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A recent analysis of the USFDA Adverse Event Reporting System revealed that patients taking both metformin and a PPI experienced significantly higher rates of hospitalizations and life-threatening complications related to B12 deficiency (such as severe neuropathy and cognitive decline) compared to those on monotherapy
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The most common method, also introduced by Schilling, is to inject a high dose of unlabeled B12 to saturate all binding capacities of the B12 binding proteins, and thereby facilitating urinary excretion of the absorbed radioactively labeled B12
Combined supplementation improves resistance to infections and supports faster recovery
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