Does Metformin Cause Dementia?

Written by Nguyenjessica

Published on April 22 2025

Managing type 2 diabetes with metformin can feel like a double-edged sword. On one hand, it’s a trusted, effective medication that controls blood sugar and prevents complications like nerve damage and heart disease. On the other hand, questions about its impact on brain health—like the risk of dementia or memory issues—can leave you feeling uncertain.n this guide, we’ll explore metformin’s impact on your brain, who needs to be cautious, and simple tips to safeguard your cognitive health. Keep reading to take control of your health with confidence!

Key Points

Metformin’s Brain Benefits
Studies show metformin not only controls blood sugar but may also lower the risk of dementia and Alzheimer’s. It works by reducing inflammation and protecting neurons.

Risk of Vitamin B12 Deficiency
Long-term use of metformin can lower vitamin B12 levels. This may lead to memory issues, cognitive decline, and nerve damage. Regular B12 checks are essential.

Who Should Be Careful
People with kidney or liver problems, severe infections, or heavy alcohol use should use metformin cautiously. It can increase the risk of lactic acidosis.

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Table of content

What exactly is metformin and why do people take it?

Can taking metformin increase my risk of dementia?

How might metformin affect my brain?

Who needs to be extra careful when taking metformin?

Does metformin mess with your B12 levels and brain function?

How can I protect my brain while taking metformin?

What exactly is metformin and why do people take it?

Metformin is a popular medication for type 2 diabetes. It helps lower blood sugar by improving how the body uses insulin. It also reduces how much sugar the liver makes.

Many people take metformin to manage diabetes when diet and exercise aren’t enough. It helps prevent complications like nerve damage, kidney issues, and heart disease. For those with prediabetes, it may delay or prevent diabetes.

Metformin is also used for PCOS. It helps lower insulin levels and can improve fertility. Researchers are studying it for other uses, like heart health, cancer, and liver disease. There’s even interest in its potential effects on aging and brain health, but more studies are needed.

Side effects are usually mild, like nausea or diarrhea. Long-term use might cause vitamin B12 deficiency. Unlike some diabetes drugs, it doesn’t cause weight gain.

Metformin is affordable, safe, and effective. It’s widely used for diabetes and other conditions, making it a trusted option worldwide.

Can taking metformin increase my risk of dementia?

There’s good news for those taking metformin: it doesn’t raise your risk of dementia. In fact, studies suggest metformin might even help protect your brain, especially for people with type 2 diabetes.

Research has shown that people with diabetes who stop taking metformin (while not having kidney issues) face a higher chance of developing dementia. Specifically, they had about a 21% greater risk compared to those who stayed on the medication. This isn’t just about blood sugar control—it seems metformin itself might offer some protection for the brain.

Other studies back this up too. Metformin has been linked to a lower risk of both dementia and Alzheimer’s disease when compared to other diabetes treatments or no treatment at all. Scientists believe this could be due to the way metformin improves how the brain processes glucose, reduces inflammation, and protects neurons. It may also reduce harmful tau protein buildup, which is often seen in Alzheimer’s.

How might metformin affect my brain?

Metformin can boost memory and thinking skills. It fights inflammation and stress in the brain, which are big causes of aging and disease. It works through pathways like Akt and AMPK.

It also protects brain cells by calming inflammation in cells like microglia. This can slow damage linked to Alzheimer’s and Parkinson’s. Plus, it helps grow new neurons and lowers harmful tau proteins, which are a problem in Alzheimer’s.

Metformin may also improve mood and brain function by helping nerve connections work better. It even changes how the brain uses energy, reducing stress on cells and keeping them healthy.

Metformin isn’t perfect. High doses or long-term use, especially in people without diabetes, might hurt memory or increase Alzheimer’s markers like amyloid plaques.

It can also cause vitamin B12 deficiency, linked to memory problems. This might explain why some studies show mixed results. Interestingly, its benefits might differ by gender. Some studies show it helps females more than males.

Who needs to be extra careful when taking metformin?

Metformin is generally safe, but some people need to be cautious because of potential side effects, especially lactic acidosis. Here are the groups who should take extra care or avoid metformin:

Kidney Problems
If you have severe kidney issues or poor kidney function, metformin isn’t recommended. It can build up in your system and raise the risk of lactic acidosis.
Liver Disease
Liver problems can make it harder for your body to clear metformin and increase risks of complications.
Heart Issues
People with conditions like heart failure or a recent heart attack are more prone to oxygen shortages, which can make metformin dangerous.
Older Adults
Those over 65 should monitor their kidney function closely since they’re more likely to have kidney problems.
Surgeries or Imaging with Contrast Dye
If you’re having surgery or a scan with contrast dye, you may need to stop metformin temporarily. This helps avoid kidney issues.
Severe Infections or Breathing Problems
Serious infections, dehydration, or low oxygen levels can increase the risk of lactic acidosis while taking metformin.
Heavy Alcohol Use
Excessive drinking can raise the chance of lactic acidosis and low blood sugar when combined with metformin.
Acute Metabolic Conditions
Conditions like diabetic ketoacidosis or metabolic acidosis make metformin unsafe.
Allergies to Metformin
If you’re allergic to metformin or similar drugs, it’s best to avoid it.

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Does metformin mess with your B12 levels and brain function?

Yes, metformin can lower your vitamin B12 levels, and this might impact brain health over time.

Metformin reduces how your gut absorbs vitamin B12. It affects the calcium-dependent process that helps your body take in B12. Over time, this can lead to lower levels, especially if you’re on higher doses or take it for a long period. The deficiency often develops slowly, sometimes taking months or years to become noticeable.

Low B12 levels can cause memory problems, cognitive decline, mood changes, and even nerve damage. Studies show that diabetic patients on metformin with low B12 levels don’t do as well on cognitive tests. This suggests that B12 deficiency might explain some of metformin’s effects on brain function

If you’re taking metformin, get your B12 levels checked regularly, especially if you’ve been on it for a long time. If levels are low, your doctor may recommend B12 injections or oral supplements to prevent complications.

How can I protect my brain while taking metformin?

1. Keep an Eye on Vitamin B12 Levels

Get Tested Regularly: Ask your doctor to check your B12 levels, especially if you’ve been on metformin for a long time.
Eat B12-Rich Foods: Include fish, meat, eggs, and dairy in your diet to naturally boost levels.
Take Supplements if Needed: If you’re low on B12, consider supplements like methylcobalamin under your doctor’s guidance.

2. Maximize Metformin’s Brain Benefits

Understand Its Role: Metformin reduces inflammation, encourages new brain cell growth, and protects against certain brain injuries.
Use the Right Dose: Work with your doctor to ensure you’re taking the right amount to balance benefits and side effects.

3. Live a Brain-Healthy Lifestyle

Eat Well and Exercise: A balanced diet with antioxidants and regular physical activity can support your brain and complement metformin’s effects.
Reduce Stress: Activities like meditation or yoga can help your brain stay sharp and reduce mental strain.

4. Stay Connected with Your Doctor

Regular Check-Ups: Share any concerns about memory or cognitive changes with your healthcare provider.
Stay Informed: Keep up with the latest research on metformin and brain health to make the best decisions for your care.