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Long term metformin therapy and vitamin B12 deficiency: An association to bear in mind PMC Why Should Metformin Users Watch Their Vitamin B12? The People's Pharmacy If you have been on Metformin for several years, monitoring is essential. The B12 Link: Long term use (typically 4+ years) can interfere with Vitamin B12 absorption. Symptoms to Watch: Fatigue, memory issues assalamuwalaikum, Metformin can reduce absorption of Vitamin B12, and this is a well established long term adverse effect. Mechanism Metformin mainly interferes with: Calcium dependent absorption of the intrinsic factorB12 complex in the terminal ileum Metformin use and vitamin B12 deficiency: New MHRA guidance DiabetesontheNet

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