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[31], the mean duration between the initiation of metformin treatment and the onset of vitamin B12 deficiency was 5.3 years
Switching to preservative-free formulations typically resolves the issue for people who need b12 but react to standard preparations

Gastric acid is responsible for the process of breaking down food so that the body can store B12 in the liver and muscles until it's needed

Don't shake or aggressively mix it