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Vitamin B12 plays a vital role in converting carbohydrates, fats, and proteins into usable cellular energy

In a previous randomised, placebo-controlled trial, de Jager et al (2010) added metformin 850 mg three times daily to insulin therapy (a higher metformin dose than is usually now used) and demonstrated a number needed to harm of just under 14 for development of B12 deficiency over the 4.3 years of the trial

When to Avoid the Use of B12 Fortunately, for most animals, it is uncommon to overdose on B12

Turn the bottle of B12 upside down, insert the clean needle into the rubber seal and withdraw the required dosage

10.1016/j.abb.2014.08.017 158 XuW.HouL.LiP.LiL

roughly 50-98 % of an administered dose is renally excreted unmetabolized, underscoring the low intrinsic toxicity