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[5], metformin was associated with a significantly increased risk of vitamin B12 deficiency starting in the fourth year of treatment

Causes of vitamin B12 deficiency Several things can cause vitamin B12 deficiency, including: pernicious anaemia your immune system mistakenly attacks cells in your stomach that produce intrinsic factor (a protein you need to absorb vitamin B12) diet plant-based diets, like vegan, vegetarian, and dairy-free diets are sometimes lacking in vitamin B12 medication some medications, like proton pump inhibitors (PPIs), can inhibit the absorption of vitamin B12 Youre also more at risk of vitamin B12 deficiency if you: are pregnant or breastfeeding are over 50 years old because you might stop producing enough hydrochloric acid in your stomach, which is needed for absorption of vitamin B12 suffer from a gastrointestinal disorder like coeliac disease or Crohns disease You should also remember that folic acid supplements can mask vitamin B12 deficiency

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