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assalamuwalaikum, Metformin can reduce absorption of Vitamin B12, and this is a well established long term adverse effect. Mechanism Metformin mainly interferes with: Calcium dependent absorption of the intrinsic factorB12 complex in the terminal ileum Long term metformin therapy and vitamin B12 deficiency: An association to bear in mind PMC How B12 injections can boost energy and health Mind Matters Weight Loss Clinic posted on the topic LinkedIn Metformin & Vitamin B12 Deficiency: What Diabetics Need to Know TikTok Why Metformin Users Need to Monitor Vitamin B12

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