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Studies suggest that a significant proportion of long-term metformin users may develop biochemical B12 deficiency, though estimates vary widely depending on the population studied, the duration of use, and the B12 threshold applied

Daratumumab monotherapy in patients with treatment-refractory multiple myeloma (SIRIUS): an open-label, randomised, phase 2 trial

Therefore, its worth asking your doctor to also check your active vitamin B12 levels (also known as holotranscobalamin II) and blood or urine levels of methylmalonic acid (5)

hypomagnesemia has been linked to an increase in endothelial permeability, decreased vasodilatation and an increase in the production of vasoconstrictor substances, and rapid damage to micro vessels, leading to focal hemorrhages and cerebral edema