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Digestive disorders such as Crohns disease or celiac disease, or those who have had gastric bypass surgery, can interfere with B12 absorption
It could point to several things: A different cause: your fatigue might stem from thyroid problems, iron deficiency, or sleep apnea rather than B12
In the study Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin , it was found that providing calcium supplementation to people taking metformin, was able to help prevent metformin-induced vitamin B12 deficiency
Effectiveness of lifestyle interventions for individuals with severe obesity and type 2 diabetes: results from the Look AHEAD trial
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