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Individual regimens may vary, but treatment cycles typically consist of 8 to 12 weeks of usage followed by 4 to 8 weeks off

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Check vitamin B12 levels in people treated with metformin who have symptoms suggestive of vitamin B12 deficiency This will also include patients found to have megaloblastic anaemia (raised mean corpuscular volume [MVC]), who may be asymptomatic (MHRA, 2022)

doi: 10.1038/s41586-022-05022-3 210 WuZGengYLuXShiYWuGZhangMet al

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Other microbial metabolites, such as polysaccharide A and retinoic acid produced by commensal Clostridia , Faecalibacterium prausnitzii , and Bacteroides fragilis , induce the accumulation of regulatory T (Treg) cells, which suppress inflammation (Forbes et al., 2016)