Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes
It is crucial to note that there is no official link definitively proving that elevated B12 causes these conditions , but observational studies have identified correlations warranting clinical awareness
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Taking an oral multivitamin on top likely wont cause harm because excess B vitamins are water-soluble and your body will excrete what it doesnt need
Furthermore, for individuals with MTHFR mutations or compromised liver function, methylcobalamin bypasses the metabolic bottlenecks that prevent the synthetic form from being utilized, ensuring the cells actually receive the active nutrient
Apply HCPCS code J3420 (1 unit per 1000 mcg administered) and CPT 96372 for the injection administration