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Some patients feel as though they want more frequent injections, and occasionally we test levels to see if they are receiving adequate replacement, but Im not sure how strong the evidence is to support this. GPs should consider periodic vitamin B12 testing of higher-risk patients who take metformin, even if they dont display symptoms of deficiency, the UK medicines regulator said earlier this year

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Feeling down or moody: Scarce B12 throws off your brains chemistry, lifting homocysteine levels and stirring up low moods or irritability

Keith Ladner is a double board-certified and fellowship-trained facial plastic surgeon in Denver, CO and Beverly Hills, CA