#metformin #primarycare #diabetes #b12 #neuropathy

Metformin is one of the most effective and widely used medications for insulin resistance and type 2 diabetes.

But one important, often overlooked effect: ➡️ It can lower vitamin B12 levels over time

Metformin appears to interfere with vitamin B12 absorption in the small intestine (terminal ileum) through:

Low B12 can cause:
✅Peripheral neuropathy (numbness, tingling, burning)
✅Fatigue
✅Cognitive changes
✅Macrocytic anemia

In patients on metformin with symptoms or long-term use, start with:
✅Vitamin B12 level
✅Methylmalonic acid (MMA)
✅CBC (look for macrocytosis)
✅Folate level (if anemia present)

➡️➡️➡️The American Diabetes Association recommends periodic B12 monitoring in patients on metformin

❎If a patient on metformin develops neuropathy symptoms…
➡️ Don’t assume it’s just diabetes
➡️ Check B12 — it may be treatable

#metformin #primarycare #diabetes #b12 #neuropathy

Видео #metformin #primarycare #diabetes #b12 #neuropathy канала ElsieOseiMD