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:

• Losing sense of smell or taste from COVID-19
• Sugar cravings after meals
• Feeling “hangry” between meals
• Weight loss resistance
• Weight gain
• Polycystic ovarian syndrome (PCOS)

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?

Age

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.

Genes

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!