Are You Taking Metformin?

Here's something I need to share.
Ini complete COPY-PASTE dari newsletter yang aku dapat.
Since zaman skang ramai yang PCOS dan ramai yang doc prescribe with Metformin, here's what the doc will never tell you about Metformin.

- kalau rajin bace lah.
:)

Aku penah ambik metformin for straight 2 month and i hated the drug sebab side effect kat aku SANGAT TERUK - diarrhea SETIAP HARI, perut kembung berangin, lepas makan je mesti ceri-beri. And it doesnt improve my eggs or period. So, menyakitkan perot aku je ambik.
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Hidden long-term side effect with metformin? 

  Are you taking metformin? 

Metformin (Glucophage) is thought by many to be the most effective medication for treating PCOS. 

The obvious benefit of metformin is that it can substantially reduce the severity of your symptoms.  But do you ever think about the possible side effects? 

You may be aware of discomfort in your GI tract, possibly including nausea or diarrhea.  In this case, you doctor may have advised you to reduce the dose until the problems go away and then gradually increase the dose. 

Let's say you're one of the "lucky ones" and can tolerate this drug.  Is there anything else to be concerned about? 

Well, there is a suspected long-term side effect that can remain hidden for a very long time. 

It appears that people who take metformin for a lengthy period (years) and/or who are on a high dosage, may develop a vitamin B12 deficiency.  The problem is that metformin interferes with your ability to absorb vitamin B 12 from your food.   

Vitamin B12 is absolutely essential for your health: 
- Carbohydrate and fat metabolism 
- Healthy nervous system development and function 
- Cell formation and longevity 
- Proper circulation 
- Adrenal hormone production 
- Feelings of well-being and mood regulation 
- Healthy immune system function 
- Mental clarity and memory function 
- Support of female reproductive health 
- Physical, emotional and mental energy. 

As you can see, vitamin B12 is really important! 

But here's the tricky part.  There is no obvious sign or symptom to warn you that you don't have enough vitamin B12.  You can have insufficient vitamin B12 for years before any symptoms show up. 

Some possible early signs could be fatigue or lack of energy, impaired memory, mood problems, or subtle disturbances in your nervous system, such as numbness or tingling.  By the time these signs become evident, a vitamin B12 deficiency could be well advanced.  If the B12 deficiency is severe enough, there could be irreversible nerve damage. 

The University of Calgary (Canada) recently conducted a study of people with diabetes.  They found that the individuals who had had the clearest signs of vitamin B12 deficiency also had the most peripheral neuropathy (nerve damage) and had been taking metformin for longer than six months.  They said the patient's B12-related "abnormalities were correlated strongly with cumulative metformin exposure".   

So here's a question.  Did the doctor who prescribed the metformin counsel you about avoiding a possible vitamin B12 deficiency?  Or maybe you were told you have nothing to worry about? 

Without some laboratory data, it's anyone's guess as to whether you now have a vitamin B12 deficiency as a result of metformin, a vegetarian diet or some other cause.  But it appears that vitamin B12 loss is cumulative; the deficiency just keeps building up until it is corrected. 

You could get a blood test to check your level of B12.  But this test may show an artificially low level because metformin is thought to cause movement of B12 from the blood into the liver and muscle.  So this test may be inconclusive. 

If the blood level of B12 is on the low side, two additional blood tests would be informative:  homocysteine and methylmalonic acid.  These substances are increased when there is insufficient B12 in your body. 

Other than lab testing, is there anything you can do?  Here are some tips: 

- Improve the quality of your diet so that you can reduce your dosage of metformin. 
- If you have a serious B12 deficiency, consider B12 injections to rebuild your B12 levels faster. 
- Consider taking NAC and berberine as alternatives to metformin.  Neither of these causes a B12 deficiency and several studies of women with PCOS have indicated they are as effective as metformin. 
- Take calcium.  Calcium appears to help absorption of vitamin B12 if you're taking metformin.  However, calcium should be taken with magnesium and other minerals, as in amulti-vitamin/mineral formula. 
- Take B-complex vitamins to reduce homocysteine levels if they are high.  Excessive homocysteine is associated with cardiovascular disease and brain shrinkage and injury. 
- If a vegetarian and taking metformin, get tested for possible vitamin B12 deficiency. 
- The d-pinitol formula may be helpful for reducing insulin resistance so that you won't have to rely entirely on metformin.