Diabetes and Dementia and B12 Deficiency, Oh My!

Diabetes affects 11.3% of people in the US, and 90-95% of those people have type 2 diabetes. What many people may not know, however, is that all forms of diabetes will increase your risk of dementia. Glucose (sugar) is an essential source of energy for your brain, so when your insulin is not metabolizing it in a way that makes it useful, your brain misses out on important fuel. A pre-diabetic state is marked by insulin resistance, which is when your insulin cells can’t use glucose effectively.

Some early signs of insulin resistance include:

The catch is, even if you try to get your diabetes under control with medications such as metformin, you will still be increasing your chances of getting dementia.

The Misfortune of Metformin 

Metformin may be prescribed as generic, or by brand names such as Fortamet or Glumetza. It is a commonly used drug for type 2 diabetes and has been prescribed to over 120 million people worldwide.

Numerous studies have shown a correlation between use of metformin and chronic vitamin B12 deficiency. Typically within one year of consistent usage of metformin, your ability to absorb B12 becomes compromised and you may experience symptoms of B12 deficiency including:

  • Fatigue
  • Weakness
  • Headaches
  • Vomiting
  • Nausea
  • Dizziness
  • Lightheadedness especially coming from seated to standing
  • Feeling cold
  • Muscle pain or weakness
  • Tingling and numbness in the hands and feet
  • Loss of reflexes, which may progress to depression, confusion, and memory loss

B12, also known as cobalamin, is a vitamin that is essential for brain health and nervous system function. It is needed for the creation of red blood cells, which help distribute oxygen to the rest of our bodies (including our brains). It is no wonder, then, that low B12 levels have been linked to dementia. Researchers Norbert Goebels, M.D. and Michael Soyka, M.D wrote:

“Cobalamin deficiency has been shown to be the most frequent associated physical disease in patients with dementia.”

So, diabetes can lead to dementia, and the medication for diabetes can also lead to dementia. Not to mention the recent national recall for metformin based on a batch containing a carcinogenic (cancer-causing) chemical. Is there no way to win here? Well, our office has a different approach.

What Else Can Cause B12 Deficiency?


Besides medications like metformin, there are other risk factors that can lead to a B12 deficiency. Age is one of these factors. Ten to thirty percent of people over the age of 50 produce too little stomach acid to release B12 from the foods they eat. A certain amount of stomach acid is required to break down the carrier foods and release the B12 vitamin. This could mean that even though you are eating foods that technically contain B12, you may not be breaking the food down enough to actually absorb the B12. The older you get, the less stomach acid you produce, so this risk only increases.


MTHFR is a gene that helps our bodies convert folate, A.K.A. vitamin B9, to an activated version that our bodies can use. All B vitamins need to be converted to their methylated forms in order for our bodies to use them. What does this have to do with B12?

Our bodies need activated (methylated) folate in order to use B12. So, when there is a mutation on our MTHFR gene, it affects our body’s ability to make activated folate, and therefore our ability to use B12. This creates an interesting dynamic where someone can have completely normal levels of B12 in their blood, but are actually deficient in the vitamin and have the corresponding symptoms.

At Dr. Autoimmune, we are able to order specialized blood tests to detect mutations on the MTHFR gene when Dr. Ian suspects this may be a concern.

Managing Diabetes Naturally

Instead of prescribing medications that increase your risk of dementia, our office seeks to address the underlying cause of your condition and develop a management plan using lifestyle changes and proper supplementation.

One tool we frequently use is a continuous glucose monitor (CGM) to help our clients learn exactly how different foods affect their blood sugar. While we use this tool to manage and make decisions about diet changes, we also dive deeper.

As we mentioned at the beginning of this article, insulin resistance is a precursor to diabetes. Insulin resistance is caused by systemic inflammation in the body. This can be caused by gut dysbiosis, food sensitivities (particularly to gluten), toxin exposure (such as mold), stress, and hormone imbalances, just to name a few.

By identifying and addressing these root causes, rather than managing symptoms with a band-aid medication, our patients find that their bodies have exceptional healing abilities when given the right tools! If you are ready to change your life, click the “Start Your Journey” button at the bottom of this page.

