How much B12 should a diabetic take?
Some experts believe that adults with type 2 diabetes and over the age of 50 should take 2.4 mg of vitamin B12 daily, either through a synthetic supplement or through fortified foods. ... People with low levels of potassium should take vitamin B12 supplementation with caution because as soon as the deficiency of B12 is corrected, potassium can ...
What does it mean when your blood test shows high B12 levels?
High vitamin B12 is a symptom of an underlying illness that causes the amount in your blood to increase. For example, a damaged liver may release the vitamin out of storage and into the blood. In early stages, illnesses associated with high vitamin B12 often have generic symptoms, such as fatigue and loss of appetite.
What does high B12 blood levels really mean?
- Liver disease due to release of B12 from damaged liver cells into the bloodstream
- Kidney disease due to impaired function of the kidneys to excrete excess B12
- Increased levels of transcobalamin, which is a transporter of B12 in the bloodstream
- Inflammatory conditions: rheumatoid arthritis, lupus
Will B12 raise blood sugar?
Vitamin B12 is important for the proper functioning of nerve cells and blood cells. It also plays an integral part in the synthesis of DNA and promotes the ability of your digestive system to maintain steady glucose blood levels. You get vitamin B12 naturally in foods such as beef, fish, milk, eggs, meats and poultry.
How much B12 should a diabetic take?
In the US, it is currently believed that adults with type 2 diabetes that are over 50 should take 2.4 µg of synthetic vitamin B12 daily either in supplement form or in fortified food.
Can B12 affect blood sugar?
Vitamin B-12 and Hypoglycemia Vitamin B-12 deficiency can therefore cause low glucose levels. One of the main symptoms of hypoglcemia is fatigue and vitamin B-12 supplements are widely used to treat severe fatigue. The supplements increase energy by helping the body convert food into glucose.
Is it OK to take B12 with metformin?
But in some cases, metformin can cause vitamin B12 deficiency. Your healthcare provider should monitor your vitamin B12 levels if you are taking metformin. You don't always need to take a vitamin B12 supplement if you're taking metformin.
How much B12 should a diabetic on metformin take?
All individuals age 14 or higher need 2.4 mcg B12 daily. Women who are pregnant or nursing will need slightly more. Mandatory supplementation with B12 has now been proposed for those taking metformin. Taking a daily multivitamin containing 100% of the daily value (DV) for vitamin B12 will do the trick.
Which vitamins should a diabetic take?
What are the best vitamins for people with diabetes?Thiamin (b1) Those with type 1 or type 2 diabetes are more likely to have lower blood levels of thiamin and usually suffer a higher risk of thiamin deficiency than people who don't have diabetes. ... Vitamin B12. ... Vitamin D. ... Magnesium. ... Vitamin E. ... Vitamin C.
Is B12 shots good for diabetics?
Treatment with B12 injections or supplements would help in reducing risk of low B12 and HHcy-related symptoms. Such practice would reduce pain and suffering of diabetic patients. It would also decrease medical cost associated with treatments of diabetic co-morbidities.
What are symptoms of low B-12?
Symptoms of vitamin B12 deficiencya pale yellow tinge to your skin.a sore and red tongue (glossitis)mouth ulcers.pins and needles (paraesthesia)changes in the way that you walk and move around.disturbed vision.irritability.depression.More items...
What vitamins should not be taken with metformin?
No interactions were found between metformin and Vitamins.
Can taking metformin cause B12 deficiency?
It has been reported that an average of 6% to 30% of patients could show vitamin B12 deficiency due to metformin use. In addition, some studies have reported that serum vitamin B12 levels were inversely related to the duration and dose of metformin use.
Is it OK to take 1000 mcg of B12 a day?
There is no risk of an overdose when taking large amounts of vitamin B-12 such as 1000 mcg, because it is a water-soluble vitamin. Meaning the body will use the amount that it needs then the excess will be excreted through urine.
Can you take too much B12?
Since B12 is a water-soluble vitamin, it's generally considered safe, even at high doses. No Tolerable Upper Intake Level (UL) has been established for B12, due to its low level of toxicity. UL refers to the maximum daily dose of a vitamin unlikely to cause adverse side effects in the general population.
Is B complex good for diabetics?
Diabetic patients are recommended by healthcare providers to take B complex tables for improved functioning of their bodies. The most recommended dose of B complex may contain 1.5 mg of B1, 25 mg of B2, 75 mg of B6, 150 mcg of B12, 2.5 mg of folic acid, as well as 300 mcg of biotin.
Does vitamin B affect blood sugar?
Possible side effects of B-vitamin may include high blood glucose. High doses of nicotinic acid, a synthetic form of vitamin B-3 are seen to be associated with high blood sugar levels.
Do B vitamins raise blood sugar?
Vitamin B3 or Niacin, taken to reduce bad cholesterol, increases insulin resistance and raises blood sugar levels.
Can low B12 cause high A1c?
Based on the study results by Pendela et al., treatment of iron deficiency and or vitamin B12 deficiency anemia can significantly elevate or reduce a patient's A1c level.
Can low B12 cause insulin resistance?
The study reveals that vitamin D, B12, and folic acid levels were low and poor vitamin D and B12 status were associated with insulin resistance in nondiabetic obese patients.
Why do you need a blood test for B12?
Since diabetes puts you at risk for a deficiency of vitamin B12, you also need regular blood tests to monitor your B12 blood level. If you are deficient, your doctor might recommend certain steps to increase your B12 levels because maintenance of proper B12 levels is vital to your health.
