Some forms of metformin are taken only once daily with the evening meal. Follow your doctor's instructions. Metformin is only part of a complete program of treatment that also includes diet, exercise, and weight control. It is important to use this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. Do not crush, chew, or break an extended-release tablet Glucophage XR. Swallow the pill whole.

Breaking the pill may cause too much of the drug to be released at one time. Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office. Visit your doctor regularly.

Check your blood sugar carefully during a time of stress or illness, if you travel, exercise more than usual, drink alcohol, or skip meals. These things can affect your glucose levels and your dose needs may also change. I went out and purchased b mgs yesterday and started … hopefully it makes me feel better and kills these aches and numbness. My level is at now since the 3X a day metformin. I really have trouble sleeping because of the uncomfortable aches and pains..

I take many hot baths to soothe the pain and then it comes right back,, temporary relief is better than nothing …whew.. Hopefully the b helps out.

Maybe in a couple days-weeks.. Pain is always a cause for concern and you should let your doctor know to rule out other possible causes. I will let the doctor know today.

Its crazy when you will try anything to feel better these days. Not 75 mcg, but 75 mg. Is this OK to take without side affects? Is this normal for a multi-vitamin? Large doses of vitamin B12 are likely not harmful, but more than mg per day of vitamin B6 may lead to nerve damage, and 50 mg or more of niacin may cause flushing.

Deb I was recently tested and my B12 was extremely low. I have been using metformin for 8 years. I am now taking a B12 shot on a regular basis. I have been on mg of Metformin twice daily since then I now also take a low dose of Glymepiride once daily. Until recently, I was between 6.

Once my B12 level was back to normal, my neuropathy declined to infrequent. Desiring to take no more meds than reasonably necessary, I stopped taking the oral B12 supplement probably about a year ago and have not had a blood test within that time that screened for B12 deficiency.

Three months ago, suddenly, my A1C was 7. I weigh , down from , but my endocrinologist wants me to lose 25 pounds more at , I would be quite thin. I have been giving myself the shots now for about a week. Today, I began hearing my heartbeat in my ears very prominently and continuously.

In my case, this condition is known as subjective bilateral pulsatile tinnitus. It is annoying at best, debilitating at worst. I have been experiencing it on a minor and quite tolerable level for several years. Tonight, I am very thankful to have found your blog because, from it, I now know that my Metformin quite likely has caused my B12 deficiency to return, and I have learned that the incrased heart rate I have been feeling is quite likely the result of the Byetta.

I will seek to begin B12 shots tomorrow, and I will discontinue the Byetta because I cannot tolerate the increased heart rate causing this terrible increase in the pulsatile tinnitus.

This blog entry is to thank you for your work and concern, and it is meant to add to the discussion in hopes of being helpful to other readers. Don vijayakumar Hi i am taking mg of Metformin daily for the past 6 months. Before that i was taking Dianel 5 mg , but discontinued as i was going Hypo 60— I have developed Nueropathy of feet and also i have problem with Eye squeezing on one side and feeling numbness in my left side of my Head.

My Hemoglbin levels were before Is it necessary to take Nerobion B complex with B12 Thanks in advance and regards Posted by vijayakumar Jan 12, at 4: I take quite a few OTC supplements to counteract nutritional defeciencies. You should avoid this supplement if you have kidney or liver disease. If you do take creatine, be on the lookout for muscle pain, leg pain, dizziness, and irregular heart beat. Also, in theory, creatine could interact with insulin or other glucose-lowering drugs, and caution is advised if taking creatine with diuretics and other drugs that could damage kidneys, such as ibuprofen.

Please let your physician know, too, if you do start taking this supplement. Over the past year or so, I have gotten to where my whole body feels like it is shaking all over, even though you cannot see it. I have had fogginess and also forgetfulness, and I have had to hold onto the railing to climb up the steps from the basement. I am ONLY 40 years old!!! All this time, my PCP and my Endocrinologist kept telling me it was neuropathy from my diabetes.

My HBA1C ranges from 7. I was borderline low and started last week taking B12 injections of mcg. They were ordered only monthly. Last night, on my 8th day after my first injection, my symptoms came back very severe.

I had a horrible night and had to call the PCP to get him to order my shots increased to weekly. I take Lantus at night. I will discuss this tomorrow with my Endocrinologist. Thank you for your blog. I am grateful for the information here! Recently my Endo decided in addition to checking my thyroid levels and low Vit. D levels he would check B and Folic Acid. He asked me if I ate green leafy veggies and fruit, which I do daily at just about every meal.

