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Does Metformin Interfere With Thiamine?

Does Metformin Interfere With Thiamine? Recent letters call attention to the tendency of metformin to interfere with vitamin B12 function.1,2 Perhaps metformin antagonizes other vitamins as well. Phenformin, the relatively toxic predecessor of the metformin, exhibited antithiamine activity in laboratory animals.3-5 Because thiamine vitally participates in the entrance of glycolytic pyruvate into the mitochondrial Krebs cycle, I hypothesize that an antithiamine effect of metformin contributes to some cases of metformin-associated lactic acidosis. Perhaps, as in beriberi, thiamine should be administered in a large dose to patients who develop metformin-associated acidosis.4,6,7 Metformin and thiamine have little molecular structure in common, but both are cationic molecules. References 1. Andrès ENoel EGoichot B Metformin-associated vitamin B12 deficiency. Arch Intern Med. 2002;1622251- 2252Google ScholarCrossref 2. Gilligan MA Metformin and vitamin B12 deficiency. Arch Intern Med. 2002;162484- 485Google ScholarCrossref 3. Loubatieres ALLoubatieres-Mariani MMAlric RBlayac JPValette G Effects of thiamine pyrophosphate and sodium dichloroacetate on the increase of lactate and insulin outputs induced by phenformin on the isolated and perfused rat pancreas. C R Seances Soc Biol Fil. 1977;171155- 160Google Scholar 4. Valette GRibes GRondot AMLoubatieres-Mariani MMLoubatieres AL Effect of cocarboxylase on hyperlactatemia and hyperpyruvicemia induced by phenformin in dogs. C R Seances Soc Biol Fil. 1975;169121- 125Google Scholar 5. Valette GRibes GLoubatieres-Mariani MMLoubatieres AL Consequences of the chronic administration of phenformine on the blood thiamine level in the dog. C R Seances Soc Biol Fil. 1975;1691562- 1567Google Scholar 6. Calabrese ATColey KCDaPos SVSwanson DRao RH Evaluation of prescribing practices: risk of lactic acidosis with metformin therapy. Arch Intern Med. 2002;162434- 437Google ScholarCrossref 7. Gan SCBarr JArieff AIPearl RG Biguanide-associated lactic acidosis: case report and review of the literature. Arch Intern Med. 1992;1522333- 2336Google ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Does Metformin Interfere With Thiamine?

Alston, Theodore A.
Archives of Internal Medicine , Volume 163 (8) – Apr 28, 2003
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Does Metformin Interfere With Thiamine?

Abstract

Recent letters call attention to the tendency of metformin to interfere with vitamin B12 function.1,2 Perhaps metformin antagonizes other vitamins as well. Phenformin, the relatively toxic predecessor of the metformin, exhibited antithiamine activity in laboratory animals.3-5 Because thiamine vitally participates in the entrance of glycolytic pyruvate into the mitochondrial Krebs cycle, I hypothesize that an antithiamine effect of metformin contributes to some cases of metformin-associated...
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References (7)

Publisher
American Medical Association
Copyright
Copyright © 2003 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.163.8.983
Publisher site
See Article on Publisher Site

Abstract

Recent letters call attention to the tendency of metformin to interfere with vitamin B12 function.1,2 Perhaps metformin antagonizes other vitamins as well. Phenformin, the relatively toxic predecessor of the metformin, exhibited antithiamine activity in laboratory animals.3-5 Because thiamine vitally participates in the entrance of glycolytic pyruvate into the mitochondrial Krebs cycle, I hypothesize that an antithiamine effect of metformin contributes to some cases of metformin-associated lactic acidosis. Perhaps, as in beriberi, thiamine should be administered in a large dose to patients who develop metformin-associated acidosis.4,6,7 Metformin and thiamine have little molecular structure in common, but both are cationic molecules. References 1. Andrès ENoel EGoichot B Metformin-associated vitamin B12 deficiency. Arch Intern Med. 2002;1622251- 2252Google ScholarCrossref 2. Gilligan MA Metformin and vitamin B12 deficiency. Arch Intern Med. 2002;162484- 485Google ScholarCrossref 3. Loubatieres ALLoubatieres-Mariani MMAlric RBlayac JPValette G Effects of thiamine pyrophosphate and sodium dichloroacetate on the increase of lactate and insulin outputs induced by phenformin on the isolated and perfused rat pancreas. C R Seances Soc Biol Fil. 1977;171155- 160Google Scholar 4. Valette GRibes GRondot AMLoubatieres-Mariani MMLoubatieres AL Effect of cocarboxylase on hyperlactatemia and hyperpyruvicemia induced by phenformin in dogs. C R Seances Soc Biol Fil. 1975;169121- 125Google Scholar 5. Valette GRibes GLoubatieres-Mariani MMLoubatieres AL Consequences of the chronic administration of phenformine on the blood thiamine level in the dog. C R Seances Soc Biol Fil. 1975;1691562- 1567Google Scholar 6. Calabrese ATColey KCDaPos SVSwanson DRao RH Evaluation of prescribing practices: risk of lactic acidosis with metformin therapy. Arch Intern Med. 2002;162434- 437Google ScholarCrossref 7. Gan SCBarr JArieff AIPearl RG Biguanide-associated lactic acidosis: case report and review of the literature. Arch Intern Med. 1992;1522333- 2336Google ScholarCrossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Apr 28, 2003

Keywords: metformin,thiamine

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