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Unlike methyl-B12, it does not directly donate methyl groups and can actually help buffer excess methylation

[23] [24] The MHRA advises testing for B12 deficiency if symptoms or signs develop in patients taking metformin, and considering periodic monitoring in those at risk

These bacteria use the B12 vitamins in the body thus leading to lesser amounts available for your use

Gastrointestinal malabsorption: Patients with Crohns disease, celiac disease, gastric bypass or intestinal surgery often cant absorb B12 properly

Chronic conditions with poor blood supply -- where the tissue needs ongoing support to rebuild vasculature -- fit this profile well