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The magnitude of this genetic interaction with metformin exposure is large and clinically relevant: 14% of the population with the AA genotype are ~2.5 times more likely than the wild-type GG group to require vitamin B 12 replacement therapy in the UKB and Scottish cohorts

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B12 shots work faster than oral sources of B12 and therefore are recommended for individuals who need rapid improvement

Altogether it can be concluded that an observed elevation of cobalamin in blood merits the a full diagnostic work up to assess the presence of disease

Always calculate and report the correct number of units based on the actual dose administered as documented in the medication administration record (MAR)