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Nevertheless, use of metformin may decrease vitamin B 12 status: a meta-analysis of four short-term intervention trials (up to 4 months duration) in patients with type 2 diabetes found that metformin use decreased serum cobalamin concentrations by 57 pmol/L, which could have clinical implications if such patients have suboptimal vitamin B 12 status (146)

Women who follow vegan or vegetarian diets, have digestive issues (like Crohns or celiac disease), or have had weight-loss surgery may struggle to absorb enough B12 from food

They offer detailed insights into vitamin B12s health benefits and how it fights diseases

Conclusion To answer the original question directly: high B12 levels themselves don't typically cause symptoms

However, if serum cobalamin concentration is within the normal range, treatment should be continued at least monthly and the owner should be forewarned that clinical signs may recur sometime in the future

The problem