Nevertheless, use of metformin may decrease vitamin B 12 status: a meta-analysis of four short-term intervention trials (up to 4 months duration) in patients with type 2 diabetes found that metformin use decreased serum cobalamin concentrations by 57 pmol/L, which could have clinical implications if such patients have suboptimal vitamin B 12 status (146)
Vitamin B12 (cobalamin) is a water-soluble vitamin essential for red blood cell formation, neurological function, and DNA synthesis
For those incorporating it into a weight loss program, injections are typically scheduled once per week to maintain energy and support metabolic function
Given their non-invasive nature, accessibility, and cost-effectiveness of sublingual formulations, they may represent a promising approach for long-term B12 management, particularly in patients with impaired absorption or in resource-limited settings
Moderate to Severe Deficiency: For moderate to severe deficiencies, the dosage may increase to 1,000 mcg several times a week initially, followed by a maintenance dose