B12 Levels

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Pinky&TheBrain

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Type 2
After suffering from a rapid blood loss - 1 litre - in January '19, I was diagnosed with pernicious anaemia in May '19, after which I was put on B12 injections every 12-weeks - despite never showing any of the B12 deficiency symptoms. I suffered another rapid blood loss - again a litre - less than 18-months later [discovered after my youngest son insisted I contacted my GP, who immediately arranged for me to go the the hospital for tests], possible cause was put down to a possible burst duodenal ulcer. Late '21 I went through a period of rapid weight loss, and after contacting my GP, a number of blood tests were prescribed, which resulted in my being diagnosed with Type 2 diabetes, which then put me on daily Metformin.
I have read that a side effect of Metformin is the creation of B12 deficiency. However, I have been unable to find out the B12 side effect impact taking Metformin has, if someone is already B12 deficient.
Any views?
 
Metformin can stop the gut from absorbing B12 in food, but not in everyone who takes it.
The higher the dose, the more likely it can happen.

You should be OK if you're having injections.
 
harbottle. Many thanks for your comments. However, I think you missed my point. Having already been diagnosed B12 deficient almost 2 years before being diagnosed as Type 2, it was what impact taking Metformin - 1000mg a day [as well as Gliclazide - 30mg a day] would have on my already compromised B12 deficiency. GP is as much use as a brick wall.
 
Hi and welcome.

Sorry to hear about all the health issues you have been having.
I am concerned that your blood loss has not been fully investigated (it sounds like the duodenal ulcer is a guess from the wording of your post) and particularly when you now have rapid and unexplained weight loss which is a sign of Type 1 diabetes not Type 2. This is a very serious matter as it could also be an indication that something is seriously amiss with your pancreas (tumour or cyst or inflammation) and in your position I would be pushing for more investigation and probably a scan of your pancreas and liver to check for abnormalities.
Do you know the result of the HbA1c test which is done to diagnose diabetes? It will usually be a number in excess of 47 but can be into 3 figures if things have gone seriously amiss. In your situation with dramatic weight loss, if your HbA1c is also very high then that would also point towards Type 1 rather than Type 2. You could be at risk of Diabetic Ketoacidosis (DKA) if your pancreas is no longer producing enough insulin. The first thing to do is to find out your HbA1c result if you don't know it. In your position I would also invest in a Blood Glucose (BG) meter so that you can test your BG levels from a finger prick. They are not overly expensive at about £15 for a basic meter kit but you will need extra test strips as it usually only comes with 10 test strips. The two most frequently recommended by people who self fund here on the forum are the Gluco Navii or the Spirit Tee2. If your HbA1c is very high you might also want to ask your GP/nurse to provide some Ketostix to check your urine for ketones. These develop when there is insufficient insulin in your body and if your BG levels get high, your blood becomes acidic and ketones with acidic conditions are dangerous/life threatening, so testing for ketones when BG levels are persistently mid teens or above is important to keep yourself safe. If your GP will not prescribe them, then they can be bought over the counter or online for about £5 for a pot of 50 Ketostix which you dip in your urine.

I know this will all sound a bit complicated but many GPs have very little understanding of diabetes other than Type 2 (they are general practitioners not specialists after all) and they assume you must be Type 2 if you are a mature adult and/or a bit overweight. Some even still believe that Type 1 diabetes only develops in children.

Anyway, that sudden weight loss is a big red flag that needs much more thought and investigation so please ask some difficult questions of your nurse or doctor ie why they think you are Type 2, find out your test results and come back to us and if you can, get yourself some testing kit, so that you can find out what is going on.

It might also be worth mentioning that if you start to develop bowel problems like diarrhoea that may also indicate damage because the pancreas produces enzymes which break your food down and if it is failing, your will struggle to get the nutrition from your food and hence lose weight but your toilet visits will become "challenging" I believe. I mention this because some people are too polite or don't want to discuss such issues on a public forum, but it is important to know what to look out for. We have quite a few members here who need to take Creon which is digestive enzymes to replace the ones that their pancreas can no longer make. If this paragraph doesn't apply, ignore it but just wanted to make you aware in case you were having digestive problems. Unfortunately the first line medication for diabetes (Metformin) has a reputation for digestive upset too, so it can all get a bit confusing. If you have a recurring duodenal ulcer, Metformin might not be a good choice or insist on the slow release version because of your medical history.
 
Pinky&TheBrain said:
harbottle. Many thanks for your comments. However, I think you missed my point. Having already been diagnosed B12 deficient almost 2 years before being diagnosed as Type 2, it was what impact taking Metformin - 1000mg a day [as well as Gliclazide - 30mg a day] would have on my already compromised B12 deficiency. GP is as much use as a brick wall.
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Well it could make it worse, or may have no effect, as it doesn't affect everyone. If you're having injections of B12 every nine weeks it shouldn't an issue.

As you're a T2 diabetic, on Metformin, you should get an annual check.
 
If you are on B12 injections then hopefully you should no longer be deficient and the Metformin will not impact the efficacy of the injected B12, only oral supplements and dietary.
 
Welcome to the forum @Pinky&TheBrain

Hope you are able to get to the bottom of your weight loss, and confirm the cause of the bleeds you have experienced recently
 
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