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Summary-level data for 4 enzymes including alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma glutamyltransferase (GGT), was available from the UK Biobank

Metformin, commonly prescribed for type 2 diabetes, is well-known to cause diarrhoea and is also associated with B12 deficiencymeaning patients may be taking both simultaneously

Some people who need shots include those who have had gastrointestinal surgery if their digestive system cannot absorb vitamin B12 efficiently

How Can Vitamin B12 Shots Help With Weight Loss

In addition to limited absorption via the IF, the intake of high-dose supplements leads to passive diffusion, i.e., the vitamin can freely enter the bloodstream without IF binding and receptor uptake