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Case report reveals symptomatic vitamin B12 deficiency in metformin users, highlighting risks of neuropathy, cognitive impairment, and anaemia.
Metformin is an invaluable hypoglycaemic agent. We report two cases who had symptomatic vitamin B12 deficiency related to metformin use; the mechanisms are discussed. The clinician must be aware of the possibility of metformin-associated B12 deficiency in users who suffer cognitive impairment, peripheral neuropathy, subacute combined degeneration of the cord or anaemia.
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Liu et al. (2006) studied this question.
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