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Studies suggest that a significant proportion of long-term metformin users may develop biochemical B12 deficiency, though estimates vary widely depending on the population studied, the duration of use, and the B12 threshold applied

Thompson R, Taddei T, Kaplan D, Rabiee A

Potential benefits may include support for: Healthy red blood cell production Normal neurological function Energy metabolism General wellbeing where deficiency exists It is important not to assume that vitamin B12 injections are suitable or necessary for everyone

Animal studies in diet-induced obese rats show tesofensine treatment produces improvements in metabolic status including increased insulin sensitivity, reductions in plasma lipid levels, and enhanced glucose homeostasis

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