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Nevertheless, use of metformin may decrease vitamin B 12 status: a meta-analysis of four short-term intervention trials (up to 4 months duration) in patients with type 2 diabetes found that metformin use decreased serum cobalamin concentrations by 57 pmol/L, which could have clinical implications if such patients have suboptimal vitamin B 12 status (146)
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The NHS advises that taking up to 2mg (2000 micrograms) daily of vitamin B12 supplements is unlikely to cause harm, with no established upper limit in the UK
"[205] Preparation of the reduced forms of vitamin B12 and of some analogs of the vitamin B12 coenzyme containing a cobalt-carbon bond", Vitamins and Coenzymes , Methods in Enzymology, vol
Harrison RF et al
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