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Therefore, people on vegetarian or vegan diets need to make sure they are getting enough B12 from other sources

People taking metformin, the common diabetes drug, are known to develop B12 deficiency as well, and people who avoid animal products can be deficient

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The search strategy, developed according to PRISMA, and Cochrane best practices, encompassed five major databases (PubMed/MEDLINE, Cochrane Library, Google Scholar, ClinicalTrials.gov, and ProQuest) alongside manual searches of key references, grey literature, and clinical trial registries to ensure comprehensive retrieval of both published and unpublished studies