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A GP blood test is the only reliable way to confirm a deficiency, and NICE advises testing anyone on metformin who has a symptom or a risk factor

The practice profit comes from the spread between acquisition cost and payer reimbursement

Niacin or B3 Taking high-dose niacin supplements can result in skin-related allergic reactions, such as extreme facial flushing, also referred to as niacin flush. Flushing causes generalized itching and a burning sensation that is typically limited to the face and chest and lasts 20 to 30 minutes(1)

So, there is no one-size-fits-all answer