injection vitamine b12 Sandoz Vitamin Injectable Solution - 1000 mcg/10 mL Vitamin B-12 Injection - Mobile

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Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes

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Patients taking certain medications (e.g., chloramphenicol may reduce the effectiveness of B12 therapy) or with risk factors for B12 deficiency (metformin use, proton pump inhibitors, nitrous oxide exposure, vegan diet) should discuss these with their healthcare provider

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It is a biologically active fraction of vitamin B 12 that can be readily taken up by all cells and represents only 6% to 20% of total serum vitamin B 12 .23 In vitamin B 12 deficiency, serum level of holotranscobalamin decreases even before elevation in homocysteine and MMA levels occurs.24 It has been shown that holotranscobalamin is the most sensitive marker for vitamin B 12 deficiency, followed by MMA.23 25 Like homocysteine and MMA, holotranscobalamin cannot be tested in renal patients as its level increases in renal impairment.23 Furthermore, higher cost and lesser availability than homocysteine and MMA testing make it difficult to acquire wide clinical acceptance