Dr. Ian recently went viral with a video about MTHFR and B12 deficiency related to metformin use. Make sure to subscribe to him on TikTok to get daily health tips and kernels of knowledge!

Still Can’t Smell or Taste After COVID?

The virus that shook the world has a few symptoms we all know, such as loss of taste and smell. And by now, most of us have heard of the term “long-COVID”, referring to recovered COVID-19 patients who have symptoms long after they test negative for the virus. Long-COVID symptoms include continued absence of smell and taste, difficulty breathing, fatigue, and brain fog. If you have been struggling with this, there is hope!

According to an early study funded by the National Institutes of Health, about 70% of COVID-19-positive patients had lost their sense of taste and smell. A later study found that 61% of recovered COVID patients still had symptoms after 6 months. That is a long time to go without being able to smell anything!

So why are so many people not able to smell for months after they had the virus? Loss of smell (anosmia) is actually a sign that the brain is inflamed.

What Causes Brain Inflammation?

Diabetes, obesity, and insulin resistance are risk factors for severe COVID-19. In fact, this whole-population study in England showed that one third of all the COVID-19-related deaths occurred in people with diabetes. That’s a huge percentage!

While it is known that these are risk factors for severe COVID, emerging evidence is also tying these to long-COVID, especially loss of smell and taste. As we mentioned before, the loss of smell and taste is actually related to brain inflammation. This can be caused by insulin resistance.

When you eat, your food is broken down into glucose (sugar) molecules. Your body then releases insulin, which is a hormone that allows glucose to enter a cell and be used for energy. When your cells become resistant to it, glucose can no longer enter and be used. This causes two things: your cells no longer have an energy source, and inflammation starts to accumulate.

Insulin is an important hormone for brain function. Insulin resistance causes your brain to not have enough energy to function properly and become inflamed. It has been tied to the loss of smell that is common in diabetes patients, so it is no wonder that it is also the culprit behind your long-COVID symptom. Insulin resistance is also one of the most common culprits behind autoimmune disorders and dementia.

Other symptoms of insulin resistance:

  • Sugar cravings after meals
  • Fatigue
  • Feeling “hangry” between meals
  • Weight loss resistance

Insulin Resistance and Alzheimer’s

Your inability to smell or taste anything months after you had COVID-19 is an important sign that you may have insulin resistance that is causing your brain to become inflamed. This is important for you to get on top of not only so that you can enjoy your essential oil diffuser again, but also so that you can protect your brain from long-term damage.

Insulin resistance and diabetes have been linked to neurodegenerative diseases such as Alzheimer’s and other dementias for the same reasons they cause the loss of taste and smell. Over time, insulin resistance causes the brain to become more inflamed and receive less fuel for cell energy. Correcting insulin sensitivity levels can help you prevent, and sometimes even reverse, dementia.

Smell and Taste Again with Dr. Autoimmune

At Dr. Autoimmune, we have helped many patients resolve their long-COVID symptoms. We can get to the underlying cause of your extended suffering and find solutions that work for you. Insulin resistance can be brought under control with the right diet and supplementation regimens for your body. We frequently use continuous glucose monitoring to help patients understand exactly how different foods affect their blood sugar levels. Our extensive blood panel, including a fasting insulin marker, also helps us get a better picture of your metabolic health.

Do you miss being able to taste your favorite foods and smell your favorite natural candles? Fill out the form below to get started on your healing journey!

Long COVID Doesn’t Need to be Exhausting

Are you ready to overhaul your COVID symptoms? Finding relief at the end of a very long, arduous fight can be resolved with proper diagnostics and support. Getting to the root cause of your aches and pains is just what Dr. Autoimmune ordered. 

What is long COVID?  

Current research is conflicting, but it appears continuing symptoms could persist 1-3 months after infection, or even longer. The virus can trigger inflammation in various systems in your body, creating one or more symptoms.

