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With daily B12 shots, you will at least prevent symptoms and nerve damage from getting much worse

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 )

Its used to treat B12 deficiency

This means your medication came lyophilized and needs to be mixed

NNMT Inhibition, NAD+ & Obesity/Type 2 Diabetes Pathway Review (PMC, 2021) 5-Amino-1MQ as a Validated Research Tool for NNMT-Linked Metabolic Pathways A comprehensive review of NNMTs roles in obesity and type 2 diabetes published in BioMed Research International and indexed on PubMed Central evaluated 5-Amino-1MQ alongside other NNMT inhibitors