What to do if you have a vitamin B12 deficiency?
Correcting B12 Deficiency. If you have diabetes and develop a vitamin B12 deficiency, your doctor might recommend an oral B12 supplement. If that is not effective because of a medical condition or because of a medication you are taking, your doctor could administer a B12 injection.
How does B12 affect the body?
Vitamin B12 taken orally must form a complex with a stomach protein called intrinsic factor before it can enter the bloodstream, where it exerts its beneficial biological effects. The B12-intrinsic factor complex enters the bloodstream from the small intestine. If you have type 1 diabetes, you may have a B12 deficiency called pernicious anemia, because your immune system attacks the intrinsic factor protein. If you have type 2 diabetes and are taking metformin, the most widely prescribed type 2 drug, you may experience B12 deficiency at some point. This is because metformin interferes with the absorption of the B12-intrinsic factor complex from the small intestine.
What is the role of B12 in the body?
Vitamin B12 is important for the proper functioning of nerve cells and blood cells. It also plays an integral part in the synthesis of DNA and promotes the ability of your digestive system to maintain steady glucose blood levels.
What is the hallmark symptom of diabetes?
By Robert DiPardo Updated December 09, 2018. The hallmark symptom of diabetes is chronically high glucose levels in the blood. If you have diabetes, you must control and constantly monitor your glucose levels.
What happens if you are deficient in B12?
Effects of Deficiency. If you are deficient in vitamin B12, you may experience fatigue, weakness, constipation, loss of weight, loss of appetite or megaloblastic anemia, a condition characterized by enlarged red blood cells. You also might incur nerve damage that shows as numbness or tingling in your hands and feet.
Can B12 deficiency cause numbness?
You also might incur nerve damage that shows as numbness or tingling in your hands and feet. This damage may become permanent if you don't address the B12 deficiency. Other deficiency symptoms include memory lapses, depression, confusion, difficulty balancing and a sore mouth or tongue.
How to get B12?
Vitamin B12 is necessary for a healthy nervous system and healthy blood cells. The best way to get vitamin B12 is through your diet. This important vitamin is found in meat, fish, poultry, and dairy products. If you don’t eat enough of these foods, it could leave you with a deficiency. Consuming enough vitamin B12 isn’t the only problem. Your body also needs to be able to absorb it efficiently. Some medications like Pepcid AC, Prevacid, Prilosec, and Zantac, as well as others used to treat acid reflux, peptic ulcer disease, and infection, may make it harder for your body to absorb B12. Another medication that may interfere with B12 absorption is metformin, a common type 2 diabetes treatment. Simply having diabetes may make you more prone to B12 deficiency. A 2009 study found that 22 percent of people with type 2 diabetes were low in B12. Read on to learn the symptoms of B12 deficiency, what it could mean for your overall health, and what you can do about it. Symptoms of vitamin B12 deficiency may be mild at first, and not always obvious. If you’re slightly low on B12, you may not have any symptoms at all. Some of the more common early symptoms are: tiredness weakness loss of appetite weight loss constipation It may be easy to dismiss these as minor complaints, but over time, insufficient B12 can lead to bigger problems. Very low levels of B12 can result in serious complications. One of these is called pernicious anemia. Anemia means you don’t have enough healthy red blood cells. This deprives your cells of much-needed oxygen. According to a study in the Journal of Oral Pathology Medicine, less than 20 percent of those with a B12 deficiency experience pernicious anemia. Symptoms of anemia include: fatigue pale skin chest pain dizziness headache You may even lose Continue reading >>
What is the role of vitamin B12 in the body?
Go to: Introduction Vitamin B12 or cobalamin is a water soluble vitamin that plays a very fundamental role in DNA synthesis, optimal haemopoesis and neurological function. The clinical picture of vitamin B12 deficiency hence, is predominantly of features of haematological and neuro-cognitive dysfunction [1]. This review will mainly discuss the physiological roles of vitamin B12, the varied pathophysiological mechanisms of vitamin B12 deficiency among patients with type 1 and 2 diabetes mellitus (DM) and perspectives on screening for vitamin B12 deficiency and supplementation of vitamin B12 among diabetic patients. Absorption of vitamin B12 The principal source of vitamin B12 is animal proteins. The preliminary step in the metabolism of vitamin B12 involves its release from animal sources, a process mediated by the action of pepsin and gastric acid. After the release, dietary vitamin B12 binds to the R-protein secreted by the salivary glands. In the duodenum, in the presence of an alkaline medium and pancreatic proteases, the R- protein is hydrolysed to release vitamin B12 which later binds with the intrinsic factor (IF) secreted by the gastric parietal cells. The vitamin B12 –IF complex is highly resistant to proteolytic degradation. The complex attaches at its specific receptors on the mucosa of the terminal ileum, a site where its absorption occurs. This stage of vitamin B12 absorption is calcium mediated. The intracellular vitamin B12 is released following IF degradation. This free vitamin B12 attaches to another protein carrier, transcobalamin –II (TC-II) and is later released into the circulation. This vitamin B12 – TC-II complex, also referred to as holo TC-II is then actively taken up by the liver, bone marrow and other vital body cells. The liver serves as Continue reading >>
Should Patients Taking Metformin Also Take Vitamin B12?
