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Methods We searched Google Scholar and PubMed using the keywords metformin, diabetes, vitamin B 12 , deficiency, metabolism, mechanism, risk factors, and side effects

If you are considering switching between medications, understanding injection technique at each site gives you flexibility

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My mum said she thinks its just a normal reaction but I just wanted to see if anyone else has ever had this heavy, achy pain in the upper arm going into the armpit and shoulder

However, NICE guidelines for substance misuse do not include NAD therapy, and evidence remains largely anecdotal

Contrary to the increase in homocysteine levels that is stated above, a cross-sectional study that concluded 1111 patients with type 2 diabetes who took metformin for at least 6 months reported that homocysteine levels were negatively correlated with vitamin B 12 levels, and suggested a hypothesis that B 12 deficiency due to the use of metformin occurred at the tissue level [40]