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It is therefore possible to be B12 deficient despite having high B12 blood levels for example, if the vitamin cannot correctly bind to transport molecules (6)
Unlike oral supplements, because it is injected and not ingested, it goes directly into the system without being diluted or wasted to enhance mental performance, energy levels, and overall quality of life
It is also used as an antidote in problems with paracetamol overdose to protect liver cells
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)
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