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Metformin remains a widely used pharmacological option for PCOS, particularly for women with insulin resistance or impaired glucose tolerance

Blood levels of methylmalonic acid, a protein breakdown product, and homocysteine are better markers that capture actual vitamin B12 activity

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Dizziness and fatigue Memory loss, difficulty in concentrating, and cognitive difficulties Anemia or iron deficiency anemia Muscle cramps Shortness of breath Erratic moods and possible signs of mental health disorders such as depression Irregular or halted menstruation Inflamed tongue Low energy Hair Your Vitamin B12 deficiency may also be a symptom in itself of other diseases such as SIBO ( Small Intestinal Bacterial Overgrowth ) or other gut-related disorders