If you have tested positive, or know you were exposed and have new or persisting symptoms from the the list below, your inflammation could be getting the better of you. Unfortunately these symptoms are so common that one research article indicated 52% of 16-30 year olds had symptoms at 6 months post-infection. These are some of the symptoms associated with long COVID:


  • Insomnia
  • Headaches
  • Fatigue
  • ‘Brain fog’
  • Anxiety/depression
  • Memory impairments
  • Pain syndromes

Lung / Pulmonary:

  • Reduced lung capacity
  • Wheezing / gasping / unable to get full breath
  • Chest pain / tightness


  • Palpitations
  • Abnormal heart rhythm
  • Clotting abnormalities


  • Abdominal pain
  • Nausea
  • Weight loss
  • Constipation
  • IBS


  • Elevated insulin
  • Fatigue after meals
  • Shaky, lightheaded or ‘hangry’

Why me?

Long COVID thrives on immune system weaknesses! There are multiple reasons why some experience long symptoms, while others are unscathed. Contributing factors may include age, obesity, inflammatory markers, and insulin resistance (IR). IR is when your cells resist insulin and can no longer use glucose for energy. This can cause sugar cravings after meals, weight loss resistance, and fatigue. 

One of the common symptoms of long COVID, loss of smell and taste, may indicate that the brain is resistant to insulin and therefore not getting enough fuel. Insulin resistance can lead to neurodegeneration (conditions like Parkinson’s and Alzheimers). Correcting insulin imbalances often lessen or eradicate symptoms.

How do we control insulin resistance?  

Functional medicine might be the answer to your blood sugar handling issues. Assessing inflammation in the body is the first step for determining if your problem is systemic and what the root cause may be. Commonly, the culprit is in your gut. Imbalances in your microbiome have a profound effect on all of your bodily systems. Hormone imbalances can have a similar impact. Could cortisol and stress dysregulation be causing sleep disturbances, leading to insulin resistance? A resounding yes!  

Dr. Autoimmune can help!

We have seen a dramatic increase of long COVID cases hauling their way through our practice. For many, autoimmunity was triggered or exasperated by the virus. Our proprietary process of diet, supplementation, lifestyle strategies and therapies can change your life. We have even seen cases that are now two years old improve or remiss!  

Call us today and find out how our New Patient Exam process can help your health soar.

Masking Your Child’s Immune System

Masks have become so politicized that even physical altercations have broken out regarding their usage. While many see mask-wearing as a decision that affects other people and is therefore not entirely personal, others maintain that everyone should take their health into their own hands.

Most schools around America that have been operating physically have implemented some sort of mask requirement. Even though children represent the demographic that is of the lowest risk and lowest spreading rate, they’ve still been forced to participate in the mask-wearing that has been the theme of this past year. Given the known negative effects of wearing masks along with the knowledge that children are of the lowest risk of mortality or getting severely ill from a COVID-19 infection, why are they still being forced to wear them?

Concerns have been raised over a false sense of security that may come from wearing a mask. If an individual is under the impression that a mask will protect them and others, they may become lax with other strategies that are equally, if not more effective at limiting the virus’s spread. Another concern is masks that are not properly kept clean may become spreading agents themselves. When considering children, can we really expect them to keep their masks properly sanitized? Sure, parents are responsible for this, but this brings us to our next issue. Think for a moment about how many people reuse their (often homemade) cloth masks every day.

The type of mask definitively alters its effectiveness. In this Vietnamese study, there was a significant difference in viruses spread among cloth mask wearers versus medical mask wearers. Hospital workers wearing cloth masks were 13 times more likely to contract an influenza-like virus. According to the study, “Penetration of cloth masks by particles was almost 97% and medical masks 44%.” Even more shockingly, cloth mask wearers were 3 times MORE likely to contract a virus than those who didn’t wear any mask at all. This means that the cloth masks actually increased the risk. Now ask yourself, is this good science or virtue signaling?

