Type 2 Diabetes and Vitamin B12 Deficiency- Are you at Risk?

If you have type 2 diabetes, your chances of developing vitamin B12 deficiency are greater than those of non-diabetics. That’s because metformin, a popular drug for diabetes interferes with vitamin B12 absorption, causing severe B12 deficiency. Other causes for vitamin B12 deficiency include pernicious anemia, bariatric surgery, and gastrointestinal disorders.

Vitamin B12- Cobalamin

Vitamin B12 is a water-soluble nutrient that occurs naturally in protein-based foods, including beef, chicken, fish, eggs, milk, and cheese. It is one of a group of B vitamins (B complex). Vitamin B12 performs many crucial functions for your body:

Vitamin B12 aids in producing red blood cells
Vitamin B12 protects your nervous system
Vitamin B12 is required for DNA synthesis
Vitamin B12 lowers homocysteine levels, thus reducing your risk for heart attack and stroke
Vitamin B12 helps your body convert fat to energy

Metformin- its effect on B12 levels

Metformin, a hypoglycemic drug for treating type 2 diabetes, interferes with your body’s ability to digest vitamin B12. According to numerous studies, up to 30% of diabetics who take metformin suffer the effects of vitamin B12 deficiency. Researchers believe that metformin may hinder the production of intrinsic factor, a protein your body uses to grab vitamin B12 from food sources and absorb it into the bloodstream. Other suggestions for metformin’s link with B12 deficiency include possible bacterial overgrowth and hindered movement of the small intestines.

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How much vitamin B12 do you need?

The Recommended Dietary Allowance (RDA) for vitamin B12 varies by age, and applies to healthy individuals:

Infants: .4 mcg to .5 mcg
Toddlers: .9 mcg
Children, 4-8 yrs. of age: 1.2 mcg
Children, 9-13 yrs. of age: 1.8 mcg
Adult males: 2.4 mcg
Adult females (not pregnant or lactating): 2.4 mcg
Pregnant females: 2.6 mcg
Lactating females: 2.8 mcg

Diabetics, Take Heed

For people who diagnosed with chronic illness, the recommended dose of vitamin B12 is much higher. People who need more than the RDA of vitamin B12 include:

Elderly individuals
People with pernicious anemia
People taking proton pump inhibitors for acid reflux or stomach ulcers
People with gastrointestinal disorders like Crohn’s disease or Celiac disease
Diabetics taking metformin

Diabetics need even more B12

According to a recent 7-year survey, type 2 diabetics taking metformin need higher doses of vitamin B12 than originally believed, stating that the current RDA for 2.5 mcg is not sufficient for preventing vitamin B12 deficiency symptoms.

Of the survey participants who took metformin for type 2 diabetes, 5.8% had vitamin B12 deficiency- low B12 levels in the blood.
Only 2.4% of diabetics not taking metformin had low levels of vitamin B12.
About 3.3% of test subjects who did not have diabetes showed signs of vitamin B12 deficiency.
For diabetics, taking oral vitamin B12 supplements did not affect B12 levels, nor did it reduce the symptoms of vitamin B12 deficiency.
When intestinal disorders interfere with B12 absorption, the only other method for supplementing vitamin B12 is directly through the bloodstream.

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Do you have vitamin B12 deficiency?

Vitamin B12 deficiency is diagnosed through blood testing. However, many of the signs of B12 deficiency may be masked by other prevailing ailments, so it’s important to know the symptoms.

Symptoms of vitamin B12 deficiency include:

Chronic fatigue
Depression
Memory loss
Anxiety
Hallucinations
Aggressive behavior
Mental confusion, “brain fog”
Difficulty concentrating
Painful numbness in hand and feet, “tingling” sensations
Poor motor coordination
Clumsiness, stumbling
Sore tongue
Altered taste perception
Eye twitches

Untreated, vitamin B12 deficiency could result in severe nerve damage, early-onset dementia, increased risk for heart attack and stroke, cancer, and death.