Expert Opinion on Association of Metformin Use and Vitamin B12 Deficiency in Older Adults

Wong Chit Wa et al., in which they aimed to investigate whether metformin use is associated with vitamin B12 deficiency in the institutionalized elderly, and found that metformin use lead to an increased risk and severity of vitamin B12 deficiency. In this study vitamin B12 de？ciency was diagnosed if the serum vitamin B12 concentration was <150 pmol/L and the clinical presentation of cases defined as vitamin B12 deficient was not mentioned. Selecting serum vitamin B12 concentration below 150 pmol/L is not enough to diagnose B12 deficiency. Clinical presentation, functional tests, intracorpuscular vitamin B12 levels and the comorbidities which have effect on vitamin B12 should be evaluated to diagnose vitamin B12 deficiency