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However, a 2017 expert review and best-practice statement produced by the American Gastrointestinal Association (6) concluded that “Long-term PPI users should not routinely raise their intake of… vitamin B-12… beyond the Recommended Dietary Allowance (RDA)” and that “Long-term PPI users should not routinely screen or monitor… vitamin B-12.” Moreover, a 2014 commentary concluded that “there is no evidence that pathological levels of the biochemical markers of B12 are more common in metformin-treated compared with non–metformin-treated patients, despite lowering B12 in serum or plasma” (7)
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