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showed that low serum vitamin B 12 levels were observed in individuals taking metformin at doses over 2000 mg/day, and a prevalence of mild neuropathy reaching 22.3% in the metformin-users group compared to 15.1% in the non-metformin users group, consistent with the results of previous studies in the literature [49]

The subcutaneous injection of long-acting irritating substances (such as long-acting glucocorticoids) should be avoided

Pernicious anaemia , the autoimmune condition causing B12 malabsorption, may coexist with other autoimmune disorders, including autoimmune thyroid disease and, less commonly, rheumatoid arthritis

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