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[1] The mechanism by which metformin reduces serum vitamin B12 levels has not been elucidated, but the most likely hypothesis is that metformin interferes with calcium-dependent membrane action responsible for vitamin B12 intrinsic factor absorption in the terminal ileum

The biggest change to current clinical practice is likely to be the advice to consider periodic monitoring of B12 levels in patients taking metformin who are at risk of deficiency, which includes a wide range of our patients living with type 2 diabetes

If your symptoms stay under control or lab results remain stable, the substitute for Eldervit 12 Injection Combipack is likely working well

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Butaphosphan is an organic compound that is a type of phosphonous acid