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Dr called shortly after I placed my order, & B12 arrived 2 days later

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This means the cells produce more of the receptor, making them more responsive to vascular growth signals

Cyanocobalamin Pharmacokinetics European Journal of Cardiovascular Medicine: Vitamin B12 Deficiency in Long-Term Metformin Users USFDA Adverse Event Reporting System: Vitamin B12 Deficiency Associated with Metformin and PPIs MedRxiv (PNAS Preprint): Patient-Reported Treatment Outcomes in ME/CFS and Long COVID Journal of Neurological Sciences / Nutrients: Cognitive Function and Neuropathy

These findings are intriguing yet still incomplete

For patients concurrently taking metformin, periodic B12 monitoring should be considered , particularly if you have been on metformin for several years or have symptoms of deficiency, in line with MHRA and NICE recommendations