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8,9 Table 1 Risk Factors for Vitamin B12 Deficiency A multicenter randomized controlled trial of 390 patients with diabetes mellitus showed that those taking 850 mg of metformin three times per day had an increased risk of vitamin B 12 deficiency (number needed to harm = 14 per 4.3 years) and low vitamin B 12 levels (number needed to harm = 9 per 4.3 years) vs

Many clients make B12 part of their regular wellness routine and schedule injections weekly or monthly depending on their goals and provider recommendations

Primary Care Guidelines for B12 and Folate Testing Indications for B12 and Folate Testing No need to check B12 levels in patient on parenteral B12 treatment (they will always be high) There is no indication to check GPA or INF purely because of family history of autoimmune disease or hypothyroidism Care should be taken when prescribing folic acid alone If folic acid is given to a patient who is actually b12 deficient, this may precipitate irreversible neurological complications References 1