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In addition, many risk factors have been associated with the impact of metformin on vitamin B 12 levels in diabetic patients such as dose and duration where longer durations showed a greater prevalence of developing vitamin B 12 deficiency

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Low serum vitamin B12 concentrations in people using metformin are associated with hyperhomocysteinemia [48], a higher incidence of neuropathy [49,50], and worse neuropathy scores [51]

Overdosage with iron dextran is unlikely to be associated with any acute manifestations

Mild deficiency: Patients with mild B12 deficiency might only need a small dose

Vitamin B12 is an essential nutrient that helps support several important body functions, including energy production and nerve health