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Routine testing of vitamin B12 levels in metformin-treated patients should be considered. Because metformin often causes digestive tract upset, many patients are also put on a proton pump inhibitor (PPIs) such as esomeprazole ( Nexium ), lansoprazole ( Prevacid ) or omeprazole ( Prilosec )

The figure shows the precursors of L-methylmalonyl-CoA: Fatty acids and amino acids can be metabolized to propionyl-CoA, which is converted to D-methylmalonyl-CoA and then to L-methylmalonyl-CoA

Reduced stress can have a wide variety of other positive benefits on your body

Body composition: May support lean-mass and fat-loss goals over a cycle

Vitamin B12 injections are generally safe and well tolerated, with fewer side effects than corticosteroids