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At the molecular level, it seems that the mechanisms of action vary depending on the dose of metformin used and duration of treatment

As a result, it is often mistaken for other conditions or dismissed as simply feeling run down. These symptoms can range from mild to debilitating and often include: Fatigue or extreme tiredness Brain fog or memory problems Depression and low mood Pale or jaundiced skin Numbness or tingling in hands and feet Shortness of breath or dizziness Muscle weakness A swollen, inflamed tongue (glossitis) Pins and needles (paraesthesia) Visual disturbances Heart palpitations If left untreated, vitamin B12 deficiency can lead to serious and irreversible neurological problems

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In the case of weight loss, a physician-supervised weight loss program will be the most effective way to lose weight and keep it off long-term

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