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Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy.

Abstract

Chronic metformin use results in vitamin B12 deficiency in 30% of patients. Exhaustion of vitamin B12 stores usually occurs after twelve to fifteen years of absolute vitamin B12 deficiency. Metformin has been available in the United States for approximately fifteen years. Vitamin B12 deficiency, which may present without anemia and as a peripheral neuropathy, is often misdiagnosed as diabetic neuropathy, although the clinical findings are usually different. Failure to diagnose the cause of the neuropathy will result in progression of central and/or peripheral neuronal damage which can be arrested but not reversed with vitamin B12 replacement. To my knowledge, this is the first report of metformin-induced vitamin B12 deficiency causing neuropathy.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Southside Endocrinology and Division of Diabetes, Endocrinology, and Metabolism, University of Alabama Medical School, Birmingham, AL 35205, USA. dshbell@yahoo.com

    Source

    Southern medical journal 103:3 2010 Mar pg 265-7

    MeSH

    Aged
    Humans
    Hypoglycemic Agents
    Male
    Metformin
    Peripheral Nervous System Diseases
    Vitamin B 12 Deficiency

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    20134380

    Citation

    Bell, David S H.. "Metformin-induced Vitamin B12 Deficiency Presenting as a Peripheral Neuropathy." Southern Medical Journal, vol. 103, no. 3, 2010, pp. 265-7.
    Bell DS. Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy. South Med J. 2010;103(3):265-7.
    Bell, D. S. (2010). Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy. Southern Medical Journal, 103(3), pp. 265-7. doi:10.1097/SMJ.0b013e3181ce0e4d.
    Bell DS. Metformin-induced Vitamin B12 Deficiency Presenting as a Peripheral Neuropathy. South Med J. 2010;103(3):265-7. PubMed PMID: 20134380.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy. A1 - Bell,David S H, PY - 2010/2/6/entrez PY - 2010/2/6/pubmed PY - 2010/4/21/medline SP - 265 EP - 7 JF - Southern medical journal JO - South. Med. J. VL - 103 IS - 3 N2 - Chronic metformin use results in vitamin B12 deficiency in 30% of patients. Exhaustion of vitamin B12 stores usually occurs after twelve to fifteen years of absolute vitamin B12 deficiency. Metformin has been available in the United States for approximately fifteen years. Vitamin B12 deficiency, which may present without anemia and as a peripheral neuropathy, is often misdiagnosed as diabetic neuropathy, although the clinical findings are usually different. Failure to diagnose the cause of the neuropathy will result in progression of central and/or peripheral neuronal damage which can be arrested but not reversed with vitamin B12 replacement. To my knowledge, this is the first report of metformin-induced vitamin B12 deficiency causing neuropathy. SN - 1541-8243 UR - https://www.unboundmedicine.com/medline/citation/20134380/full_citation L2 - http://dx.doi.org/10.1097/SMJ.0b013e3181ce0e4d DB - PRIME DP - Unbound Medicine ER -