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People with diabetes who take metformin are at higher risk of developing B12 deficiency because this drug can reduce the absorption of vitamin B12 in the body B12 deficiency impairs motor and sensory nerve function

downregulation of destructive MMPs (MMP-1, MMP-3) Antioxidant systems: Increased expression of glutathione reductase, thioredoxin reductase, and superoxide dismutase isoformseffects documented in Pickarts 2015 study (PMID: 28386432) Angiogenesis control: Modulation of VEGF and angiopoietin pathways, explaining observed wound-healing acceleration in diabetic ulcer models Neuronal protection: Upregulation of neuronal survival factors and downregulation of pro-apoptotic proteins in hippocampal neuron culturesa neuroprotective dimension entirely absent from UK marketing materials This gene-regulatory breadth means clinical applications extend far beyond dermal cosmesis

Vitamin B12 is an essential, water-soluble vitamin

The early human research mostly used the cruder gland extract, which is one reason the evidence is messier than the sales pages admit

Its very common in older men