Metformin and Vitamin B12 Deficiency - What Are the Alternatives?

by Amanda

I'm sorry if this is not the right way to get a question answered, but I wonder if you just might have an answer to this question at your fingertips?!

My daughter has PCOS and has been taking Metformin for a couple of years now. She has recently developed a B12 deficiency which is making her very tired and a bit sick.

She is also feeling extremely fed up and I wonder if this is connected to her physical condition?

Her doctor is going to refer her to a consultant to investigate a diagnosis of "pernicious anaemia". This sounds pretty worrying to us all.

Basically, we would just be very interested to know what you think about Metformin and whether its side effects outweigh its usefulness? Is there an alternative medication that your group might suggest?

Thank you for your help,

Amanda Griffiths


Editor's comments: Hi Amanda,

Metformin is useful only if she has insulin resistance. There is no other reason for her to be taking it. Does she in fact have insulin resistance?

The most effective, long-term method for preventing insulin resistance is diet combined with exercise. This is why we have an e-book on this topic.

There are also many nutrients that help to reduce insulin resistance, and could be used in conjunction with diet/exercise -- a few examples that come to mind are chromium, vitamin D, NAC, fish oil. There are others.

Many if not most women with PCOS have a problem metabolizing the B-vitamin inositol. Studies have clearly shown that taking inositol (in large amounts) reduces symptoms of PCOS. It has no side effects.

This is why we have an online store of specialty supplements for PCOS.

Metformin is well known to induce a vitamin B12 deficiency. We continually warn people about this problem.

In your daughter's case, she may need to use vitamin B12 injections for some length of time in order to rebuild her depleted B12 levels. It takes a fairly long time to become deficient in B12, and it takes a relatively long time to build the levels back up if depleted.

A possible alternative to metformin is NAC, which does not have the side effects that metformin has.

We wrote an article on this.

This article reports about a medical study showing that NAC was virtually as effective as metformin.

The "pernicious anemia" may be due to effects of metformin.

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