Vitamin B12 deficiency is associated with long-term metformin use, with reduced B12 levels occurring in approximately 1030% of users, though clinically significant deficiency is less common
However, most weight loss specialists recommend continuing therapy at a lower dose rather than stopping completely, since even microdosing maintains some appetite suppression
People with diabetic retinopathy, sleep apnea, or serious gastrointestinal issues may need special medical care
High-fructose, medium chain trans fat diet induces liver fibrosis and elevates plasma coenzyme Q9 in a novel murine model of obesity and nonalcoholic steatohepatitis
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I saw a number of people who developed a syndrome like anorexia nervosa on Topamax, Schwartz says disordered behaviors that disappeared once they stopped the drug