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Skip Navigation LinksHome > March 2010 - Volume 103 - Issue 3 > Metformin-Induced Vitamin B12 Deficiency Presenting as a Per...
Southern Medical Journal:
doi: 10.1097/SMJ.0b013e3181ce0e4d
Case Reports

Metformin-Induced Vitamin B12 Deficiency Presenting as a Peripheral Neuropathy

Bell, David S.H. MD

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Abstract

Chronic metformin use results in vitamin B12 deficiency in 30% of patients. Exhaustion of vitamin B12 stores usually occurs after twelve to fifteen years of absolute vitamin B12 deficiency. Metformin has been available in the United States for approximately fifteen years. Vitamin B12 deficiency, which may present without anemia and as a peripheral neuropathy, is often misdiagnosed as diabetic neuropathy, although the clinical findings are usually different. Failure to diagnose the cause of the neuropathy will result in progression of central and/or peripheral neuronal damage which can be arrested but not reversed with vitamin B12 replacement. To my knowledge, this is the first report of metformin-induced vitamin B12 deficiency causing neuropathy.

© 2010 Southern Medical Association

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