An alternative conservative start uses 1mg for the first four weeks before moving to 2mg
In the randomized placebo-controlled HOME trial of 390 adults with type 2 diabetes (de Jager and colleagues, Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency, BMJ, 2010), metformin lowered serum B12 by a mean of 19 percent over 4.3 years
WELLBEING HEALTH BOOSTERS VITAMIN B12 INJECTION Vitamin B12 injections are offered following a full clinical consultation to assess suitability and potential deficiency
If switching is necessary, allow a 35 day washout period to clear residual plasma levels, then treat the new route as a fresh baseline
Lyophilized: Store at 28 C (35.646.4 F) for short-term or 20 C (4 F) for long-term storage in dry, dark conditions [10] [11]
Reduced appetite and maybe about 5 pounds weight loss after 4 weeks