Nevertheless, use of metformin may decrease vitamin B 12 status: a meta-analysis of four short-term intervention trials (up to 4 months duration) in patients with type 2 diabetes found that metformin use decreased serum cobalamin concentrations by 57 pmol/L, which could have clinical implications if such patients have suboptimal vitamin B 12 status (146)
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Below is a quick recap of the main procedures and some final tips to help reinforce earlier guidelines
Making gradual and sustainable adjustments, rather than drastic, unsustainable changes is key
I will start the next higher dosage in about a week and a half
(PubMed) Clarke R, Birks J, Nexo E, et al