Should Patients Taking Metformin Also Take Vitamin B12? Should I recommend vitamin B12 to patients taking metformin ? Response from Gayle Nicholas Scott, PharmD Assistant Professor, Eastern Virginia Medical School, Norfolk, Virginia; Clinical Pharmacist, Chesapeake Regional Medical Center, Chesapeake, Virginia Metformin is a first-line type 2 diabetes treatment that effectively lowers blood glucose and has a good long-term safety record. (It has been available in the United Kingdom since 1958 and the United States since 1995). [ 1 ] Metformin also offers the important advantage over most other antihyperglycemic drugs of improved cardiovascular morbidity and mortality risk. [ 2 ] Beyond monitoring renal and hepatic function and avoiding concomitant drugs that interfere with renal tubular secretion (eg, cimetidine), metformin use has become rather mundane. A sometimes forgotten disadvantage of metformin is its effect on vitamin B12 absorption. Although the liability of metformin to lower vitamin B12 levels has been well described, [ 3 ] interest in the need for monitoring for vitamin B12 deficiency is more recent. [ 1 , 4 , 5 , 6 ] Vitamin B12 deficiency is estimated to be present in up to 30% of patients with diabetes taking metformin. [ 1 ] The risk for vitamin B12 deficiency increases with patient age and the dose and duration of metformin use. [ 5 , 7 ] Concomitant conditions such as suboptimal dietary intake, which is common among vegetarians and alcohol abusers, and malabsorption due to atrophic gastritis, pernicious anemia, chronic pancreatitis, and celiac disease may further increase risk for vitamin B12 deficiency. [ 5 ] The combination of metformin with proton pump inhibitors has been reported to have an additive effect on risk for vitamin B12 deficiency. [ 8 ] Vitamin Continue reading >>
Can Diabetics Take B12?
Since diabetes puts you at risk for a deficiency of vitamin B12, you also need regular blood tests to monitor your B12 blood level. If you are deficient, your doctor might recommend certain steps to increase your B12 levels because maintenance of proper B12 levels is vital to your health. Vitamin B12 Vitamin B12 is important for the proper functioning of nerve cells and blood cells. It also plays an integral part in the synthesis of DNA and promotes the ability of your digestive system to maintain steady glucose blood levels. You get vitamin B12 naturally in foods such as beef, fish, milk, eggs, meats and poultry. Some breakfast cereals are fortified with vitamin B12 during the manufacturing process. Effects of Deficiency If you are deficient in vitamin B12, you may experience fatigue, weakness, constipation, loss of weight, loss of appetite or megaloblastic anemia, a condition characterized by enlarged red blood cells. You also might incur nerve damage that shows as numbness or tingling in your hands and feet. This damage may become permanent if you don't address the B12 deficiency. Other deficiency symptoms include memory lapses, depression, confusion, difficulty balancing and a sore mouth or tongue. Diabetes and B12 Vitamin B12 taken orally must form a complex with a stomach protein called intrinsic factor before it can enter the bloodstream, where it exerts its beneficial biological effects. The B12-intrinsic factor complex enters the bloodstream from the small intestine. If you have type 1 diabetes, you may have a B12 deficiency called pernicious anemia, because your immune system attacks the intrinsic Continue reading >>
Is Vitamin B12 Good For Diabetics?
Cale holds a Bachelor of Arts in English from the University of Windsor and advanced writing certificates from the Canadian Film Centre and the National Theatre School of Canada. Clams are an excellent source of vitamin B12. Vitamin B12 might be good for diabetics for several reasons. Recent research has shown that vitamin B12 might help mitigate some of the most common complications associated with long-term diabetes, including diabetic retinopathy and diabetic neuropathy. Some diabetic medications, including metformin, might also cause vitamin B12 deficiency, so supplementation might benefit diabetics. Speak to your doctor or health care practitioner about vitamin B12 if you are diabetic or at risk of becoming diabetic. Vitamin B12 is an integral component of homocysteine metabolism. Homocysteine is an amino acid, and without enough vitamin B12, blood levels of homocysteine rise. High levels of homocysteine have been linked to diabetic retinopathy, a complication that causes damage to the blood vessels in the eye. A 2008 study conducted by Australian researchers and published in the journal Diabetes Care examined 168 type 2 diabetics of both genders and found higher levels of homocysteine in those with retinopathy. Vitamin B12 might also be good for diabetics with neuropathy painful nerve damage that often afflicts diabetics in their legs and feet. According to researcher Y. Henry Sun of the Institute of Molecular Biology at the Academia Sinica in Taiwan, vitamin B12 has shown some effectiveness in minimizing several symptoms associated with diabetic neuropathy, including pain, numbness, prickling and tingling. Vitamin B12 might also be g Continue reading >>
How to control blood sugar in diabetics?
