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[20] Patients should contact their GP or bariatric team promptly if they experience any of the following: New or worsening tingling, numbness, or weakness in the limbs Difficulty with balance, coordination, or memory Unexplained fatigue, breathlessness, or palpitations A sore or swollen tongue, or persistent mouth ulcers Any concern that they have missed supplementation for a prolonged period Symptoms that suggest anaemia, such as pallor or dizziness New or worsening neurological symptoms such as paraesthesia, gait disturbance, or cognitive change warrant same-day assessment

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"Prevalence of vitamin B12 deficiency in type 2 diabetic patients using metformin: a cross-sectional study"