Metformin and B-12 Malabsorption
Authors: VICTOR HERBERT
Journal: Annals of Internal Medicine (1972)

Editorial Notes1 January 1972Metformin and B-12 MalabsorptionVICTOR HERBERT, M.D.VICTOR HERBERT, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-1-140 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSeveral drugs, including certain chemotherapeutic agents (methotrexate), antimalarials (pyrimethamine), diuretics (triamterene), protozoacides (pentamidine isethionate), antibacterials (trimethoprim), anticonvulsants (diphenylhydantoin sodium), sedatives (barbiturates), oral contraceptives, antituberculous agents (cycloserine, para-aminosalicylic acid), and colchicine (for gout), may produce intestinal malabsorption of vitamin B-12 or of folic acid, or both (1). The latest culprit to be added to the ranks of such drugs is metformin (2), a member of the biguanide group of oral hypoglycemic agents used to treat obese, mild-diabetes patients, in whom they are alleged to favor weight loss (3).Any drug capable of producing intestinal malabsorption may potentially produce malabsorption of vitamin...References1. WAXMAN S, CORCINO J, and HERBERT V: Drugs, toxins and dietary amino acids affecting vitamin B12 or folic acid absorption or utilization. Am J Med 48:599-608, 1970 CrossrefMedlineGoogle Scholar2. BERCHTOLD P, BOLLI P, and ARBENZ U: Intestinale AbsorptionsstÖrung infolge Metforminbehandlung. Diabetologia 5: 405-412, 1969 CrossrefMedlineGoogle Scholar3. DANOWSKI T (editor): Diabetes mellitus and obesity: phenformin hydrochloride as a research tool. Ann NY Acad Sci 148:573-962, 1968 Google Scholar4. HERBERT V: Malabsorption syndrome secondary to B12 deficiency, in Hematopoietic and Gastrointestinal Investigations with Radionuclides, edited by GILSON AJ, SMOAK WM. Springfield, Ill., Charles C Thomas, Publisher, 1972 Google Scholar5. STOWERS J and BEWSHER P: Studies on the mechanism of weight reduction by phenformin. Postgrad Med J, supplement, May 1969, pp. 13-19 MedlineGoogle Scholar6. WILLMS B and CREUTZFELDT W: Contribution to the intestinal resorption of vitamin B12 (abstract). Diabetologia 6:652, 1970 Google Scholar7. TOMKIN G, HADDEN D, and WEAVER J: Vitamin-B12 status of patients on long-term Metformin therapy. Br Med J 2:685-687, 1971 CrossrefMedlineGoogle Scholar8. CZYZYK A, TAWECKI J, and SADOWSKI J: Effect of biguanides on intestinal absorption of glucose. Diabetes 17:492-498, 1968 CrossrefMedlineGoogle Scholar9. HOLLOBAUGH S, RAO M, and KRUGER F: Studies on the site and mechanism of action of phenformin. Diabetes 19:45-49, 1970 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: VICTOR HERBERT, M.D.Affiliations: Columbia University College of Physicians & Surgeons Bronx Veterans Administration Hospital New York, N.Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMetformin Is a Pyridoxal-5′-phosphate (PLP)-Competitive Inhibitor of SHMT2Metabolomic fingerprint reveals that metformin impairs one-carbon metabolism in a manner similar to the antifolate class of chemotherapy drugsVitamin B12 and Folic Acid: Clinical and Pathophysiological ConsiderationsArzneimittel und VitaminversorgungNutritional Anemias Overview; Megaloblastic AnemiasDie klinische Anwendung der Biguanide 1 January 1972Volume 76, Issue 1Page: 140-141KeywordsAnticonvulsantsAntimalarialsDrugsHypoglycemicsOral contraceptive therapyOverweightPyrimethamineSedativesSodiumWeight loss ePublished: 1 December 2008 Issue Published: 1 January 1972 PDF downloadLoading ...