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The MHRA advises that metformin commonly reduces B12 levels and recommends testing if deficiency is suspected (for example, in patients with anaemia or neuropathy) and considering periodic monitoring in people with risk factors such as higher doses, longer duration of treatment, or other risk factors for deficiency

Nervous System Health: B12 plays a crucial role in maintaining a healthy nervous system

Injections bypass the gut and deliver B12 directly into circulation, making them particularly effective in these cases