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Long-term metformin use is associated with B12 deficiency in approximately 10-30% of patients, with risk increasing with duration of therapy and higher doses

It can change the color of hair and eyes, and white patches can also appear inside the mouth

Widely used in sports medicine and orthopedic practices globally

He received a diagnosis of B 12 deficiency 10 years ago, and during the covid-19 pandemic he switched from intramuscular hydroxocobalamin 1000 mcg once monthly to oral B 12 supplementation

however, some individualsespecially those on certain diets or medicationsmay struggle to absorb sufficient B12 from food alone