Long-term use of the diabetes medication Metformin is associated with reduced B vitamin absorption and elevated homocysteine levels. Homocysteine is an amino acid that when elevated is associated with cardiovascular disease, particularly arteriosclerosis, which is characterized by a thickening of your artery walls. These associations are not dose dependent, but rather dependent on length of use. Your doctor will typically prescribe B-12 and folate to help reduce your risk of elevated homocysteine levels.
Metformin
Metformin is used to control your blood sugar if you have Type 2 diabetes. High blood sugar can have detrimental effects on your body such as nerve and kidney damage. Several risk factors, such as being overweight, can make it harder for your body to use insulin, a blood sugar-regulating hormone. The initial treatment dose of Metformin is typically 500 mg. This is often enough to bring your blood sugar under control, however, some people will need a higher dose.
Homocysteine
Your body produces homocysteine from another amino acid called methionine, which is found abundantly in animal-derived products. Homocysteine is normally harmless, however, if allowed to rise it may damage the lining of your arteries, according to FamilyDoctor. Your body uses nutrients such as vitamin B-6, B-12 and folate to regulate homocysteine levels. These key nutrients convert homocysteine to a more beneficial amino acid known as cysteine, which acts as an antioxidant.
Link
Although 500 mg is the lowest starting Metformin dose, it does not decrease your risk of elevated homocysteine. Most Metformin doses taken long-term are associated with depleted B vitamins, and without enough of these key nutrients, homocysteine levels rise and place cardiovascular health at risk, according to FamilyDoctor. Treatment of diabetes is typically life-long, so short-term treatment is often not an option. If you are prescribed 500 mg of Metformin for long-term use, discuss your concerns with your doctor.
Reduce Risk
It is common for your health care provider to measure your homocysteine levels prior to prescribing Metformin. This helps determine whether you will need immediate intervention. If your homocysteine levels are currently high enough to place you at risk, your doctor can prescribe a homocysteine-lowering medication. If your homocysteine levels are in normal range and you are prescribed 500 mg of Metformin for long-term use, your doctor will typically prescribe a B vitamin combination to reduce your risk of depletion.
