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So, the B12 in the serum is OK, but in the brain, it is low

[11] found that NNMT expression levels are elevated in WAT and the liver of the T2D mice and that NNMT knockdown improves the glucose tolerance and insulin sensitivity in the T2D mice

Routine testing of vitamin B12 levels in metformin-treated patients should be considered. Because metformin often causes digestive tract upset, many patients are also put on a proton pump inhibitor (PPIs) such as esomeprazole ( Nexium ), lansoprazole ( Prevacid ) or omeprazole ( Prilosec )