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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
A slowed metabolism and weight gain can occur for a variety of reasons, such as not eating enough calories, too much cortisol, high insulin levels, or thyroid problems
Convenient: Sublingual B12 can be purchased OTC and taken at home, without a prescription
This includes confirmed low serum vitamin B12 levels, pernicious anaemia, malabsorption states such as coeliac disease, inflammatory bowel disease, or post-gastric or bariatric surgery, unexplained anaemia, neuropathy or neurological symptoms consistent with vitamin B12 deficiency, a long-term vegan diet with symptoms or low levels, or failure of oral vitamin B12 supplementation
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