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NICE NG28 similarly recommends considering periodic monitoring of B12 in people at risk on long-term metformin this is not a blanket recommendation for all metformin users, but is targeted at those with relevant risk factors or symptoms

The improvement in how the skin looks and feels and consequently in confidence and overall wellbeing is a genuine and meaningful benefit that builds progressively with regular treatment

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Int J Epilepsy

Clin Rev Allergy Immunol 61(3):403423

The aim of treatment is to reduce both GH and IGF-1 to within normal limits