The Norwegian Institute of Public Health (NIPH) recommended against mask wearing for individuals without respiratory symptoms, citing concerns over proper usage. The researchers maintained that in order for an official recommendation to be effective, customized mask training needed to be provided directly to communities. They also stated that there is no reliable evidence that non-medical masks provide any protective effect. Let’s take a second to reflect on what this means, taking into account the supplies shortage we’ve seen regarding proper masks for medical workers. If we can’t even supply our front-line workers with proper equipment, the majority of the public is not going to be able to find the proper equipment. We’ve already seen that this leads to an increase in homemade cloth masks.

Children’s immune systems are young and flexible, making it the perfect time to introduce them to potentially harmful pathogens in the world so that they can learn how to protect themselves. It also makes them extremely resilient and quick to launch an attack on the virus (and we don’t have time to discuss how amazing breast feeding works for a baby’s immune system). Researchers have discovered that the SARS-CoV-2 virus is not able to replicate rapidly in childrens’ bodies due to a combination of factors. For one, because children’s immune systems are young, they contain many naive T cells just waiting to be deployed. Naive T cells are immune cells that have not yet been assigned to a specific virus or other pathogen, so they are readily available to study and launch an attack against a new pathogen. As a person grows up and is exposed to new environments, their bodies make less naive T cells because they’ve already learned the majority of antigens they encounter regularly.

Further evidence of a rapid immune response amongst children is found in the types of antibodies present in children versus adults following a COVID infection. Adults developed both antibodies against the SARS-CoV-2 spike protein (which allows the virus to enter a cell), and against its nucleocapsid protein (which is essential for the virus to replicate). Children, on the other hand, did not develop antibodies against the nucleocapsid protein because this protein is typically only present once the virus is widespread in the body.

All of these factors help to explain why some children develop Covid symptoms but repeatedly test negative for the virus on a PCR test. The virus simply is not able to replicate enough to show up on the test before the child’s body squashes it.

Another interesting possible reason for the low risk amongst children revolves around a specific enzyme found inside the nose called angiotensin-converting enzyme 2 (ACE2). This enzyme binds to spike proteins on the surface of the SARS-CoV-2 virus and allows it to enter the human cells. This study found that the amount of ACE2 in the nose increased with age, starting a very low amount for the youngest age group.

Age has been determined to be a large risk factor regarding Covid-19. One reason for this is the increased instance of comorbidities (other life-threatening conditions) amongst older populations. For example, Covid-19 patients who also have heart conditions are more likely to pass away from the infection. However in this study, age was independently a significant risk factor even after adjusting for such comorbidities. It is undeniable that children are at much lower risk than older adults, and not just for their lack of other health issues.

A child’s immune system is malleable and needs to be regularly challenged and stimulated in order to continue growing and strengthening. This study demonstrated the connection between growing up in a sterile environment and having a suppressed immune system. This concept is known as the ‘hygiene hypothesis’, which claims that early exposure to pathogens (amongst other things such as dander, mold and allergens) is integral to immune system development. If the child’s naive T cells never have the chance to meet any pathogens, how can they protect the child from disease later in life? 

In addition to learning about the external environment, the immune system must also learn to tell the difference between a real pathogen and a human cell look-alike. When foreign material resembles a bodily cell, such as gluten proteins with thyroid tissue, an inexperienced immune system may accidentally end up attacking the host’s own body. This is how autoimmunity begins.  But, gluten is not enough!  We must remember that the immune system is complex and it involves genetics, environment and triggers (all three are required for autoimmunity).  Merely having a family member with a chronic illness does not warrant the need to isolate our children – in fact, it harms their ability to respond when we don’t give them the opportunity to be outside, live life and just be kids!

There are also other factors to consider when discussing mask-wearing for children, notably the psychological effects it may have on them. Social distancing and school closures pose a new kind of challenge to a child’s interpersonal development. Hearing-impaired children lose the important tool of lip-reading as well as the practice necessary to hone that skill. Similarly, children within the autism spectrum lose the opportunity to practice reading facial expressions, which is something that they are predisposed to struggling with.

The question of whether we should force children to wear masks is a question of risk-benefit analysis. Simply, do the possible benefits outweigh the possible harms? If this isn’t the case, we cannot in good conscience advocate for society-wide mask requirements.

Yours in health,

– Dr. Ian Hollaman DC, MSc, IFMCP