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As well as causing B12 deficiency, an increase in methylmalonic acid occurs, which is thought to result in loss of myelin in the peripheral nerves and, consequently, neuropathy, which may be symptomatic as early as 2 years into metformin treatment

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Signs and Symptoms of B12 Deficiency A lack of Vitamin B12 can show in many ways, including: Fatigue and Weakness : Early signs from not making enough red blood cells

Mol Neurodegeneration 19 , 6 (2024).