He mentioned that my B was ok but that I was very deficient in Folic Acid. I realize this forum is mostly on the subject of B, but my Endo had no answer for me about possible drug interactions as I am on a statin and 3 Blood pressure meds too. Can you possibly answer me about whether Metformin or Byetta could possibly be a reason for this?

The form of folic acid in food is called folate. Folic acid deficiency can occur due to a number of reasons, including: Also, certain mediciness may block the absorption of folic acid, including anticonvulsants, methotrexate, drugs for ulcerative colitis, oral contraceptives, triamterene a blood presure drug , and metformin! The RDA for folate is micrograms for adult women; however, your doctor may prescribe a folic acid supplement to correct your deficiency.

Donna Thank you for answering, and your time. At one time my symptons all of the ones posted plus others including eye and hearing problems and external reorbtion dental problems and poor healing and open to simple infrections becoming serious, also confusion and lack of concentration.

I was offered anti-depressants which I declined and held out for a diagnosis of exclusion of diabetes plus a glucose tolerance test which was not done as a routine only HBA1c Been taking Metformin for 3 years at x 2 daily Just been informed that my B12 is low but now have lumbar spinal compression problems: Yours is a very interesting site from this side of the pond too. From what little I know of spinal compression, much has to do with normal wear and tear as well as aging.

I was able to have 3 wonderful kids so now that fertility is not an issue anymore do I need to stay on the metformin? Also I get kidney stones and am tired all the time…and then there is the tingling in the wrists and feet especially upon waking or working out…which most doctors thought was related to poor circulation or carpel tunel syndrome. The question is will affect kidney stone issues either for the better and halt their creation or for the worse in making them grow or continue to crop up faster than normal.

I know you are not a doctor and cannot tell me definitively what to do, but any guidance is appreciated. It seems like somehow all of these things are linked but so far most doctors are telling me NO they really are not. Find out what your glucose, cholesterol, and blood pressure numbers are and discuss with your doctor. Your doctor should be able to check your vitamin levels and then prescribe doses to correct any deficiencies.

As for your kidney stones, treatment depends on the type of stone you have. Also, cutting back on sodium and animal protein and drinking plenty of fluids may help prevent kidney stones, too. The citrate in citrus fruit juices can reduce the formation of calcium oxalate stones the most common type.

Lemonade or lemon juice is often recommended for preventing kidney stones, but a study from found that drinking 3 cups of orange juice per day did a better job at increasing the acidity of the urine and hence, likely, stone formation. The catch, though, is that oj is pretty high in carbohydrate and calories.

You might also try True Lemon, which is crystallized lemon juice also available in orange and lime to add to foods and beverages without adding calories or carbohydrate. Vanessa Recentyl I had problems with my balance when walking and standing. It got really bad to ehre sometimes I felt like I was going to fall. My primary care doctor referred me to a neurologist. The neurologist had me take a blood test to see if my B12 levels were low and they were I have been taking B12 shots for about two weeks and my energy level has increased but my balance issue is still a problem especially in the evenings.

The neurologist did a nerve test and MRI and there were no problems noted on these tests. I also saw an ENT and had an eye exam and no problem there. I take 2, mg of Metformin a day. Will the B12 shots eventually help my balance issue?

If so usally how long does it take before you see improvement in this area. Also I never liked taking such a high dosage of Metformin but my doctor wants to keep me on it because he feels its the best medicine for treating my Type 2 diabetes.

What is the ideal B12 level if you are a diabetic? A B12 deficiency can cause problems with balance. So, if this is the case for you, you should expect your balance to improve as your B12 levels come back up to normal. Normal blood levels of B12 range from about to picograms per milliliter. It will likely take at least a month to build up your B12 levels. Metformin is a very effective diabetes medicine, but there certainly are others available, too. Lynn A month ago I was diagnosed with type 2 diabetes after informing my doc what my blood sugars were running and then a Hemoglobin A1C was done.

They are not way high, I just monitor them regularly because I come from a Long line of diabetics on both sides of my family. Prior to this, I have been taking B inj. It is all good.. Only have a period about every 4 months so that is not it either. I wish I had answers myself. Have you been tested for pernicious anemia or atrophic gastritis a chronic inflammation of the lining of the stomach?

Are you on the correct doses of B12 and iron? Perhaps your doctor would consider referring you to a specialist for further workup?

There may be a better choice of medicine for you. Please let me know how you make out. The only invasive type tests were a colonoscopy and a swallowing test done with a xray. I have also done several fecal occult tests.

