Depletions

Taking metformin may deplete vitamin B9 and vitamin B12.

Low levels of folic acid in the body may be linked to:

• Anemia
• Heart disease
• Birth defects

Symptoms may include:

• Weakness
• Mouth sores
• Swollen tongue
• Depression
• Poor growth

Low levels of vitamin B12 may cause any of the following symptoms:

• Irritability
• Weakness
• Numbness
• Anemia
• Loss of appetite
• Headache
• Personality changes
• Confusion

Low levels of vitamin B12 may increase the risk of heart diseases.

Editorial Note

The information presented here covers some of the nutrients that may be affected when you take certain medicines. If you have any of these signs and symptoms, it does not always mean you have low levels of these nutrients.

Factors that affect the level of nutrients are:

• Your medical history
• Diet
• Lifestyle
• How long you have been taking the medicine

Please talk to your health care provider. They can best address your health care needs and see if you are at risk for low levels of any nutrients.

Supporting Research

Dominiczak MH, Broom JI. Vitamins and minerals. In: Baynes JW, Dominiczak MH, eds. Medical Biochemistry . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 11.

Gold Standard Drug Database: Drug Monograph: Metformin, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-379 . Accessed July 7, 2016.

Greenbaum LA. Vitamin K deficiency. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 53.

National Institute of Health. Vitamin B12; Fact Sheet for Consumers. 2011. ods.od.nih.gov/factsheets/VitaminB12-Consumer . Accessed May 19, 2016.

Shenkin A, Roberts NB. Vitamins and trace elements. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics . 5th ed. St. Louis, MO: Elsevier Saunders; 2012:chap 31.