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Importantly, this study also demonstrated that the B12 reduction associated with metformin use is not transitory but persists and progresses over time and, in some patients, to levels at which replacement is recommended

Their deficiency is among the most common and impactful nutritional shortfalls affecting quality of life tingling, numbness, fatigue, and cognitive decline are all correctable symptoms of deficiency

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Clinical Trials: Impact of B12 Supplementation on Metabolites Serum B12 Holotranscobalamin Methylmalonic Acid Homocysteine Notes on Clinical Trials of B12 Supplementation Appendix C