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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

Deficiencies can be easily prevented with proper supplementation

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

2-APQC, a small-molecule activator of Sirtuin-3 (SIRT3), alleviates myocardial hypertrophy and fibrosis by regulating mitochondrial homeostasis

Pharmaceutics 14:411

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