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🤔 Does metformin cause vitB12 deficiency?
❗️Metformin is the most prescribed drug for type 2 diabetes. Should you monitor vit B12 in pts taking it?
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#MedTwitter #tweetorial #Endotip
❗️Metformin is the most prescribed drug for type 2 diabetes. Should you monitor vit B12 in pts taking it?
Follow the🧵
#MedTwitter #tweetorial #Endotip
Let's start with a poll. Do you order vit B12 for pts taking metformin?
ADA Standards of Care 2022
"Long-term use of metformin may be associated with biochemical vitamin B12 deficiency; consider periodic measurement of vitamin B12 levels in metformin-treated patients, especially in those with anemia
or peripheral neuropathy."
pubmed.ncbi.nlm.nih.gov/34964876/
"Long-term use of metformin may be associated with biochemical vitamin B12 deficiency; consider periodic measurement of vitamin B12 levels in metformin-treated patients, especially in those with anemia
or peripheral neuropathy."
pubmed.ncbi.nlm.nih.gov/34964876/
Hey #MedTwitter,
An asymptomatic patient came to the outpatient clinic because of low TSH, high fT4/T3, and positive TRAb
Final diagnosis: Biotin supplement use🤔
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#Endotip #MedEd
An asymptomatic patient came to the outpatient clinic because of low TSH, high fT4/T3, and positive TRAb
Final diagnosis: Biotin supplement use🤔
Follow the 🧵
#Endotip #MedEd
Biotin supplements are commonly used and do not change thyroid function.
On the other hand, biotin often causes lab assay interference mimicking Graves' disease:
⬇️ TSH
⬆️ fT4 and T3
⬆️ TRAb
On the other hand, biotin often causes lab assay interference mimicking Graves' disease:
⬇️ TSH
⬆️ fT4 and T3
⬆️ TRAb
TRAb is a marker of Graves' disease, the most common cause of thyrotoxicosis/hyperthyroidism, and has a high accuracy :
- Sensitivity: ~ 97%
- Specificity: ~ 99%
📢Beware that despite high reliability, TRAb result can be falsely elevated in the setting of biotin use
- Sensitivity: ~ 97%
- Specificity: ~ 99%
📢Beware that despite high reliability, TRAb result can be falsely elevated in the setting of biotin use
