Metformin and Vitamin B12 Deficiency
Although this commentary states that the average time to develop a B12 deficiency with this diabetic drug is 10 to 15 years, this can still be an important factor for any patient on this medication for many years. I’m sure this is compounded by poor absorption of B12 in the elderly due to low levels of stomach acid. At any rate, B12 deficiency is very prevalent at varying degrees of severity, and any elderly patients should be considered for evaluation or supplementation with this cheap and safe supplement. Many studies have supported high dosages in the elderly population (2,000 mcg) to override the poor absorption.