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Metformin & Folic Acid

Sep 2, 2011 | By Joseph Pritchard

Folic acid, or folate, is a water-soluble B vitamin found in both synthetic and natural form. Dietary sources of folate include cereals, leafy vegetables, bananas, melons and legumes. Folate helps lower your risk of developing cardiovascular conditions by lowering your levels of homocysteine, MayoClinic.com notes. The recommended daily dose of folate for anyone 14 and older is 400 mcg. Metformin lowers folate levels, according to a study published in a 2003 “Journal of Internal Medicine.”

Metformin and Safety

Metformin is an oral diabetes medication that helps people with Type 2 diabetes manage their blood sugar. This medication is often part of a treatment program that includes diet, exercise and weight management. Avoid drinking alcohol when taking metformin. Other adverse effects associated with Metformin are muscle pain and weakness, numbness of the arms and legs, breathing difficulties, dizziness, arrhythmia and stomach upset. Always take metformin as directed by your doctor, and seek medical attention in the event of adverse effects.

Short-Term Effect on Folic Acid Levels

A study featured in a 2003 issue of the “Journal of Internal Medicine” found that metformin lowers folate and vitamin B-12 levels in as little as 16 weeks. The study examined the short-term effects of metformin treatment on folate, vitamin B-12 and homocysteine levels of Type 2 diabetics also being treated with insulin. A total of 745 insulin-treated Type 2 diabetics participated in the study. The results showed a 4 percent increase in homocysteine levels coinciding with a 7 percent drop in folate and 14 percent decrease in vitamin B-12 levels. This suggests that short-term treatment with metformin slightly elevates your risk of developing cardiovascular problems because homocysteine has a negative effect on your overall cardiovascular health. Folic acid and vitamin B-12 supplementation are likely necessary to prevent deficiency and manage homocysteine levels.

Long-Term Effect on Folic Acid Levels

Long-term metformin treatment has been associated with a 5 percent decrease in folate levels, according to a study published in a 2010 issue of the “British Medical Journal.” The study involved 390 insulin-treated Type 2 diabetics who were given 850 mg doses of metformin three times a day for 4.3 years. The percentage change in vitamin B-12, folate and homocysteine levels were measured at the start of the study and then at four, 17, 30, 43 and 52 months. The results showed a 5 percent increase in homocysteine levels and a 19 percent drop in vitamin B-12 levels. This suggests a higher likelihood of vitamin B-12 than folate deficiency resulting from long-term metformin treatment.

Metformin Effects and Folic Acid Supplementation

Folic acid supplementation enhances the positive effects of metformin and prevents potential folate deficiency, according to a study published in a 2010 issue of “Diabetes Care.” The study had 50 participants affected by polycystic ovary syndrome but who did not have metabolic or cardiovascular diseases. The subjects were treated with daily doses of 1,700 mg of metformin and 400 mcg of folic acid or a placebo for six months. The group receiving folic acid supplementation did not exhibit elevated homocysteine levels compared to the group on the placebo. This suggests that folic acid supplementation helps keep homocysteine levels from elevating as a result of metformin treatment. However, more research is necessary to examine the effects of supplementation on Type 2 diabetics.

References

Article reviewed by Bonny Brown Jones Last updated on: Sep 2, 2011

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