Neuropathy Nugget #3: Does the use of metformin impact thiamine (vitamin B1) utilization?

Which of the following is true?

A. Research indicates that people on metformin are at equal risk of thiamine deficiency when compared to diabetics not on metformin.

B. Research indicates that people on metformin are at greater risk of thiamine deficiency when compared to diabetics not on metformin.

C. Research indicates that people on metformin are at lesser risk of thiamine deficiency when compared to diabetics not on metformin.

 

Thiamine (vitamin B1) deficiency, a condition that is endemic in diabetics, is a well-established cause of polyneuropathy. Reversing thiamine deficiency is an important clinical goal in the treatment of diabetic and other polyneuropathies.

All diabetics are at great risk of being thiamine deficient. An important study published in 2007 found that plasma thiamine levels were decreased by 75% in diabetics when compared with non-diabetics. The study showed that the cause of the deficiency was due to kidney dysfunction. People with diabetes urinated out thiamine at rates 16 to 20 fold of non-diabetics.

The problem of thiamine deficiency is compounded in diabetics on metformin. Metformin has been shown to inhibit thiamine transporter molecules found in the intestines and other tissues.

 

The correct answer is:

B. Research indicates that people on metformin are at greater risk of thiamine deficiency when compared to diabetics not on metformin.

 

So, when a patient is on metformin and presents with polyneuropathy, consider supplementation with benfotiamine, a lipid soluble thiamine derivative that is absorbed from the intestines via passive diffusion. The absorption of benfotiamine from the intestines is independent of thiamine transporters.

 


 

This Neuropathy Nugget is authored Dr. Richard Mann, CEO and Founder of Realm Labs, makers of NeuRemedy®.  Feel free to contact Dr. Mann at (561)-549-9099 or rhm123@gmail.com if you would like to discuss with him ways in which you can more effectively treat polyneuopathy in your office.

NeuRemedy® improves the function of the nerves in the feet and legs. NeuRemedy® is licensed by Health Canada to support the healthy function of nerves in individuals with polyneuropathy.*  To begin dispensing NeuRemedy in your office call (561)-549-9099 today.

 

 

*This statement has not been evaluated by the Food and Drug Administration.  This product is not intended to diagnose, treat, cure or prevent any disease.

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