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If you are taking metformin, your healthcare provider may recommend additional vitamin B-12 supplementation, especially if you are on a high dose of metformin or if you have other risk factors for vitamin B-12 deficiency

"It occurs in people whose B12 deficiency is caused by pernicious anemia," explains vitamin B12 expert and researcher Ralph Green, MD, PhD, a Distinguished Professor at the UC Davis School of Medicine

Vidal-Alaball J, Butler CC, Potter CC (2006) Comparing costs of intramuscular and oral vitamin B12 administration in primary care: a cost-minimization analysis