Eating a varied diet rich in natural sources of vitamins is a good idea for diabetics. Nutritional support is critical for diabetics because diabetes tends to drain nutrients. When levels of glucose are high in the blood, the body tries to ‘wash’ the excess sugar out. This is why diabetics need to use the washroom frequently. Unfortunately, diabetics also lose nutrients via their urine. Research studies show that diabetics are repeatedly found to be deficient in important water-soluble vitamins and minerals. What’s more, the loss of these vitamins worsens the body’s ability to manage blood sugar, creating a vicious cycle. Combining a healthy diabetes diet plan and a daily exercise routine with the best vitamin supplements for diabetics goes a long way in achieving stable blood sugar levels. What Vitamins Are Diabetics Deficient In? The term vitamin is short for “Vital Amino Acid”. This means that these are vital for the proper functioning of hundreds of chemical processes in the body which the body cannot manage by itself. Proper blood sugar control is one such function for which vitamins are critical. There are 13 essential vitamins that the human body requires and they must be obtained from an external source — through food and/or supplements. Diabetics need two kinds of vitamins: Water Soluble – Vitamins B1, B2, B3, B6, B12, C, Biotin, and Folate are water-soluble and cannot be stored in the body for longer periods of time. Diabetics are often deficient in these vitamins since they pass greater amounts of urine daily. As their body tries to get rid of extra sugar, diabetics lose more water-soluble vitamins than most others. That’s why diabetics need to to get these vitamins daily in doses larger than what normal people need. Luckily, you can get all Continue reading >>
Is It Safe To Take Supplements If You Have Diabetes?
According to CDC, use of supplements is common among US adult population – over 50% adults used supplements during 2003-2006, with multivitamins/multiminerals being the most commonly used. So when you are a diabetic, especially if you have prediabetes and type-2 diabetes, you may find yourself confronting a large number of options for supplements that claim to support, reduce and even cure your diabetes. Diabetes is quite a frustrating disorder and you may find yourself tempted to try out these supplements one after another. But is it really safe to take supplements when you are a diabetic? Let us find out. But before that you need to understand what exactly supplements are. Defining Supplements As the name suggests, a supplement is anything that adds on to something. A dietary supplement is therefore something that one takes in addition to one’s diet to get proper nutrition. US Congress in the Dietary Supplement Health and Education Act defines dietary supplements as having the following characteristics: It is a product that is intended to supplement the diet; It contains one or more dietary ingredients (including vitamins, minerals, herbs and other botanicals, amino acids, and other substances) or their constituents; It is intended to be taken by mouth as a pill, capsule, tablet, or liquid; It is not represented for use as a conventional food or as sole item of a mean or a diet; and, It is labeled on the front panel as being a dietary supplement. Now let us look at some general benefits and risks of taking supplements. We will discuss these in context of diabetes later in the article. Benefit Continue reading >>
What is the importance of vitamin B12?
Vitamin B12 is an essential micronutrient required for optimal hemopoetic, neuro-cognitive and cardiovascular function. Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus.
What happens if you don't take B12?
Metabolically significant vitamin B12 deficiency hence will result in disruption of the methylation process and accumulation of intracellular and serum homocysteine. Hyperhomocysteinemia has been shown to have potentially toxic effects on neurones and the vascular endothelium. This reaction is also essential in the conversion of dietary folate (methyl-tetrahydrofolate) to its active metabolic form, tetrahydrofolate. In another essential enzymatic pathway, vitamin B12 as a co-factor mediates the conversion of methylmalonyl coenzyme A (CoA) to succinyl-CoA. In the presence of vitamin B12 deficiency, this conversion pathway is diminished and an increase in the serum methylmalonic acid (MMA) ensues. This is followed by defective fatty acid synthesis of the neuronal membranes [3]. Vitamin B12 is also essential in the synthesis of monoamines or neurotransmitters like serotonin and dopamine [4]. This synthesis is impaired with vitamin B12 deficiency.
What is the role of vitamin B12 in the salivary gland?
After the release, dietary vitamin B12 binds to the R-protein secreted by the salivary glands. In the duodenum, in the presence of an alkaline medium and pancreatic proteases, the R- protein is hydrolysed to release vitamin B12 which later binds with the intrinsic factor (IF) secreted by the gastric parietal cells.
How does B12 affect the body?
Vitamin B12 exerts its physiological effects through mediating two principal enzymatic pathways i. e. the methylation process of homocysteine to methionine and the conversion of methylmalonyl coenzyme A (CoA) to succinyl-CoA. Vitamin B12 as a co-factor facilitates the methylation of homocysteine to methionine which is later activated into S-adenosyl-methionine that donates its methyl group to methyl acceptors such as myelin, neurotransmitters and membrane phospholipids.
What is the role of B12 in DNA synthesis?
Vitamin B12 or cobalamin is a water soluble vitamin that plays a very fundamental role in DNA synthesis, optimal haemopoesis and neurological function. The clinical picture of vitamin B12 deficiency hence, is predominantly of features of haematological and neuro-cognitive dysfunction [1].
Why is B12 deficiency common in autoimmune patients?
Vitamin B12 deficiency among patients with autoimmune hypothyroidism could be explained by the presence of antibodies to the gastric parietal cells and intrinsic factor , reduced oral intake, dyserythropoesis due to thyroid hormone deficiency and defective absorption due to reduced bowel motility, bowel wall oedema and bacterial overgrowth [40].
When does vitamin B12 deficiency manifest?
Clinically overt features of vitamin B12 deficiency manifest by 5–10 years owing to the large body stores in the liver mainly that are not quickly depleted [28].
How do people with diabetes become deficient in vitamin B12?
This increase the likelihood of B12 deficiency as vitamin B12 is not protected as it passes through the gut.
What is vitamin B12?
Vitamin B12, also called cobalamin, is a water-soluble vitamin. It works closely with folate, another B vitamin, and they depend on each other for activation, so they can carry out their necessary functions in the body.
What causes inadequate consumption of vitamin B12?
