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I used to find IGF1 confusing too and to be honest, I still have to pull out a notebook now and then

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Metformin reduces intestinal absorption of vitamin B12 in up to 30 % of patients, and lowers serum vitamin B12 concentrations in 510 %, but rarely causes megaloblastic anemia

J Hum Reprod Sci (2015) 8(4):191

Proposed mechanisms encompass modulation of nuclear factor-kappa B (NF-B), tumor necrosis factor-alpha (TNF-), interleukin-6 (IL-6), C-reactive protein (CRP), reactive oxygen species pathways, and downstream metabolic networks that regulate insulin signal transduction ( Critically, the published clinical literature on curcumin in type 2 diabetes is characterized by wide heterogeneity in formulation type, dose, treatment duration, and participant phenotype