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This raises a question for vegans whove gone some time without a source of B12: Could they be suffering from mild B12 deficiency such that the small amounts of B12 in multivitamins might not be enough to correct their deficiency

Yes, B12 supplementation is appropriate if deficiency is confirmed, and the MHRA recommends monitoring B12 levels in people on long-term metformin

It does not significantly alter your appetite, your blood sugar, your mood, or your energy levels

If you use sterile water instead, you lose that protection entirely

Choline is essential for fat metabolism and liver function

If they are severe or persistent, they warrant contact with your prescribing provider