Metformin,PPIs,and teh Risk of โVitamin B12 Deficiency
Dr. Kumar, in a recent โฃYouTube โคvideo, cautionedโฃ that long-term โuse of two commonโค medications – metformin โฃand proton pump inhibitors (PPIs) – can interfereโข with โthe body’s ability to absorb vitaminโค B12, possibly leading to deficiency.โฃ Understanding this connection and proactively โmonitoring B12 levels is crucial for those on these medications.
How Metformin Impacts B12 โAbsorption
Metformin, frequentlyโฃ prescribedโ for managingโ diabetes,โข polycystic ovary syndrome (PCOS), and metabolic โฃdisorders, canโ hinder vitamin B12 absorption in the small intestine.โ Dr.โฃ Kumar explained that prolonged โinterference can gradually lower B12 levels. Individuals on long-term metformin therapy should be vigilant for signs of vitamin deficiency, including fatigue, numbness, tingling sensations, forgetfulness, and mood disturbances. he recommends regularโ B12 level testing – at least every one to two years – particularly for โขthose taking the medication for an extended period.
The role of Stomach Acidโข and PPIs
The secondโฃ class of drugs identifiedโ asโฃ potentiallyโค problematic are proton pump inhibitors โข(PPIs), used to treat acidityโค and โpeptic ulcers.โ Common examples โinclude omeprazole, pantoprazole, rabeprazole, and esomeprazole. Dr. Kumar highlighted that whileโ effective at reducing stomach acid, โthis reduction โimpactsโข the release of vitamin B12 from food, ultimatelyโ loweringโข absorption. Individuals relying on PPIs for chronic acidity or digestive issues mayโ unknowingly โdevelop a B12 deficiency due to decreased gastric acid secretion.
Importantly,Dr. Kumar stressed thatโข patients โshould not โฃ discontinue either metformin or PPIs without first consulting their doctor. Instead, he advocates for regularโฃ B12 level monitoring and promptโ testing if โany deficiency symptoms arise.Early detection allows for straightforward correction through supplementation or dietary changes.
Recognizing Early Warning โขSigns of B12 Deficiency
According to the Cleveland โคClinic, vitamin B12โฃ deficiency frequently enough develops โคslowly, with subtle early symptomsโ that can worsen over โคtime. Theseโค include:
* Fatigue and Weakness: Resulting โfrom reducedโ red blood cell production.
* Neurological Symptoms: Tinglingโฃ or numbness in the hands and feet dueโฃ toโ nerve issues.
* Skin โchanges: Paleโฃ or slightly โฃyellow skin.
* Cognitive and Mood Changes: Memory lapses,โ difficulty concentrating, andโฃ irritability.
* Oral โคSymptoms: Inflammationโค of the tongue and painfulโ mouth sores.
* severe Symptoms: โ Inโ advanced cases, vision problems and shortness of breath with heartโ palpitations can โoccur.
it’s important to noteโค that someโค individuals may experience few noticeable symptomsโ despite lowโข B12 levels, emphasizingโ the importanceโ of regular โmonitoring.
Understanding the Root Causes of Deficiency
Vitamin B12 deficiency can occur when the body doesn’t receiveโ enough โB12 or struggles to absorb โit effectively. Contributingโข factorsโฃ include:
*โ Dietary โฃIntake: Low consumption of animal โฃproducts.
* โ Digestiveโข Disorders: โConditions like Crohn’s disease or โceliac disease.
* Stomachโค Acid โIssues: โฃConditions โaffecting stomach acid production or intrinsic factor.
* Medications: As highlighted,โฃ metformin and PPIs.
* Lifestyle Factors: Chronic alcohol use.
* Medical Procedures: Gastrointestinal surgeries.
* Genetics: Inherited predispositions.
Certainโข populationsโ areโข at higher risk,including older adults,vegetarians,and individualsโ with digestive problems. โขRegular monitoring and proactive โฃmanagementโ are key to preventing and addressing vitamin B12 deficiency.
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