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Social media, podcasts, and influencer culture have really accelerated the awareness, says Jen Sogol Ash, ND, a doctor of naturopathic medicine, functional medicine expert, and a longevity director at Concierge MD and Drip Hydration in Los Angeles

It is likely that many patients will require intramuscular B12 replacement for the duration of their metformin treatment, although a trial of oral replacement initially may be worthwhile.