Low or depleted vitamin B12 status appears more common in people with obesity, contributing to weight gain through impaired metabolic reactions and reduced insulin sensitivity. Obesity itself exerts about a 1.6-fold decreasing effect on vitamin B12 levels, underscoring the importance of monitoring BMI and B12 across the lifespan for multisystem health, including neuronal migration. Large population data further confirm that higher serum B12 levels are inversely associated with obesity, highlighting the need to optimize B12 to mitigate these interconnected risks. This medication is commonly used for Diabetes.
Sun Y, Sun M, Liu B, Du Y, Rong S, Xu G, Snetselaar LG, Bao W. Inverse Association Between Serum Vitamin B12 Concentration and Obesity Among Adults in the United States. Front Endocrinol (Lausanne). 2019 Jun 27;10:414. Boachie J, Adaikalakoteswari A, Samavat J, Saravanan P. Low Vitamin B12 and Lipid Metabolism: Evidence from Pre-Clinical and Clinical Studies. Nutrients. 2020 Jun 29;12(7):1925. Demirtas MS, Kilicaslan C, Erdal H. Evaluation of vitamin B12 levels among severe obese and obese adolescents. J Investig Med. 2024 Apr;72(4):319-325. Samavat, Jinous (2019) The role of vitamin B12 deficiency on obesity, adipocytes and inflammation. PhD thesis, University of Warwick. Neal ES, Kumar V, Borges K, Cuffe JSM. Vitamin B12 deficiency induces glucose intolerance, delays peak insulin levels and promotes ketogenesis in female rats. J Endocrinol. 2023 Jan 19;256(2):e220158.
Some side effects may be linked to nutrient depletion caused by this medication.
Long term treatment with Biguanides, such as Metformin or Metformin combinations with other drugs, are found in research to reduce vitamin B12 absorption due to it hindering the activity of a calcium-dependent mechanism. Insufficient levels of vitamin B12 can lead to higher circulating homocysteine levels and the elevated risk of neurological problems and cardiovascular diseases.
Biguanide (anti-diabetic) drugs have been found in scientific evidence to decrease serum levels of coenzyme Q10. Type 2 diabetes can increase oxidative stress in the body, weakening its defenses and potentially harming cells. CoQ10, a powerful antioxidant, plays a crucial role in protecting cells from this damage. CoQ10 supplementation may help restore these levels, potentially improving mitochondrial function and protecting the kidneys from damage.
Research has shown that anti-diabetic Biguanide drugs may reduce folic acid absorption. Folic acid is a powerful antioxidant and low levels make the body more susceptible to oxidative stress, which can damage enzymes involved in homocysteine metabolism, and subsequently increase its accumulation. Elevated levels of homocysteine (hyperhomocysteinemia) are a risk factor for various health problems including cardiovascular diseases, neurological problems, osteoporosis, and vision problems.
Biguanides, such as Metformin or Metformin combinations with other drugs, may contribute to reduced levels of thiamine (vitamin B1) in end-stage renal failure patients. Research has found metformin encephalopathy present in patients on hemodialysis for end-stage diabetic renal failure (ESRD). Patients with ESRD should consider having thiamine (vitamin B1) status monitored and supplementing with thiamine when levels are insufficient or deficient.