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Ishay Lev, MD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In the October 9th issue of the ARCHIVES, Ting et al¹ reported a dose-dependent inverse relationship between daily metformin dosage and low levels of vitamin B₁₂. They also found a higher prevalence of vegetarians in the same group of patients with metformin-related low levels of vitamin B₁₂ (referred to as borderline significant due to a P value of .04 and an odds ratio of 8.19 [95% confidence interval, 0.91-73.9]). The authors tried to suggest a causative relationship and recommend forgoing the annual blood examinations for vitamin B₁₂ levels in metformin-treated patients with diabetes, since the results of such screening should be regarded as obvious.¹

Vitamin B₁₂ deficiency and its relationship with metformin treatment has been studied extensively since the beginning of the 1970s.² Many suggestions were put forward to prevent or treat low levels of vitamin B₁₂, although there are no clear associations . . . [Full Text of this Article]

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RELATED LETTER

Metformin and Vitamin B₁₂ Deficiency: Association and Not Causation May Play a Major Role in Cohort Studies—Reply
Kai Ming Chow, Rose Zhao-Wei Ting, and Cheuk Chun Szeto
Arch Intern Med. 2007;167(7):730-731.
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