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Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes

Clinical stage 3 Individuals in stage 3 perform in the impaired/abnormal range on objective cognitive tests

Symptoms of vitamin B12 deficiency include: In most cases of vitamin B12 deficiency, the body has not absorbed the required amount through digestion for several reasons

Symptoms of vitamin B12 deficiency: extreme tiredness a lack of energy pins and needles a sore and red tongue mouth ulcers muscle weakness problems with your vision psychological problems, which can range from mild depression or anxiety to confusion and dementia problems with memory, understanding and judgement Causes of a vitamin B12 deficiency: pernicious anaemia a lack of these vitamins in your diet medicine certain medicines, including anticonvulsants and proton pump inhibitors (PPIs), can affect how much of these vitamins your body absorbs

Label every vial with both the compound name and dose units to avoid 1,000x errors

Too much B12 by blood testing indicates your form is working