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In a previous randomised, placebo-controlled trial, de Jager et al (2010) added metformin 850 mg three times daily to insulin therapy (a higher metformin dose than is usually now used) and demonstrated a number needed to harm of just under 14 for development of B12 deficiency over the 4.3 years of the trial

Vitamin B12 plays a vital role in converting carbohydrates, fats, and proteins into usable cellular energy

The median increase of vitamin B12 levels in the non-responder group was 97 pmol/l (IQR: 78, 173) and in the responder group 934 pmol/l (IQR: 571, 1130)

Intervertebral Disc Stenosis Suppose a 62-year-old patient visits the clinic with ongoing neck pain that spreads into both shoulders

When to Avoid the Use of B12 Fortunately, for most animals, it is uncommon to overdose on B12