I recommend 1,000 micrograms of B12 daily, taken in sublingual form (dissolved under the tongue). I find that of the three B12 forms, methylcobalamin is by far the best.
B12 needs other nutrients in order to be most effective. So I recommend:
- Folate – 1.6 mg daily
- Vitamin B6 – 100 mg daily
- Magnesium – 400 to 500 mg daily
Your best dietary sources of B12 are primarily meat, fish and eggs (so vegetarians and vegans will definitely want to supplement). Folate and B6 are found in asparagus, lentils, chickpeas, most varieties of beans, and especially spinach and other leafy green vegetables. For magnesium, you want to eat plenty of avocados, nuts, seeds, whole grains, and (again) leafy green veggies.
I recommend the Wellness Essential for Bloood Sugar packet.
May 2010 — In type 2 diabetes, long-term metformin treatment is linked to vitamin B12 deficiency, according to the results of a multicenter, randomized, placebo-controlled trial reported Online First May 20 in the BMJ.
”Metformin is considered a cornerstone in the treatment of diabetes and is the most frequently prescribed first line therapy for individuals with type 2 diabetes,” write Jolien de Jager, from the Academic Medical Center in Amsterdam, the Netherlands, and colleagues. “Metformin does, however, induce vitamin B-12 malabsorption, which may increase the risk of developing vitamin B-12 deficiency — a clinically important and treatable condition.”
“Long term treatment with metformin increases the risk of vitamin B-12 deficiency, which results in raised homocysteine concentrations,” the study authors write. “Vitamin B-12 deficiency is preventable; therefore, our findings suggest that regular measurement of vitamin B-12 concentrations during long term metformin treatment should be strongly considered.”
Dr. Tucker’s comments: Dietary counseling should be considered with every person on Metformin. I know eating a low-sugar diet can be difficult. A new formula called Glucorest contains touchi extract which has been shown to blunt the glycemic response and supports healthy glucose and triglyceride metabolism – without reported adverse effects. Order Glucorest from the Metagenics link.
BMJ. Published online May 20, 2010.