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Deficiencies can be easily prevented with proper supplementation

The mechanisms behind B12 deficiency in metformin users are multifactorial but are probably related to intestinal absorption, so it seems sensible to assume that oral B12 replacement may be less effective, although there is little evidence in this area

Association of Vitamin B12 with Pro-Inflammatory Cytokines and Biochemical Markers Related to Cardiometabolic Risk in Saudi Subjects

Your doctor may recommend taking vitamin B12, but they may also advise against taking supplements with very high concentrations of vitamin B12

By Alaiyka Parvez Owner, CoLaz Aesthetics Clinic The short version It depends on the form: hydroxocobalamin is stored refrigerated at 2 to 8C, while cyanocobalamin is generally stable at room temperature