Q: Metformin tends to decrease the level of which vitamin?
Answer: Vitamin B12
Patients on Metformin on a long-term basis may develop vitamin B12 deficiency. Metformin is known to lower serum vitamin B12 concentrations, particularly in patients who are also vegan or have absorption issues. Although the actual mechanism for this effect is not well understood but appears to be absorption related, as metformin is known to decrease the appetite and cause weight loss.
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Reference:
Yang W, Cai X, Wu H, Ji L. Associations between metformin use and vitamin B12 levels, anemia, and neuropathy in patients with diabetes: a meta-analysis. J Diabetes. 2019 Sep;11(9):729-743. doi: 10.1111/1753-0407.12900. Epub 2019 Mar 29. PMID: 30615306.
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