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The current serum vitamin B12 assay has limited specificity and sensitivity and there is much debate on what level should be classed as normal, as there is not always correlation between serum level and the symptoms experienced by the patient[11,17]
Regular measurement of hematologic parameters is recommended in all patients on chronic metformin treatment
The angiogenic action appears tied to T4s actin-binding motif: Philp et al., FASEB J 2003 demonstrated that this seven-residue site is essential for promoting endothelial migration and vessel formation
External memory aids and systems
These neurological symptoms require urgent medical attention, as prolonged B12 deficiency can lead to irreversible nerve damage
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