8,9 Table 1 Risk Factors for Vitamin B12 Deficiency A multicenter randomized controlled trial of 390 patients with diabetes mellitus showed that those taking 850 mg of metformin three times per day had an increased risk of vitamin B 12 deficiency (number needed to harm = 14 per 4.3 years) and low vitamin B 12 levels (number needed to harm = 9 per 4.3 years) vs
see NHS guidance and Xenical/Alli SmPCs), and injectable GLP-1 receptor agonists such as semaglutide (Wegovy) and liraglutide (Saxenda)
When intake falls short or absorption fails, supplementation or injections can help restore healthy levels
This might involve looking into: Thyroid function Iron levels Sleep patterns (sleep apnoea, insomnia) Mental health assessments Chronic health conditions Dietary habits Stress management The B12 shot did its job by correcting that specific deficiency, but the journey to resolving your fatigue may require a broader look at your health
However, it can take 3-6 months to fully recover
He was told he could not have injections until a specialist could be consulted, despite that being the course of treatment the guidelines recommended