Metformin-related vitamin B12 deficiency.

Medical and Geriatric Unit, Shatin Hospital, New Territories, Hong Kong, China. kwliuhk@yahoo.com

Metformin is an invaluable hypoglycaemic agent. We report two cases who had symptomatic vitamin B12 deficiency related to metformin use; the mechanisms are discussed. The clinician must be aware of the possibility of metformin-associated B12 deficiency in users who suffer cognitive impairment, peripheral neuropathy, subacute combined degeneration of the cord or anaemia.