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First, the doctor will have to suspect B12 deficiency as a possible cause of the patients symptoms, combined with their risk factors

Georg Seifert would like to acknowledge the DBU Deutsche Bundesstiftung Umwelt (ID: 37986/01 for Nutrition for Planetary Health in der Schule)

The ascorbate portion helps improve iron uptake in the intestine, which helps restore low iron levels and may reduce symptoms such as fatigue and weakness

Since then, many small, short-term studies have reported an increased risk for biochemical vitamin B12 deficiency in patients taking metformin, with an incidence ranging from 5.6% to 36%.2-4 A large long-term study published in 2016 reaffirmed that B12 deficiency affects a small but significant proportion of patients taking metformin.5 This study analyzed data on 1,800 participants from the Diabetes Prevention Program and the Diabetes Prevention Program Outcomes Study who were at high risk for T2DM