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For many, these signs might lead them to wonder about their vitamin B12 levels

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Future studies should adopt targeted designs to mitigate these issues: Confounding by coexisting nutrient deficiencies: mineral deficiencies [e.g., zinc (344)] or vitamin deficiencies [e.g., vitamin D (169, 347349)] often co-occur with protein or fiber deficiencies

If the deficiency is detected, metformin can be continued while the deficiency is corrected with B 12 supplements

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