Inadequate consumption of vitamin B12 is often due to dietary choices, for example vegans and vegetarians. People who are vegan are more likely to become deficient in vitamin B12 as they consume no animal products. People who are vegetarian consume no meat but may consume other vitamin B12 containing animal products (milk, cheese, and eggs). Vegetarians are still at risk of developing a B12 deficiency.
What are sources of vitamin B12 in the diet?
Did you know that B12 is a unique vitamin? Vitamin B12 is unique in that it is almost exclusively found naturally in foods derived from animals. Sources of vitamin B12 include:
How do you treat vitamin B12 deficiency?
Diagnosis of a deficiency of B12 is based on a simple blood test. Sometimes there are conditions such as the oral contraceptive pill; infection; pregnancy; kidney or alcohol related liver disease which can actually affect how accurate the blood test result is and your doctor will be able to advise you about your own results. Folate levels can also be assessed by a blood test. It is recommended that those at risk of B12 and folate deficiencies increase amounts of vegetables (especially green leafy ones as they are a good source of folate); fortified breads and cereals; meat; milk (except goats milk which is low in folate) and eggs.
Why is B12 important?
Vitamin B12 plays an important role in the development of new red blood cells. When there is not enough B12 then the body is unable to make new red blood cells. This leads to a condition called anaemia. Pernicious anaemia is an autoimmune condition that prevents the binding of vitamin B12 with intrinsic factor and is a common cause ...
How long does it take for B12 to be depleted?
The liver is able to store large amounts of B12. Vitamin B12 stores in the liver can take between 3-5 years to be completely depleted.
If You Take Metformin
Top signs of B12 Vitamin Deficiency: Should diabetics take it? SugarMD
When Is B12 Considered To Be High Dose
A vitamin B12 dose of 1000 µg or more is considered high. This corresponds to over 40 000% of the daily requirement of 2.5 µg officially recommended by the Institute of Medicine , which initially appears to be an enormous overdose.
B12 For Memory And Mood
Its commonly thought that taking vitamin B12 can boost your memory and mood. However, theres not a lot of evidence to support this theory.
Vitamin B1 Or Thiamine
When taken in its fat soluble form benfotiamine, helps prevent circulatory issues in diabetics protects nerves, eyes and limbs.
Is It Safe To Take Supplements If You Have Diabetes
You will find supplements for anything and everything these days. Even when you do not suffer from an ailment, supplements are suggested to keep you healthy and ailment-free.
Foods That Contain B Vitamins
The vitamin B family is present in so many foods that this cannot be an exhaustive list by any means. However, weve picked some of the foods that have a high balance of all the Vitamins B.
Staying Healthy As The Years Go By
As we get older, we have to get more creative and involved in staying healthy. Planning regular visits to the doctor and getting blood tests can help us stay on top of vitamin deficiencies and other issues that may cause health problems. Fortunately, if you have a B12 deficiency, its relatively easy to get a diagnosis and start a treatment plan.
How to get B12?
Vitamin B12 is necessary for a healthy nervous system and healthy blood cells. The best way to get vitamin B12 is through your diet. This important vitamin is found in meat, fish, poultry, and dairy products. If you don’t eat enough of these foods, it could leave you with a deficiency. Consuming enough vitamin B12 isn’t the only problem. Your body also needs to be able to absorb it efficiently. Some medications like Pepcid AC, Prevacid, Prilosec, and Zantac, as well as others used to treat acid reflux, peptic ulcer disease, and infection, may make it harder for your body to absorb B12. Another medication that may interfere with B12 absorption is metformin, a common type 2 diabetes treatment. Simply having diabetes may make you more prone to B12 deficiency. A 2009 study found that 22 percent of people with type 2 diabetes were low in B12. Read on to learn the symptoms of B12 deficiency, what it could mean for your overall health, and what you can do about it. Symptoms of vitamin B12 deficiency may be mild at first, and not always obvious. If you’re slightly low on B12, you may not have any symptoms at all. Some of the more common early symptoms are: tiredness weakness loss of appetite weight loss constipation It may be easy to dismiss these as minor complaints, but over time, insufficient B12 can lead to bigger problems. Very low levels of B12 can result in serious complications. One of these is called pernicious anemia. Anemia means you don’t have enough healthy red blood cells. This deprives your cells of much-needed oxygen. According to a study in the Journal of Oral Pathology Medicine, less than 20 percent of those with a B12 deficiency experience pernicious anemia. Symptoms of anemia include: fatigue pale skin chest pain dizziness headache You may even lose Continue reading >>
What is the role of vitamin B12 in the body?
Go to: Introduction Vitamin B12 or cobalamin is a water soluble vitamin that plays a very fundamental role in DNA synthesis, optimal haemopoesis and neurological function. The clinical picture of vitamin B12 deficiency hence, is predominantly of features of haematological and neuro-cognitive dysfunction [1]. This review will mainly discuss the physiological roles of vitamin B12, the varied pathophysiological mechanisms of vitamin B12 deficiency among patients with type 1 and 2 diabetes mellitus (DM) and perspectives on screening for vitamin B12 deficiency and supplementation of vitamin B12 among diabetic patients. Absorption of vitamin B12 The principal source of vitamin B12 is animal proteins. The preliminary step in the metabolism of vitamin B12 involves its release from animal sources, a process mediated by the action of pepsin and gastric acid. After the release, dietary vitamin B12 binds to the R-protein secreted by the salivary glands. In the duodenum, in the presence of an alkaline medium and pancreatic proteases, the R- protein is hydrolysed to release vitamin B12 which later binds with the intrinsic factor (IF) secreted by the gastric parietal cells. The vitamin B12 –IF complex is highly resistant to proteolytic degradation. The complex attaches at its specific receptors on the mucosa of the terminal ileum, a site where its absorption occurs. This stage of vitamin B12 absorption is calcium mediated. The intracellular vitamin B12 is released following IF degradation. This free vitamin B12 attaches to another protein carrier, transcobalamin –II (TC-II) and is later released into the circulation. This vitamin B12 – TC-II complex, also referred to as holo TC-II is then actively taken up by the liver, bone marrow and other vital body cells. The liver serves as Continue reading >>
Should Patients Taking Metformin Also Take Vitamin B12?
