Risks of consuming alcohol while on Metformin

If you are used to having a glass of wine with your dinner or a can of beer now and again, you might wonder if you can continue with that habit once you are on metformin. The answer is: it depends on the dosage.

Alcohol in moderation is OK to consume for diabetic patients on metformin. One drink a day for women and two drinks a day for men seems to be a safe dosage recommended by specialists.

However, it is not advisable to go over that dosage. There are two potential conditions that are dangerous for diabetic patients that can be associated with consuming too much alcohol on metformin.

Lactic acidosis

One of them is lactic acidosis. Lactic acidosis is when a patient’s body accumulates too much lactic acid which is by itself a rare but grave side effect of metformin. The symptoms of lactic acidosis may include:

abdominal pain
difficulty breathing
decreased appetite
low blood pressure
overall tiredness.
high pulse rate

Lactic acidosis untreated can be very dangerous and even lethal. Alcohol is able to exacerbate accumulation of lactates in the body of patients on metformin, thus causing lactic acidosis. If you find that you have symptoms of lactic acidosis, be sure to consult with your doctor. Remember, it is a dangerous side effect that must not be left unattended.


Another dangerous condition that may arise in patients on metformin taking larger doses of alcohol is hypoglycemia or extremely low blood sugar. Metformin’s main role is to lower blood sugar levels in the patients. Alcohol also has this effect. Taken in combination, these two agents may cause your blood levels to go too low and cause hypoglycemia.

Hypoglycemia may express itself in:

mental fog
extreme hunger
blurred vision
slurred speech

The danger here is that a patient may think those symptoms simply arise from alcohol consumption when it is really their sugar levels being too low that cause the symptoms. If you have such symptoms after having a large dose of alcohol, be sure to check your blood sugar levels.

Often blood sugar level can be corrected at home by using glucose supplements or simply eating something that has sugar in it. Severe symptoms of hypoglycemia include loss of consciousness. If you or anyone else is experiencing strong signs of hypoglycemia and can’t correct them at home, call 9-11 immediately.

How to drink alcohol safely with diabetes

Here are some precautions related to drinking alcohol with diabetes (while on metformin medication).

Don’t drink on an empty stomach. Always have something to eat first. This will help ensure your blood sugar levels don’t go too low.

Stop consuming alcohol immediately if you notice that your blood sugar levels are low.

Drink water. It’s important to stay hydrated. Enough water will help curb alcohol’s effect on your blood sugar.

Eat after you consume alcohol as well.


Disclaimer of Medical Liability

This site is not designed to, and does not: provide medical advice, professional diagnosis, opinion, treatment, or services to you or to any other individual. Through this site and links to other sites, Metformin Facts provides general information for educational purposes only.

The information provided in this site, or through links to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call, consultation or the advice of your physician or another healthcare provider. Metformin Facts is not liable or responsible for any advice, course of treatment, diagnosis or any other information, services, or product you obtain through this site.


Metformin and Vitamin B12 Deficiency

Metformin and Vitamin b12 connection

At present, there is an increasing concern about the risk of developing vitamin B12 deficiency among patients who are taking Metformin. Cobalamin and cyanocobalamin are the other names of vitamin B12 that plays significant roles in the human body like maintaining the health of your blood cells and your nervous system.

Studies show that vitamin B12 can aid in the prevention of such conditions as heart disease, dementia, Alzheimer’s and a range of other diseases. Vitamin B12 is mainly obtained from animal products like beef, eggs, seafood and dairy products; hence, vegetarians are at a higher risk of suffering from vitamin B12 deficiency.

Often, older people are also at a risk of b12 deficiency due to the absorption problems in the gastrointestinal tract.

Anemia, memory loss, neuropathy, confusion, mood disorders, mental fog, and dementia are some of the symptoms of the lack of B12.

Along with insulin and other anti-diabetic medications, Metformin is usually the first drug to be used for patients newly diagnosed with diabetes. If you have diabetes and are taking a daily dose of Metformin, make sure to check your Vitamin B12 levels.

Because metformin hinders absorption of nutrients in the GI tract, there is a definite association of taking metformin with the risk of Vitamin B12 deficiency. A contributing factor is calcium malabsorption. Studies show that taking supplemental calcium can help in reducing the induced malabsorption of B12.

However, this doesn’t mean that you should quit taking your Metformin, unless your vitamin B12 deficiency is severe, and not without consulting your doctor first.

Metformin does an excellent job when it comes to managing type 2 diabetes and the safety record of this medication is great. It’s just that, when taking Metformin, it is suggested that you have your B12 or cobalamin level checked annually. If you have a low B12 level you should consult your physician about B12 supplementation.

It is usually very helpful to take a quality supplement (taken either orally or in the form of injections). You may also consider taking a B-complex (B100). This supplement complex may include all the needed B vitamins such as B1, B2, B3, and B6 (Pyridoxine) which are required for good absorption of vitamin B12.

A quality B-complex supplement should also contain folic acid.

