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Management If B Deficiency Is Confirmed Oral cyanocobalamin: 10002000 g daily or IM hydroxocobalamin: Loading: 1 mg weekly for 46 weeks Maintenance: 1 mg every 23 months Metformin should usually be continued Supplement B rather than stopping metformin 7
Joint Stiffness or Aches: This may be related to tissue repair activity or fluid shifts and is usually mild
tell a professional immediately if red flags emerge
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Severe nausea may occur, particularly after the first dose
Clinical Evidence: Head-to-Head Weight Loss and Metabolic Outcomes Direct comparison studies and real-world data reveal important differences in efficacy, side effect profiles, and metabolic benefits
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