Metformin & Vit B12 deficiency 2018- It's real. - FORD BREWER MD MPH

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ABOUT DR. BREWER
Dr. Brewer started as an Emergency Doctor. After seeing too many preventable heart attacks, he went to Johns Hopkins to learn Preventive Medicine. While there, he went on the run the post-graduate training program (residency) in Preventive Medicine. From there, he made a career of practicing and managing preventive medicine and primary care clinics. His later role in this area was Chief Medical Officer for Premise, which has close to 1,000 primary care/prevention clinics. He was also the Chief Medical Officer for MDLIVE, the second largest telemedicine company. More recently, he founded PrevMed, a heart attack, and stroke prevention clinic.

At PrevMed, we focus on heart attack, stroke, and cognitive decline. We serve patients who have already experienced an event as well as those who have not developed a diagnosis or event. Dr. Brewer provides services via telemedicine or in person if you're in the Lexington, KY area. We find a lot of undiagnosed Pre-Diabetes or Insulin Resistance. Treating unrecognized risk factors like Pre-Diabetes allows reduction of risk and prevention of disease.

ABOUT THIS VIDEO:

This video covers metformin and decreased serum vitamin B12. This was a study nested within NHANES, the National Health And Nutrition Examination study. They did confirm a decrease in serum levels of vitamin B12.
Other studies have shown that it takes about 4 years to see this impact. Government and other standards committees, such as the US Preventive Services Task Force DON'T have recommendations re: this issue. That's because this appears to be a "biochemical" deficiency. In other words, it's not clear that this is related to anemia, depression, neuropathy or other significant problems.
Normal supplements did not impact these levels. Higher concentration, specific supplementation, such as B12 injections did impact the deficiencies.

[wcbibb]

I always took B-12 with Metformin, especially after becoming a vegan.

[Radnally]

I really appreciate how you analyze studies and articles. Much more informative than others that just casually site studies while speaking.

[ksharpe]

What a timely video....I had an appointment with my PCP yesterday and we’ve been monitoring my A1C and thru diet & exercise I am only one point away from being out of the pre diabetes stage. He prescribed Metformim because he thinks I could benefit from it but I was on the fence about it since my numbers are improving. Your video has changed my mind. I will begin taking them in the morning. Thanks for sharing your wealth of knowledge Dr. Brewer.

[ladyb]

New sub came over to subscribe after watching Old Alabama Gardner's video introducing you. My only problem was what videos to start on. I have a feeling I'll be watching for a while. Thank you for doing what you do for us. Take care.

[livincincy]

When you are prescribed Metformin you also told to start eating the ADA Dietary Guidelines. The guidelines have you raise your Insulin levels because you are eating 6+ times per day and consuming carbohydrates at a level 50-60 per meal. So you are putting your body into nutritional deficiency do to meds, high insulin levels, and diet. Eventually you will inject insulin... They Banked on you progressing to insulin and the bank officer already signed the loan.

Just eat larger levels of Vitamin rich Foods and skip the simple & refined carbohydrates you are directed to eat per the American Diabetes Association and your Doctor. If you are diabetic your vitamin & mineral levels are not correct. Try to eat Low Carb & Healthy Fats with moderate protein and lots of vegetables.

[nickphil]

Thank you doc for spending time and effort to educate people around the world.

[saluto]

Doctor you are looking lot better and younger !!

[MrJoeyBoombotz]

Kudos, Dr Brewer for addressing this contraverisal topic.

My B12 didn't become normal until I started eating liver twice a week and supplementing daily with SUBLINGUAL and methylfolate (B9). I could not afford to find out if I had the MTHFR gene anomaly and I was pretty sure that due to being over 60 I couldn't rely on my stomach's intinsic factor/GI tract to metabolize the vitamins properly. It took several months for the extreme fatigue to be affected positively and I became less exercise resistant. I had one B12 shot that made me feel wonderful for a few hours but my doctor would not give me any more. Supplementing with regular mulitvitamins and other vitamins was useless until I started the methylated, sublinglingual cobalamin/adenosylcobalmin supplements.

[betsycambareri]

Are there any contraindications for using metformin if one is compound heterozygous for MTHFR? Other snps in the methylation pathway suggest avoiding methyl donors, so would adenyl and hydroxy B12 work for supplementation when using metformin? What is it about supplementing that doesn't work with metformin?

[warda]

Hi Dr i have been taking one 500xr once a-day in the morning to loose weight for the last 3 weeks, what is happening is i am gaining weigh with and feel hungry all the time, any one else feel the same? Why is that ! Do i stop it

[Bryndezy]

I’ve been t2d for 15+years on metformin. I took 1gm daily for years, did go up to 2gm for a while but GI problems were intolerable so reduced. After going lc have been able to to be diet controlled for past 2 years. Not long after starting metformin I got neuropathy in my feet! It took years to discover this was a B12 deficiency related to my metformin. I don’t have such tight control of bgl as I did on metformin so still have the neuropathy. I did have a period of time when ALA made a big difference, that was when I had tight control on metformin. The question is, my bloods have apparently never shown a B12 deficiency. Does this mean there is a variance between plasma level and cellular level?

[philsorensen]

Greetings. Thank for the information.
Would you know the biochemical pathways of Vit B 12 while on Metformin and why it would cause a deficiency?
Thanks!

[green]

My friend is diabetic and he has muscle cramp, can't sleep and drinks alcohol to help with nervousness or social anxiety and he uses metformin. Also anything he eats while under metformin comes right out and so when we are out he needs to know where is the nearest toilet is.