Vitamins
Vitamin B12, Metformin and Tingling Feet: What to Check First
Low vitamin B12 can cause numbness and tingling in the feet, even before anemia shows up. Metformin and acid reducers can lower B12 over time. Ask your doctor for a B12 blood test instead of guessing. Nerve Savior lists B12 as cyanocobalamin but prints no amount; label math caps it at about 667 mcg.
Written by the Nerve Savior editorial teamUpdated · 8 min read
The basics
Can low vitamin B12 cause tingling feet?
Yes. A shortage of vitamin B12 can cause numbness and tingling in the hands and feet, and it can happen even when your blood count looks normal. The NIH Office of Dietary Supplements says nerve symptoms can appear without anemia (ODS, Vitamin B12).
B12 helps keep the nervous system healthy (MedlinePlus, Vitamin B12). When levels run low for a long time, nerves may not work as they should. MedlinePlus lists loss of balance along with numbness or tingling in the arms and legs (MedlinePlus, Vitamin B12).
Adults need only 2.4 mcg a day (ODS, Vitamin B12). That is a tiny amount. Even so, some people cannot absorb enough from food.
Risk
Who is more likely to run low on B12?
People who take metformin or acid-reducing drugs for a long time are more likely to run low on B12. The ODS names both drug groups as ones that can lower B12 absorption (ODS, Vitamin B12).
Metformin
A common first drug for type 2 diabetes. Over time it can lower how much B12 your body takes in (ODS, Vitamin B12).
PPIs
Proton pump inhibitors such as omeprazole cut stomach acid. Your body needs stomach acid to free B12 from food (ODS, Vitamin B12).
H2 blockers
Another type of acid reducer. The ODS lists these with PPIs as drugs that can lower B12 (ODS, Vitamin B12).
Do not stop any of these medicines on your own. They treat real conditions. The fix, if one is needed, is a test and a plan from your doctor.
Two causes
Diabetic neuropathy or low B12: which is it?
It can be either one, or both, and only testing can tell. Diabetes is the leading cause of nerve damage in the U.S., and B12 deficiency is one of the best-known vitamin causes (NINDS, Peripheral Neuropathy).
Here is the tricky part. A person with type 2 diabetes may take metformin for years. High blood sugar can harm nerves (NIDDK, Diabetic Neuropathies). The medicine can lower B12. Both paths can lead to tingling feet. One-third to one-half of people with diabetes have nerve damage (NIDDK, Diabetic Neuropathies).
Treatment depends on the cause (NINDS, Peripheral Neuropathy). Nerve problems from low B12 may respond to B12. Nerve problems from high blood sugar call for blood sugar control and foot care.
Testing
Which B12 test should you ask your doctor for?
Ask your doctor for a vitamin B12 blood test, especially if you take metformin or an acid reducer. A blood test tells you where you stand. A guess does not.
Name your symptoms
Say where the tingling is, when it started, and if it is worse at night or on walks.
List your medicines
Include metformin, PPIs, H2 blockers and every supplement, with doses (ODS, What You Need to Know).
Ask about B12
Ask whether a B12 level, and any follow-up test your doctor prefers, makes sense for you.
Agree on a plan
If you are low, your doctor will pick the form, the dose and when to recheck.
The CDC also says not to wait for your next visit if you notice tingling, numbness or a sore on your foot (CDC, Diabetes & Feet). Our foot care guide covers daily checks.
Forms
What is cyanocobalamin, and is it safe?
Cyanocobalamin is the most common form of vitamin B12 in supplements. The ODS says it is the form most often used, and no upper limit has been set for B12 (ODS, Vitamin B12).
No upper limit means experts have not found a level where B12 from food or pills causes harm in healthy people. That does not make extra B12 useful for everyone. If your level is normal, more B12 is unlikely to change how your feet feel.
Nerve Savior lists "Vitamin B12 (as Cyanocobalamin 1%)." The 1% means the ingredient is a dilute powder: one part B12 in a hundred. See the vitamin B12 ingredient page for more.
Label math
How much vitamin B12 is in Nerve Savior?
