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Confirming or excluding interference Discordance between the result and the clinical picture raises the possibility of assay interference

Metformin, commonly prescribed for diabetes, and proton pump inhibitors used for acid reflux can both reduce B12 absorption over time

References Sourced from Neelakantan et al., Biochemical Pharmacology (2018), on NNMT inhibitors reversing diet-induced obesity in mice

Vitamin B12 shots are also prescribed for fatigue, depression and to boost cognitive functions in the elderly

This depends on how severe the deficiency is and how well the patient responds to treatment

Therefore, in patients with significantly impaired renal function or in infants, the therapy should be used only if clearly indicated and with careful monitoring