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|Articles|August 4, 2021
Pharmacy Clinical Pearl of the Day: Long-Term Metformin Use and Vitamin B12 Deficiency
Author(s)Saro Arakelians, PharmD
Patients on metformin should check their vitamin B12 levels on regular basis to make sure it is at normal range.
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Clinical Pearl of the Day:
Long term use of metformin can cause vitamin B12 deficiency.
Explanation:
- The mechanism by which metformin reduces the vitamin B12 levels is still unknown, but the most likely hypothesis is that metformin interferes with the calcium-dependent membrane action responsible for vitamin B12 intrinsic factor absorption, which occurs in the terminal ileum.
- Patients on metformin should check their B12 levels on regular basis, possibly annually, to make sure it is within a normal range.
- The normal level of vitamin B12 in the bloodstream is generally between 190 and 950 picograms per milliliter (pg/ml)
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