As a user of metformin and acarbose, I was always lead to believe that metformin use leads to a drop in folate and vitamin B12 levels, and I have been supplementing with additional folic acid and B12 to address that concern.
Then I found this paper…
It seems to hypothesise that increased carbohydrate delivery to the colon (due to action of alpha-glucosidase inhibitor) increases intestinal biosynthesis of folate. The combination of miglitol with metformin may prevent the metformin-induced fall in serum folate and vitamin B12.
What I would love to know is, is this a miglitol specific phenomenon or does it extend to acarbose as well ?
So I’m the only one who takes metformin and acarbose and supplements with extra B12 and folate ?
I was hoping maybe someone who had been on metformin long term had seen something in their blood work-up (an increase in B12 and folate levels) when they first started on acarbose.
I can’t believe that this hasn’t been seen or reported before
The article concludes: “The combination of miglitol with metformin may prevent the metformin-induced fall in serum folate and vitamin B12.”
It’s a 2000 article, only cited 20 times. I can’t find any other article backing up this claim. So it’s an interesting but very very weak assumption at this stage, unfortunately. (Remember that a third of clinical trials are fabricated…)
I’ve always had great difficulty replicating others papers, usually because they’ve left something innocuous, but important out of the methodology.
But equally I haven’t found any papers trying to replicate the study, and discrediting it.
I’m not entirely sold on the idea, but I thought it was worth raising, and I was asking if any other members had seen anything in their bloodwork to support or disprove the idea.
who takes metformin and acarbose and supplements with extra B12 and folate ?