If your health care provider suggests calcium supplementation in addition to B12, try to find a brand that uses certified pure or quality coral calcium. Certified pure suggests that the calcium is derived from coral using best methods preserving all important qualities of the mineral as well as protecting from the danger of heavy metals including mercury, lead, and aluminium.

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Metformin For The Treatment of PCOS

PCOS overview

PCOS, or Polycystic ovary syndrome, is a condition that arises in between 5% and 10% of women of childbearing age as a result of an imbalance in reproductive hormones. Women in PCOS have highly elevated levels of male reproductive hormones (androgens).  Polycystic ovaries develop as a result of being stimulated by too many androgens, especially testosterone.  The cause of PCOS is unknown, although it is believed it has a hereditary component. There seem to be two main driving forces behind the development of PCOS – high level of male hormones (androgens) and high level of insulin.

PCOS Symptoms

The symptoms of PCOS include irregularities in the menstrual cycle (no periods, or very heavy periods), excess facial hair, excess body hair, areas of darkened skin, pelvic pain, difficulty getting pregnant or infertility. Some other conditions are also associated with PCOS. For example, half of the women with PCOS is estimated to get diabetes or pre-diabetes by age forty. PCOS – affected women sometimes also tend to have high blood pressure, high levels of bad cholesterol, sleep apnea, endometrial cancer and some other conditions.

PCOS, Metformin, and Diabetes 

PCOS and diabetes are often connected because, as stated above, around 50% of women with PCOS will also have diabetes at a certain point in their lives. Apart from this connection, women with PCOS are often treated with metformin, the same drug that is used to treat type 2 diabetes, to manage their PCOS and increase their fertility. Studies have found that one of the reasons behind PCOS is insulin resistance. Insulin resistance leads to the compensatorily increased production of insulin by the pancreas, which, in its turn, leads to the increase in the levels of male hormones (androgens) in the body. The increase of androgens is the main cause of PCOS. This is the link that connects Insulin Resistance and PCOS, and this is why metformin is often used to help treat PCOS.

Studies that looked at patients with PCOS taking metformin have observed significant improvement in menstrual cycle regularity and reduction in androgen levels as well as a significant reduction in body weight of the subjects. In real life treatment, metformin, particularly Glucophage, has been proven to be very effective in treating PCOS and increasing female fertility, by the mechanisms of reducing insulin resistance, helping control blood sugar levels in the body and decreasing the amount of androgens in the system. This in its turn helps reduce the number of cysts and prevent the development of new ones. Metformin has also been proved to help induce ovulation in women with PCOS struggling with fertility.

If you are suffering from PCOS, your doctor may also prescribe other medications such as fertility treatment drugs such as Clomid. Since there is an association between PCOS and insulin resistance, lifestyle modifications should include exercise and monitoring caloric consumption to maintain proper blood sugar levels.

Miscarriage risks and metformin

Women suffering from PCOS have been shown to have a much higher risk of miscarriage than women that don’t (three times as high for women with PCOS as opposed to healthy women). In many cases, this can be connected to the prevalence of obesity in PCOS women. However, that has not been sufficiently researched. Metformin has been shown to have a positive impact on reducing risks of miscarriage for women with PCOS.

Gestational diabetes and metformin

Women that have PCOS also have a higher chance of developing gestational diabetes during their pregnancy. The reverse is also true: women with a history of gestational diabetes have as much as 40% chance to develop PCOS at some point in their lives.  Gestational diabetes is not only bad for the mother. It can also negatively affect the fetus and cause abnormalities, developmental issues, and even death. Medicating with metformin throughout pregnancy has been shown to greatly reduce the risk of PCOS women developing gestational diabetes, thus greatly improving their chances to carry the pregnancy to term and have a healthy child.

Other health issues you may need to know about if you are diagnosed with PCOS

*More than half of women suffering from PCOS will get diabetes.

*A woman affected by PCOS will have 4-7 times greater chance of experiencing a heart attack compared to one of the same age who doesn’t have PCOS.

*A woman who is suffering from PCOS is at higher risk for high blood pressure.

Metformin has been shown to be very effective in a whole range of conditions related to insulin resistance and Polycystic ovary syndrome. However, the long-term use of metformin to treat PCOS has not been studied extensively. Follow your doctor’s advice about how long you should use metformin and in what dosage. Although metformin has shown some great results, it is still not a replacement for a healthy lifestyle, including physical activity and well-balanced diet. If you are suffering from PCOS or having troubles with fertility, please consult your doctor to develop a program you can follow to maintain an overall healthy lifestyle. Exercising and healthy diet should be an important part of any medical treatment.

If you are suffering from diabetes-related neuropathy, please check out this Guide by Dr. Randall C. Labrum, Clinician, Researcher and Author. It has helped a lot of people end chronic peripheral neuropathy and regain health and well-being.

“I get so excited every time I have the opportunity to help someone with a chronic unresolved health problem. The ability to provide my expertise and experience in resolving these conditions creates a feeling of satisfaction like nothing else.”
Dr. Randall C. Labrum, Clinician, Researcher and Author