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The MHRA (2022) recently issued guidance on the increased risk of vitamin B12 deficiency in people treated with metformin, highlighting increased risks with higher metformin doses, longer treatment duration and in patients with risk factors for B12 deficiency, including the following: Existing low B12 levels

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Effects of Vitamin B12 Deficiency Vitamin B12 is essential for proper maintenance of the nervous system, red blood cell formation, and production of DNA

For these groups, vitamin B12 injection benefits often exceed those of oral supplements, delivering the nutrient directly into the bloodstream for fast, reliable absorption

Omega-3 fatty acids - EPA and DHA contribute to the maintenance of normal heart function and normal brain function and have well-studied anti-inflammatory properties relevant to the metabolic changes that accompany significant weight loss