Interactions with medications Some medications can interfere with vitamin B12 malabsorption: Metformin Medication for reflux eg Omeprazole (Losec), Pantoprazole (Somac), Esomprazole (Nexium) Cimetidine and Ranitidine Neomycin If youre starting metformin or youve been taking it and still feel unsure about it Dr Sultan has created this clear, practical guide to help you understand what its doing and what to expect
They have no diagnosis, no recent bloods, and they want it today
Patients considering combination approaches should understand that this represents an unproven strategy that increases cost and injection burden without documented benefit
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A single injection can send a serum level into the thousands and keep it elevated for weeks or months