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Facial flushing , warmth, or transient hot sensation
Metformin has also been shown to inhibit the calcium-dependent absorption of the vitamin B12IF complex at the terminal ileum
48,49 In this situation, measurement of serum methylmalonic acid and total homocysteine is useful in making the diagnosis of vitamin B12 (markedly elevated levels) deficiency in patients who have not received treatment, including those who have only neurologic manifestations of deficiency
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