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These could indicate serotonin syndrome and are a reason to call 911 or your local equivalent

2022;23(8):4429. Published 2022 Apr 17

5.7 Vitamin B12 Concentrations In controlled clinical trials of metformin of 29-week duration, a decrease to subnormal levels of previously normal serum vitamin B12 levels, without clinical manifestations, was observed in approximately 7% of patients

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GLP-1 receptor agonist effects, by contrast, are described as beginning within days to weeks, with appetite suppression often noticed in the first week