The xray test was for acid reflux and was told to take proton pump inhibitor , but the others were negative. I went back last week and was told to up my metformin to 3 daily based on my levels. I am seeing an internest not a family doc nor general practitioner.

So, other than endocrinologist for diabetes, who else would I see? Again, remembering that by no means is this a diagnosis or treatment recommendation, he mentioned the following: There is a methylated form of B12 that may be beneficial for you, including the sublingual B Proton pump inhibitors may also deplete B12, in addition to the metformin, so a methylated B12 may be in order, in addition to the folinic form of folic acid.

Regarding vitamin D, low levels of cholesterol can interfere with vitamin D metabolism, so find out what your cholesterol is. Your PCP would be able to order and interpret a Schilling test. Otherwise, perhaps a hematologist a physician who specializes in blood disorders, such as anemia could help. If you are found to have a low serum B12 below you will be given injections and when your serum B12 is re-tested again it can be or above with no ill effects. Dr Chandry of Peterlee near Newcastle has carried out some research after a patient who was confined to a wheel chair due to un diagnosed B12 deficiency and when he boosted her B12 levels to way above she regained the ability to walk and most if not all her symptoms disappeared.

I have Type 2 Diabetes, fibromyalgia and now anemia. With VA med coverage, I have yet to see an actual physician in over 12 years. I take Tramadol for neuropathy in my feet and the aches of fibromyalgia. While the mental and physical improvement since the iron infusions began makes a significant improvement in my quality of life, monthly day-long trips to the hospital for life will also have a significant impact. I feel very short on information. I finally have an appointment with a hematologist, and want to make the most of it.

Going in as a new patient with complex issues, what can I reasonably expect from the doctor, and what questions should I be asking? Thanks for your help. Be sure to mention the fact that you take two medications that may deplete B12 and ask if B12 supplementation or injections might be necessary.

Ask about your level of folic acid, as well. These conditions can prevent the absorption of vitamins, leading to deficiencies. Peter Marsh I have been diagnosed with Vitamin B12 Anemia and yes i take 2grams of metformin a day, my question is if i stop taking the metformin with the Vitamin B12 anemia be reduced in any way and if so what time frame are we talking about.

Thanks acampbell Hi Peter, Vitamin Binduced anemia can be reversed with proper treatment. You would need to have your vitamin B12 levels checked, probably for at least a few months, if not longer.

Just had a dr. He recommended a otc supplement in the mcg range. Is that your take? I hate shots…anyother otc alternatives? Thanks again for doing this blog! I am a 62 year old caucasin male, 5ft. I have been receiving treatment for all of the above for about 10 years.

I have had one minor stroke. I had complete recovery except for some loss of feeling on my left side. I have complained about feeling tired, fatigued all of the time for 10 or more years. In recent months, my family Dr. I am an attorney but I am so tired some days I go back to bed after food and pills. I have not been able to practice law for over 3 years now.

I am quite frustrated and seem to be getting worse. I would appreciate your observations and comment. Rasmussen acampbell Hi kctt1 , Glad you like the blog! Usual doses to correct a deficiency are 1,—2, micrograms daily for 1—2 weeks.

Check with your doctor about what dose is best for you. Make sure your levels are checked periodically after that, too, to ensure that your deficiency is corrected. And there could be a number of factors causing your fatigue. That can lead to fatigue. Also, ask your doctor to have your vitamin B12 level checked as that may be low due to metformin. There are injections, over the counter pills and a nasal spray you can take weekly at home. Lately I have noticed a change in my weight increasing.

I exericise on a regular basis sometimes 2 hours a day and my meals are proportioned. I do not eat junk food and I only drink water. Can taking the vitamins cause the weight gain. Think about other possible factors that could be contributing to your weight gain: Keeping a detailed food and activity record for a week can be helpful, and you might consider meeting with a dietitian if your weight gain continues.

Jlamphear Hi, I have a question. I have never been diagnosed with anything, but have always had a lower iron count as in could not give blood. I also am overweight. I have done some reading, and would like to know if it is safe to take a mcg sublingual vitamin b12, and take a mg b6 vitamin at the same time. I am also on adderol. Adderol is prescribed, and I take that for add, and it doesnot help me stay awake during the day?

Too much B6 over a long period of time can put you at risk for a type of neuropathy, or nerve damage. Taking mg per day is likely to be safe, but there may not be a need for that much the RDA is only 1. Donna Could being low on vitimin B make me not be able to walk. I am okay now but not sure as to why it came and went. One day I could not walk and days later I could walk again very slowly.

