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August 11, 2020
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Should Doctors be Testing Vitamin B12 Status in Diabetics?

The short answer is yes. Four reasons come to mind immediately, but there are others. Firstly, because vitamin B12 deficiency is known to cause peripheral neuropathy and diabetic neuropathy is present in about 20% of patients when they are first diagnosed and present in the majority of diabetics in due course. Secondly, B12 deficiency is present in up to 40% of people who take metformin, the most commonly prescribed first line oral medication for diabetes in the world. The bigger the dose and the longer the patient has been taking it, the greater the likelihood of developing B12 deficiency. Thirdly, B12 deficiency is one of the causes of elevated homocysteine, which is a well recognized risk factor for heart disease and stroke - common complications of poorly controlled diabetes. What is the fourth reason? Diabetics will tell you that watching a strict diet, taking multiple tablets or shots to control blood sugars, other medications as needed for high blood pressure, elevated cholesterol and checking blood finger-stick blood glucose levels several times a day is hard work. Very hard work. So, it makes sense that a simple test that leads to discovery of low B12, which is present in up to a third of diabetics and much higher (75%) in countries like India with high vegan or vegetarian populations, is very worthwhile if it leads to supplementing B12. This is a simple fix, that is not difficult, and may bring huge relief for neuropathy and reduce cardiovascular risk.

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Who Wrote This
Jonathan Bortz MD
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Jonathan’s background as a practicing diabetes specialist for 15 years and 17-year career developing nutritional prescriptive products for the pharmaceutical industry has contributed to his ability to understand nutrients, how they work and why they are important.

Over the years he has acquired broad and in-depth knowledge in minerals, essential fatty acids and other nutrients, but has special expertise in Vitamin B12 and choline metabolism. He is often asked to speak at national and international venues to articulate why B12, folate and choline are so important to gene function, brain development, liver and cardiovascular health. He applies pharmaceutical standards to nutrient science and has developed a unique ability to translate complicated concepts into simple promotional messages that resonate with practitioners and consumers. He has developed dozens of innovative nutritional products, of which many are category leaders in the US. Jonathan obtained his medical degree from the University of the Witwatersrand Medical School in South Africa and did his fellowship in Endocrinology at Washington University in St. Louis, MO.

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