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doi:10.2147/JBM.S25620

Metformin may result in suboptimal oral vitamin B12 absorption by competitively blocking the calcium-dependent binding of the intrinsic factor-vitamin B12 complex to its receptor

While having megaloblastic anemia, hyperhomocysteinemia, and/or neuropathy are not medical conditions that influence vitamin B12 absorption, they are clearly indications for the use of vitamin B12 supplements when deficiency is established

Vitamin B12 is predominantly excreted via the bile and is largely reabsorbed via the enterohepatic circulation

Commonly Reported Effects Injection site reactions represent the most frequent complaint, typically involving mild redness, itching, or temporary discomfort at the injection location