Should Patients Taking Metformin Also Take Vitamin B12? Should I recommend vitamin B12 to patients taking metformin ? Response from Gayle Nicholas Scott, PharmD Assistant Professor, Eastern Virginia Medical School, Norfolk, Virginia; Clinical Pharmacist, Chesapeake Regional Medical Center, Chesapeake, Virginia Metformin is a first-line type 2 diabetes treatment that effectively lowers blood glucose and has a good long-term safety record. (It has been available in the United Kingdom since 1958 and the United States since 1995). [ 1 ] Metformin also offers the important advantage over most other antihyperglycemic drugs of improved cardiovascular morbidity and mortality risk. [ 2 ] Beyond monitoring renal and hepatic function and avoiding concomitant drugs that interfere with renal tubular secretion (eg, cimetidine), metformin use has become rather mundane. A sometimes forgotten disadvantage of metformin is its effect on vitamin B12 absorption. Although the liability of metformin to lower vitamin B12 levels has been well described, [ 3 ] interest in the need for monitoring for vitamin B12 deficiency is more recent. [ 1 , 4 , 5 , 6 ] Vitamin B12 deficiency is estimated to be present in up to 30% of patients with diabetes taking metformin. [ 1 ] The risk for vitamin B12 deficiency increases with patient age and the dose and duration of metformin use. [ 5 , 7 ] Concomitant conditions such as suboptimal dietary intake, which is common among vegetarians and alcohol abusers, and malabsorption due to atrophic gastritis, pernicious anemia, chronic pancreatitis, and celiac disease may further increase risk for vitamin B12 deficiency. [ 5 ] The combination of metformin with proton pump inhibitors has been reported to have an additive effect on risk for vitamin B12 deficiency. [ 8 ] Vitamin Continue reading >>
Can Diabetics Take B12?
Since diabetes puts you at risk for a deficiency of vitamin B12, you also need regular blood tests to monitor your B12 blood level. If you are deficient, your doctor might recommend certain steps to increase your B12 levels because maintenance of proper B12 levels is vital to your health. Vitamin B12 Vitamin B12 is important for the proper functioning of nerve cells and blood cells. It also plays an integral part in the synthesis of DNA and promotes the ability of your digestive system to maintain steady glucose blood levels. You get vitamin B12 naturally in foods such as beef, fish, milk, eggs, meats and poultry. Some breakfast cereals are fortified with vitamin B12 during the manufacturing process. Effects of Deficiency If you are deficient in vitamin B12, you may experience fatigue, weakness, constipation, loss of weight, loss of appetite or megaloblastic anemia, a condition characterized by enlarged red blood cells. You also might incur nerve damage that shows as numbness or tingling in your hands and feet. This damage may become permanent if you don't address the B12 deficiency. Other deficiency symptoms include memory lapses, depression, confusion, difficulty balancing and a sore mouth or tongue. Diabetes and B12 Vitamin B12 taken orally must form a complex with a stomach protein called intrinsic factor before it can enter the bloodstream, where it exerts its beneficial biological effects. The B12-intrinsic factor complex enters the bloodstream from the small intestine. If you have type 1 diabetes, you may have a B12 deficiency called pernicious anemia, because your immune system attacks the intrinsic Continue reading >>
Should You Take B12 Supplements If You Take Metformin?
Metformin is the most widely prescribed medication to treat diabetes (usually type 2 diabetes) in the world. Its effectiveness equals or exceeds many of the other oral medications available and has an excellent safety profile for most individuals. However, for the last ten to fifteen years there has been a question as to whether metformin causes B12 deficiency in those who take the drug for long periods of time. Several studies and clinical cases have noted suboptimal blood levels of B12 in those who have taken metformin for extended periods. The National Nutrition and Health Examination reviewed the blood work on 1,621 people with diabetes, more than a third of whom were taking metformin, and demonstrated a reduction in serum B12 levels in people who took metformin compared to those who did not. But just because these people taking metformin had lower levels of B12 in their bloodstream doesn’t necessarily mean the B12 that’s there isn’t getting the job done. New measurements of B12 activity have indicated that although metformin does seem to reduce blood levels of B12, this may not reduce the vitamin’s effectiveness in carrying out it its functions in the body. When B12 doesn’t work the way it’s supposed to, levels of something called total plasma homocysteine (tHcy) go up. But newer studies looking at the levels of tHcy in people who take metformin have found that they have not been elevated. According to an article published this year in Diabetes Care, “low serum B12 alone without disturbances in the metabolic markers has no diagnostic value.” From a practical standpoint, this means that if a B12 deficiency is suspected from a serum B12 test, further testing should be undertaken before assuming the patient is B12 deficient. B12 is one of the B-family Continue reading >>
How to control blood sugar in diabetics?
