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[2,8] Metformin may reduce serum B12 levels by causing B12 to accumulate in the liver.[8] For example, randomized controlled trials of patients taking metformin for an average of 4.3 years had a ~20% decrease in B12 levels and a 7% increased risk of B12 deficiency compared to placebo

That is why supervised administration and regular follow-up are non-negotiable at our clinic

MIC B12 may be used as an add-on under clinician supervision based on your individual health evaluation and goals

[171 172 173 174] The gradual accumulation of plasma and cellular components into the interstitial tissue space leads to a chronic inflammatory process that can result in long-term tissue changes and permanent structural damage to the affected anatomical site and its overlying skin layer

This likely results from increased fatty acid oxidation and the energy cost of lipolysis itself
