Antidiabetic medications - biguanides

Biguanide antidiabetics include:

Metformin (Fortamet, Glumetza, Riomet, Glucophage, and Glucophage XR)

Depletions

Taking metformin may deplete vitamin B9 and vitamin B12.

Vitamin B9 (Folic Acid)

Low levels of folic acid in the body may be linked to:

Anemia
Heart disease
Birth defects

Symptoms may include:

Weakness
Mouth sores
Swollen tongue
Depression
Poor growth

Vitamin B12 (Cobalamin)

Low levels of vitamin B12 may cause any of the following symptoms:

Irritability
Weakness
Numbness
Anemia
Loss of appetite
Headache
Personality changes
Confusion

Low levels of vitamin B12 may increase the risk of heart diseases.

Editorial Note

The information presented here covers some of the nutrients that may be affected when you take certain medicines. If you have any of these signs and symptoms, it does not always mean you have low levels of these nutrients.

Factors that affect the level of nutrients are:

Your medical history
Diet
Lifestyle
How long you have been taking the medicine

Please talk to your health care provider. They can best address your health care needs and see if you are at risk for low levels of any nutrients.

Supporting Research

Dominiczak MH, Broom JI. Vitamins and minerals. In: Baynes JW, Dominiczak MH, eds. Medical Biochemistry. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 11.

Gold Standard Drug Database: Drug Monograph: Metformin, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-379. Accessed July 7, 2016.

Greenbaum LA. Vitamin K deficiency. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 53.

National Institute of Health. Vitamin B12; Fact Sheet for Consumers. ods.od.nih.gov/factsheets/VitaminB12-Consumer. Updated June 24, 2011. Accessed May 19, 2016.

Shenkin A, Roberts NB. Vitamins and trace elements. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 5th ed. St Louis, MO: Elsevier Saunders; 2012:chap 31.

The Basics

Advanced Study

Review Date: 9/19/2016

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. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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