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Diabetes patients face particular vulnerability due to metformin therapy, which significantly impairs B12 absorption over time

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Mecobalamin improved pernicious anemia in an elderly individual with Hashimotos disease and diabetes mellitus Of course, were not suggesting you treat PA with oral tablets

The above is usually talked of in terms of 'anaemia', but it does show that there is a complicated link between B12, B6, folic acid, zinc and vitamin D levels, chronic disease (anaemia of chronic disease) and how the body 'manages' serum iron, ferritin, and transferrin iron saturation and keeps these in balance (or not, as in your case)

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