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Metformin tops this list, with well-documented effects on b12 levels

California Medi-Cal, for example, applies MCO-specific authorization rules that differ from the state FFS program

You may benefit from a B12 injection if you are experiencing: Persistent tiredness or fatigue Low mood or irritability Difficulty concentrating Muscle weakness Pins and needles Pale skin Reduced appetite If you are unsure whether you need B12 supplements or injections, our pharmacist can provide guidance based on your symptoms and health history

[9] Transient itching or rash has been noted in some cases, possibly indicating a mild sensitivity reaction