Research suggests that metformin can reduce vitamin B12 absorption in the digestive tract, potentially leading to lower B12 levels over time
5-Amino-1MQ also increases the basal metabolic rate, helping the body burn more calories
"Nascobal (Cyanocobalamin, USP) Nasal Spray 500 mcg/spray 0.125 mL Rx only" (PDF)
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[9] Visual disturbances have been reported in patients with Leber hereditary optic neuropathy, and rapid B12 administration may precipitate optic nerve atrophy in this genetically predisposed population, mandating extreme caution or alternative therapy