From the Research
Metformin can cause tremors, although this is not a common side effect, and it is more likely to occur as a result of metformin-induced vitamin B12 deficiency rather than as a direct effect of the medication itself. The mechanism relates to the body's response to vitamin B12 deficiency, which can cause neurological symptoms like tremors. Patients taking metformin should be aware that tremors warrant attention, especially if accompanied by other symptoms like weakness, fatigue, or numbness. According to a study published in 2022 1, metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic, and cardiac neuropathy in patients with diabetes, which may lead to tremors. Another study published in 2019 2 found that metformin use is associated with a significantly higher risk of vitamin B12 deficiency, which can cause neurological symptoms like tremors.
Some key points to consider:
- Metformin can cause vitamin B12 deficiency, which can lead to neurological symptoms like tremors
- The risk of vitamin B12 deficiency increases with the dose and duration of metformin treatment
- Patients taking metformin should be monitored for vitamin B12 deficiency, especially if they have been taking the medication for more than 5 years
- Vitamin B12 supplements can help prevent or treat vitamin B12 deficiency in patients taking metformin
It's essential to note that severe vitamin B12 deficiency is relatively uncommon with metformin monotherapy compared to other diabetes medications. However, patients experiencing recurrent tremors while taking metformin should consult their healthcare provider, who may adjust the dosage or recommend taking the medication with food to minimize this effect, or consider vitamin B12 supplements to prevent or treat vitamin B12 deficiency.