Eating a varied diet rich in natural sources of vitamins is a good idea for diabetics. Nutritional support is critical for diabetics because diabetes tends to drain nutrients. When levels of glucose are high in the blood, the body tries to ‘wash’ the excess sugar out. This is why diabetics need to use the washroom frequently. Unfortunately, diabetics also lose nutrients via their urine. Research studies show that diabetics are repeatedly found to be deficient in important water-soluble vitamins and minerals. What’s more, the loss of these vitamins worsens the body’s ability to manage blood sugar, creating a vicious cycle. Combining a healthy diabetes diet plan and a daily exercise routine with the best vitamin supplements for diabetics goes a long way in achieving stable blood sugar levels. What Vitamins Are Diabetics Deficient In? The term vitamin is short for “Vital Amino Acid”. This means that these are vital for the proper functioning of hundreds of chemical processes in the body which the body cannot manage by itself. Proper blood sugar control is one such function for which vitamins are critical. There are 13 essential vitamins that the human body requires and they must be obtained from an external source — through food and/or supplements. Diabetics need two kinds of vitamins: Water Soluble – Vitamins B1, B2, B3, B6, B12, C, Biotin, and Folate are water-soluble and cannot be stored in the body for longer periods of time. Diabetics are often deficient in these vitamins since they pass greater amounts of urine daily. As their body tries to get rid of extra sugar, diabetics lose more water-soluble vitamins than most others. That’s why diabetics need to to get these vitamins daily in doses larger than what normal people need. Luckily, you can get all Continue reading >>
What is the best vitamin for diabetes?
Vitamin B12, also known as “cobalamin,” is a water-soluble essential nutrient required in our diet. When a nutrient is essential, it means the body cannot produce it internally so it must come from food we eat or supplemental form. If you have type 2 diabetes, you could be at higher risk of a vitamin B12 deficiency. Vitamin B12 supports a healthy nervous system, brain and red blood cells and is needed only in very small amounts (2.4 mcg/day). Vitamin B12 is found only in meat, poultry, fish, eggs, and dairy, which is why vegetarians and especially vegans are at higher risk for deficiency and should take a dietary supplement that includes B12. While there is no set upper limit for B12, it is useless to supplement if you do not have a deficiency. Blood levels <200 pg/mL are generally considered deficient while >400 pg/mL are sufficient. Between this range, you may want to consider supplementation. Dosing will vary depending on level of deficiency, but is often 1-2 mg daily. In some cases mega-dose injections every month are required, depending on how the person responds to supplementation or if there is a severe deficiency. What does Vitamin B12 do? Vitamin B12 plays a number of very important roles in our bodies: It is necessary for the metabolism of amino acids and fatty acids It is required for DNA synthesis It helps synthesize neurotransmitters (ie serotonin and dopamine) It is essential for cardiovascular function Vitamin B12 Deficiency and Type 2 Diabetes It’s estimated that 22% of people with type 2 diabetes have Vitamin B12 deficiency, which is much higher than the general population. Getting enough Vitamin B12 in your diet through the food you eat is only one piece of the picture. After it has been ingested, the B12 then needs to be absorbed from the gut in Continue reading >>
How to get B12?
Vitamin B12 is necessary for a healthy nervous system and healthy blood cells. The best way to get vitamin B12 is through your diet. This important vitamin is found in meat, fish, poultry, and dairy products. If you don’t eat enough of these foods, it could leave you with a deficiency. Consuming enough vitamin B12 isn’t the only problem. Your body also needs to be able to absorb it efficiently. Some medications like Pepcid AC, Prevacid, Prilosec, and Zantac, as well as others used to treat acid reflux, peptic ulcer disease, and infection, may make it harder for your body to absorb B12. Another medication that may interfere with B12 absorption is metformin, a common type 2 diabetes treatment. Simply having diabetes may make you more prone to B12 deficiency. A 2009 study found that 22 percent of people with type 2 diabetes were low in B12. Read on to learn the symptoms of B12 deficiency, what it could mean for your overall health, and what you can do about it. Symptoms of vitamin B12 deficiency may be mild at first, and not always obvious. If you’re slightly low on B12, you may not have any symptoms at all. Some of the more common early symptoms are: tiredness weakness loss of appetite weight loss constipation It may be easy to dismiss these as minor complaints, but over time, insufficient B12 can lead to bigger problems. Very low levels of B12 can result in serious complications. One of these is called pernicious anemia. Anemia means you don’t have enough healthy red blood cells. This deprives your cells of much-needed oxygen. According to a study in the Journal of Oral Pathology Medicine, less than 20 percent of those with a B12 deficiency experience pernicious anemia. Symptoms of anemia include: fatigue pale skin chest pain dizziness headache You may even lose Continue reading >>
What is high B12?
