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In the randomized placebo-controlled HOME trial of 390 adults with type 2 diabetes (de Jager and colleagues, Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency, BMJ, 2010), metformin lowered serum B12 by a mean of 19 percent over 4.3 years

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relies on internal QC Thorne Methylcobalamin Best practitioner-grade tablet Form & DoseMethylcobalamin (1,000 mcg per capsule) Servings60 capsules per bottle Price Per Day~$0.40 Best ForCapsule preference, maximum quality control Verified July 2026 Thorne is one of the most respected practitioner-grade supplement brands and one of the few that operates a TGA-registered manufacturing facility (the Australian regulator's pharmaceutical-grade standard)