The label does not say. B12 is ninth of eleven ingredients in a 600 mg blend, so the B12 powder can weigh at most 66.7 mg. At 1% strength, that is at most about 667 mcg of B12 per two capsules.
| Item | Amount | Source |
|---|---|---|
| Adult RDA | 2.4 mcg a day | NIH ODS (ODS, Vitamin B12) |
| Daily Value on labels | 2.4 mcg | FDA (FDA, Daily Values) |
| Upper limit | None set | NIH ODS (ODS, Vitamin B12) |
| Nerve Savior B12 powder (1%) | At most 66.7 mg | Label math: 600 mg divided by 9 |
| Nerve Savior B12 itself | At most about 667 mcg | 1% of 66.7 mg; real amount not printed |
The real amount could be far lower. Blend ingredients are listed from most to least by weight (FDA, Labeling Guide Ch. IV), which gives a ceiling, not a dose.
B12 has a Daily Value of 2.4 mcg (FDA, Daily Values). FDA's labeling guide says nutrients with RDIs "must be listed separately and the individual weights declared" (FDA, Labeling Guide Ch. IV). The Nerve Savior label puts B12 inside the blend with no amount. We note this as an observation, not a legal conclusion.
The Supplement Facts walkthrough shows where B12 sits on the panel.
The short version
Should you take Nerve Savior if you use metformin?
Ask your doctor first, and get your B12 checked. Nerve Savior contains some B12, but no amount is printed, so you cannot tell if it covers a shortage. It also contains cinnamon, B6 and salt, which are worth a mention at that visit.
Bottom line
What is the safest next step for tingling feet?
See a doctor and ask for a B12 test. Tingling, numbness or burning can signal diabetes, low B12 or another cause, and each one needs a different plan (MedlinePlus, Peripheral Nerve Disorders).
Keep taking your prescribed medicines. Check your feet every day. Bring every supplement bottle to your visit. Nerve Savior is a dietary supplement, not a treatment for neuropathy or any disease. Read who Nerve Savior is for before you buy.
FAQ
B12, metformin and tingling feet: common questions
Does metformin cause B12 deficiency?
Metformin can lower vitamin B12 absorption over time, according to the NIH Office of Dietary Supplements. Not everyone who takes it becomes deficient. A blood test is the way to know, so ask your doctor about checking B12, especially after years on the drug.
Can low B12 cause tingling in feet without anemia?
Yes. The NIH says B12 deficiency can cause numbness and tingling in the hands and feet even without anemia. A normal blood count does not rule out low B12, so ask your doctor about a B12 level if you have these symptoms.
Do omeprazole and other acid reducers lower B12?
They can. Proton pump inhibitors such as omeprazole and H2 blockers reduce stomach acid, which the body needs to release B12 from food. The ODS lists both as drugs that can lower B12 absorption. Do not stop them on your own; ask about testing.
How much B12 is in Nerve Savior?
No amount is printed. B12 is ninth in a 600 mg blend and is a 1% powder, so label math caps it at about 667 mcg per two capsules. The real amount may be much lower. The adult RDA is 2.4 mcg a day.
Can I take Nerve Savior with metformin?
Ask your doctor first. Nerve Savior includes cinnamon, which is studied for blood sugar, plus B6 and salt. More important, its B12 amount is not printed, so it cannot stand in for a tested B12 plan.
Is too much vitamin B12 harmful?
No upper limit has been set for vitamin B12, the NIH says, because no harm has been shown from high intakes in healthy people. Extra B12 is still not useful if your level is normal. Testing tells you whether you need it.
What blood test checks for B12 deficiency?
A vitamin B12 blood level is the usual starting point, and your doctor decides if more testing is needed. Tell them you take metformin or an acid reducer, and list every supplement you use.
Who wrote this
Written and reviewed by
Plain-language pages built from the bottle label, the order page and linked public health sources such as NIH, FDA and CDC.
Last updated . Read our editorial standards and the way we check reviews. This website is run by a U.S. retailer for Nerve Savior, not by the manufacturer. We get paid when you buy through our order links.
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