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.
Very interesting info. I take B12 1000mcg 2 times a week to get my B12 in normal range, because it was low last year. The cause is metformin 500-1000 (changed it from time to time) for maybe 5-7 years. So its interesting to add acarbose, but don’t know how to understand that it helps.
Greetings
I’m 75 yo, and have used metformin for many years.
I started Acarbose 3+ months ago.
I also take a standard multi B vitamin supplement.
A recent blood test for B12 came back at 1395 pg/ml ( N 232-1245 ).
Prior B12 tests (2023, 2020) had been approx 950
So perhaps acarbose does prevent a metformin induced fall in B12, but only an N = 1
who takes metformin and acarbose and supplements with extra B12 and folate ?