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Experts do not generally recommend discontinuing the use of metformin for people with new cases of vitamin B12 deficiency

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As absorption is reduced, body stores become low and a deficiency occurs Underlying diseases most commonly include: IBD (inflammatory bowel disease) Intestinal cancer (especially small cell lymphoma) Liver disease Pancreatitis and other pancreatic diseases Symptoms of low B12 levels Typically found in middle-aged or older cats that present with: Weight loss Diarrhea Vomiting Anorexia Thickened intestines In humans, B12 deficiency may also be associated with dementia, cardiovascular disease, and a certain type of anemia, although these are not specifically recognized problems in cats

Elevated homocysteine levels (which rise when vitamin B12, folic acid, or vitamin B6 are low) have also been associated in observational studies with higher rates of Alzheimers disease and dementia