Then I am back to normal. Donna acampbell Hi Donna, A B12 deficiency could cause nerve damage which theoretically could lead to an inability to walk. Please call your doctor to let him or her know what happened as there could be many reasons for why you were unable to walk.

I was taking Metformin mg daily , along with Avandia 4mg. In March , the doctor increased my Metformin dosage to mg daily. In early July , I began experiencing unexplained dizziness when I moved my eyes. I was started on B injections, and after getting an injection every 2 weeks for 6 weeks, my symptoms are now gone. After doing some research on B deficiency, I saw that Metformin can cause deficiency.

Doctors should know about this link!! I was asleep and in my sleep I can feel my head getting extremely light, almost like going into a very very deep sleep. I have a slight case of anemia. What I want to know is could metformin cause me to get light headed, tingling in legs and other symptoms?

I occassionaly take a dose of trihemic to help build my blood. Should I get vitamin B injections on a regular basis?. I have done numerous blood tests and they can find nothing else to indicate why I am getting these problems. Jem acampbell Hi Jem, The most common side effects of metformin are nausea, stomach upset and diarrhea.

These usually go away after a short time. However, dizziness, lightheadedness, and weakness are other possible side effects, too. To be on the safe side, you should give your doctor a call and let him know about your symptoms. You could also get your vitamin B12 level checked, too, and discuss B12 supplementation, since metformin could possibly lead to a deficiency.

Sheila I have been diabetic since I was 11yrs old I am now I have always been insuin dependent. Blood tests prove that I am well controlled but last week having had my 6 monthly blood tests ready for diabetic clinic my GP has informed me that I need to take Cyanocobalamin tablets 50mcg tablets one twice a day.

I asked my GP what he hought had suddenly caused this vitamin B12 defiency, he asked if I was a vegetarian to which I replied no. He then said perhaps your insulin has caused it I have been on Novorapid 3 times a day and Glargene before bed for 15 years.

He then said talk to the diabectic nurse when you see her next week in clinic. I also take simvistatin tablets for my cholestrol so why have I suddenly got this defiency. Aditi Hi, My husband has been diagnosed as a type II diabetes at the age of He also takes diabetic multivitamin pack.

He takes fibator for lipids. My question is can he take Vitamin B12 supplements? I recently learned metformin decreases B12 absorption. Plus, he consumes very less of meat, just some white chicken and very less of dairy. How much vitamin B12 should he be taking?

In the last year or so I have been having so many different symptoms ranging from feeling sick, being constantly bloated, diarrhoea, constipation, swelling in my legs, pains in legs and numbness, not being able to breathe properly.

Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: You may experience blurred vision , dizziness , or drowsiness due to extremely low or high blood sugar.

Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcohol while using this medication because it can increase your risk of lactic acidosis and developing low blood sugar. High fever , " water pills " diuretics such as hydrochlorothiazide , too much sweating , diarrhea , or vomiting may cause loss of too much body water dehydration and increase your risk of lactic acidosis.

Stop taking this medication and tell your doctor right away if you have prolonged diarrhea or vomiting. Be sure to drink enough fluids to prevent dehydration unless your doctor directs you otherwise. It may be harder to control your blood sugar when your body is stressed such as due to fever, infection, injury, or surgery.

Consult your doctor because increased stress may require a change in your treatment plan, medications , or blood sugar testing. Older adults may be a greater risk for side effects such as low blood sugar or lactic acidosis.

During pregnancy , this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Your doctor may direct you to use insulin instead of this product during your pregnancy. Metformin can cause changes in the menstrual cycle promote ovulation and increase the risk of becoming pregnant. Consult your doctor or pharmacist about the use of reliable birth control while using this medication. Metformin passes into breast milk in small amounts.

Consult your doctor before breast -feeding. Interactions Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Other symptoms of low blood sugar , such as dizziness , hunger , or sweating , are unaffected by these drugs. Many drugs can affect your blood sugar , making it harder to control.

Before you start, stop, or change any medication , talk with your doctor or pharmacist about how the medication may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high or low blood sugar.

See also Side Effects section. Your doctor may need to adjust your diabetes medication, exercise program , or diet. Overdose If someone has overdosed and has serious symptoms such as passing out or trouble breathing , call Otherwise, call a poison control center right away. US residents can call their local poison control center at Canada residents can call a provincial poison control center. Overdose can cause lactic acidosis.

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