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Taking care of our daily responsibilities can often leave us feeling fatigued and mentally foggy. However, if you find yourself constantly battling exhaustion, you may be suffering from a deficiency in vitamin B-12. This crucial vitamin plays a vital role in generating energy and maintaining overall health. Surprisingly, there is a connection between the popular drug metformin and B-12 deficiency, which increases the likelihood of experiencing draining deficits.

Vitamin B-12, also known as cobalamin, is an essential nutrient for the body. It plays a crucial role in metabolizing fats, proteins, and carbohydrates into energy, as explained by Dr. Fred Pescatore. Additionally, B-12 is necessary for the production of healthy red blood cells and protects the myelin sheath surrounding nerves. When the body lacks sufficient B-12, individuals, especially women, may experience symptoms such as fatigue, low mood, and brain fog. Unfortunately, these symptoms are often not associated with a B-12 deficiency, leading to undiagnosed cases.

Recent studies have revealed that deficits in vitamin B-12 are much more common than previously thought. The National Institutes of Health (NIH) found that deficiencies are 733% more prevalent than predicted. Furthermore, a mutation in the MTHFR C677T gene can increase the risk of B-12 deficiency by 320%. Even individuals without this genetic variation can experience deficiencies due to other factors. For instance, a drop in stomach acid, affecting up to 80% of women aged 50 or older, reduces the absorption of B-12. A study published in the journal Nutrients found that B-12 deficiency increased by 77% after the age of 50.

Metformin, a medication prescribed for diabetes, prediabetes, and polycystic ovarian syndrome (PCOS), has also been linked to B-12 deficiency. This drug hinders the absorption of B-12 in the small intestine, increasing the risk of deficiency. A recent study in the journal Endocrine Practice found that taking metformin for four years or more increased the risk by 41%. Another study in The International Journal of Basic & Clinical Pharmacology discovered significant B-12 drops in only three months among metformin users.

Other drugs that suppress stomach acid, such as proton pump inhibitors (PPIs) and histamine 2 receptor antagonists, used to ease heartburn, have also been identified as contributors to B-12 deficiency. Experts reported in JAMA that taking PPIs for 2 years increased the risk by 68%, while histamine 2 receptor antagonists raised the risk by 25%.

The primary sources of vitamin B-12 are found in animal meats, eggs, and dairy products. Fruits and vegetables typically contain only trace amounts, causing vegetarians to be 1,844% more likely to experience B-12 deficiencies compared to omnivores, according to a study in the European Journal of Clinical Nutrition.

Diagnosing B-12 deficiency requires blood tests, though levels measured solely for B-12 may produce false results. Dr. Pescatore advises additional tests that measure homocysteine and MMA (methylmalonic acid), as increased levels of these substances indicate B-12 deficiency. Recognizing red-flag symptoms can also provide valuable clues for diagnosis.

To combat B-12 deficiency, intramuscular injections of the vitamin can effectively reverse the condition. However, for those who fear needles and might not have insurance coverage for these injections, reliable alternatives exist. British researchers have found that B-12 supplements are equally effective as intramuscular injections. Dr. Pescatore recommends taking 2,000 mcg of methylcobalamin daily, a form readily used by the body, and opting for sublingual supplements. These supplements compensate for reduced stomach acid and deliver the vitamin directly through blood vessels under the tongue. Recommended products include Solgar, Sublingual Methylcobalamin (Vitamin B-12), 1,000 mcg.

Incorporating folate-rich foods such as broccoli, Brussels sprouts, beans, and sunflower seeds into daily meals is also advised, as folate works alongside B-12 to boost energy. Limiting the consumption of sugar and alcohol, which can deplete B-12 levels, is suggested. It is also recommended to enjoy foods high in B-12, such as beef, poultry, eggs, tuna, sardines, and salmon, at least twice a day.

Considering the widespread usage of metformin, researchers stress the importance of monitoring B-12 levels in patients taking the drug. Unfortunately, in a study published in the Journal of the Endocrine Society, only 7.6% of primary care physicians monitored B-12 levels in metformin users. Regular blood tests to check for B-12 deficits every six months are advised for those taking metformin.

Angela DeGrassi, 48, discovered the surprising connection between metformin and B-12 deficiency in her own battle with fatigue. As a working mom and wife, Angela struggled with constant exhaustion, which impacted her ability to fulfill her roles effectively. After researching potential causes, she realized that long-term use of metformin to manage her PCOS might be contributing to her fatigue. Angela consulted her doctor and underwent a blood test, confirming severe B-12 deficiency. With her doctor's recommendation, she began supplementing with vitamin B-12, experiencing a significant improvement in her energy levels within a few weeks.

Angela's story highlights the significance of recognizing the link between metformin and B-12 deficiency. Understanding the role of B-12 in overall health and seeking proper diagnosis and treatment can help individuals regain their energy and overall well-being.