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Accordingly, it has issued new advice to check vitamin B12 serum levels in patients being treated with metformin who have symptoms suggestive of vitamin B12 deficiency.[] The proposed mechanisms to explain metformin-induced vitamin B12 deficiency among patients with T2DM include alterations in small bowel motility, which stimulates bacterial overgrowth and consequential vitamin B12 deficiency, competitive inhibition or inactivation of vitamin B12 absorption, alterations in IF levels, and interaction with the cubulin endocytic receptor
It is a tolerance-building phase
Patients who transition from gastric banding to other bariatric procedures such as sleeve gastrectomy or Roux-en-Y gastric bypass should be aware that these carry a higher risk of B12 and other micronutrient deficiencies due to their malabsorptive components, and monitoring should be intensified accordingly
Use the stack calculator for dosing guidance
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If you are considering methylcobalamin, talk with your healthcare provider to determine whether it is the right form of vitamin B12 for your needs
