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Although cyanocobalamin is more readily absorbed, much of it is excreted through the urine before it can reach the cells Cyanocobalamin vs Hydroxocobalamin In comparison to hydroxocobalamin, cyanocobalamin has a significantly worse absorption rate and storability, which is why today mostly hydroxocobalamin is used in B12 injections

Safety Consult your doctor before starting any injectable treatment to ensure its safe and effective for you

Furthermore, patients with higher levels of both MMA and B12 had an elevated risk of mortality

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Food and Drug Administration: Glucophage (Metformin Hydrochloride) Tablets Label JCEM Case Reports : Metformin-Associated Vitamin B12 Deficiency: An Underrecognized Complication Clinical Diabetes : Increasing Vitamin B12 Screening Among Patients With Type 2 Diabetes on Long-Term Metformin Therapy Harvard Health Publishing: Vitamin B12 Deficiency Can Be Sneaky and Harmful Johns Hopkins Medicine: Vitamin B12 Deficiency Anemia Yale Medicine: Are You Getting Enough Vitamin B12