Hypercobalaminemia (high serum vitamin B12 levels) is a frequent and underestimated anomaly. Clinically, it can be paradoxically accompanied by signs of deficiency, reflecting a functional deficiency linked to qualitative abnormalities, which are related to defects in tissue uptake and action of vitamin B12. The aetiological profile of high serum cobalamin predominantly encompasses severe disease entities for which early diagnosis is critical for prognosis. These entities are essentially comprised of solid neoplasms, haematological malignancies and liver and kidney diseases. This review reflects the potential importance of the vitamin B12 assay as an early diagnostic marker of these diseases. A codified approach is needed to determine the potential indications of a search for high serum cobalamin and the practical clinical strategy to adopt upon discovery of elevated cobalamin levels. While low serum cobalamin levels do not necessarily imply deficiency, an abnormally high serum cobalamin level forms a warning sign requiring exclusion of a number of serious underlying pathologies. Functional cobalamin deficiency can thus occur at any serum level. High serum cobalamin (vitamin B12) is a frequent and underestimated anomaly. Hypercobalaminemia can yield clinical signs indicating functional and qualitative vitamin B12 deficiency. Methylmalonic acid and homocysteinemia are key biomarkers for the diagnosis of functional deficits in vitamin B12. However, as there is still no gold standard for diagnosis of cobalamin deficiency, therapeutic trials are warranted when clinical symptoms are consistent with deficiency. The majority of causes of hypercobalaminemia is related to quantitative anomalies pertaining to transcobalamins. Solid neoplasms, myeloproliferative blood disorders, Continue reading >>
How Dangerous Are High Vitamin B12 Levels?
Q. My husband takes metformin and some other medications as well as supplements. His last blood work showed high levels of Vitamin B12 (more than 2000 pg/ml), which is disconcerting. Is this harmful, and what could be causing it? Metformin and Vitamin B12 Levels: A. Your husband needs a thorough workup. High levels of vitamin B12 are unusual for someone on metformin. In fact, many people who take this diabetes drug have low vitamin B12 levels. A study in the Journal of Clinical Endocrinology and Metabolism (online, Feb. 22, 2016) concluded: “Long-term use of metformin in DPPOS was associated with biochemical B12 deficiency and anemia. Routine testing of vitamin B12 levels in metformin-treated patients should be considered.” Because metformin often causes digestive tract upset, many patients are also put on a proton pump inhibitor (PPIs) such as esomeprazole (Nexium), lansoprazole (Prevacid) or omeprazole (Prilosec). Such drugs also deplete the body of vitamin B12. The combination of a PPI and metformin would absolutely require regular laboratory tests for vitamin B12. What Could be Behind High Vitamin B12 Levels? We do not want to scare you, but one sign of liver problems could be high vitamin B12 levels. That is why your husband needs to see his physician promptly for a complete examination and another vitamin B12 test. Make sure he takes all his pill bottles (including vitamins and minerals) along just in case he is getting too much vitamin B12 from the supplements he is taking. Please let us know how he makes out. Continue reading >>
Can low B12 cause diabetes?
Low vitamin B12 levels linked to diabetes in pregnancy Asian women with a lower vitamin B12 status have been found to be more at risk of gestational diabetes, raising the possibility that changes or supplements to their diet could help prevent the condition. New findings from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study have revealed that vitamin B12, found in meat, fish and dairy foods, could play a key role in preventing pregnant mothers developing diabetes. The collaborative research between the team at the Singapore Institute for Clinical Sciences and Professor Keith Godfrey at the NIHR Southampton BRC is reported in the journal Clinical Nutrition . Insulin is a hormone critical to controlling blood sugar levels and during pregnancy some women will develop diabetes, when the body cannot produce or use insulin effectively. This gestational diabetes usually goes away after birth, but increases the risk of pre-eclampsia, premature birth, high birth weight and low blood sugar or jaundice in the baby. Asian women are particularly at risk, with around 1 in 5 affected during their pregnancy. The latest study analysed blood test results from 913 pregnant Chinese, Malay and Indian women participating in the GUSTO study. Blood tests to measure blood sugar and vitamin B12 levels were taken at their hospital visits at 26-28 weeks of pregnancy. In total, 48% of the women who took part had vitamin B12 insufficiency, and those who had low vitamin B12 and high folate levels were most likely to go on to develop gestational diabetes. The link was particularly strong in Indian women. While this study did not investigate the reason for this,the higher rates of vegetarianism amongst Indian women may be a possible cause, as meat, fish and dairy foods are the primar Continue reading >>
Is metformin good for diabetes?
Metformin is the most prescribed anti-diabetic drug in patients with type 2 diabetes mellitus (T2DM) and hence, considered a cornerstone in the treatment of T2DM.1It is an anti-hyperglycaemic agent that is usually well tolerated in most of the patients (except for mild gastrointestinal side effects) and it is characterized by excellent improvement in the cardiovascular morbidity Due to the numerous clinical benefits associated with metformin, some side effects with potential adverse health effects associated with its use are usually ignored and rarely investigated. One of such side effects is Vitamin B12, also called cobalamin, is a water-soluble vitamin involved in the optimal functioning of the hemopoetic, neuro-cognitive and vascular systems. It is involved in DNA synthesis, fatty acid metabolism VITAMIN B12 LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS ON K.S. Akinlade1, S.O. Agbebaku1, S.K. Rahamon1, and W.O. Balogun2 1. Department of Chemical Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria 2. Department of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria Keywords: Metformin, Type 2 diabetes mellitus, Vitamin B12 deficiency. and energy production.5 Vitamin B12 exerts its physiological effects by facilitating the methylation of homocysteine to methionine which is later activated into S-adenosyl methionine that donates its methyl group to methyl acceptors.6. Similarly, vitamin B12 mediates the conversion of methyl malonyl coenzyme A (coA) to succinyl coA, a process when hindered, results in accumulation of serum methylmalonic acid (MMA) thereby causing defective fatty acid synthesis Reports have shown that there is an association between metformin use and vitamin B12 deficiency.3, 4 However, the mechanism th Continue reading >>
