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For patients with clinical deficiency, effective replacement therapy should lead to a normal blood count after two months of treatment, while improvement in neurologic symptoms begins within one week after initiation of therapy and is usually complete within 6 weeks to 3 months.13 For patients with an asymptomatic biochemical deficiency (ie, subclinical disease), measurement of serum B12 or MMA levels should be done 2 to 3 months after initiation of replacement therapy.12 Once metformin is started, this medication is seldom discontinued unless advanced renal impairment develops

Yes, that includes sublingual forms of B12 as well

Retrieved February 19, 2022

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Maintaining optimal levels of these vitamins is particularly important during weight management or when undergoing medical treatments like semaglutide therapy, which can impact nutrient absorption

It is also a required substrate for sirtuins and PARP enzymes involved in DNA repair, gene regulation and processes tied to aging [5] [6]