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Metformin-Induced Vitamin B12 Deficiency Can Cause or Worsen Distal Symmetrical, Autonomic and Cardiac Neuropathy in the Patient With Diabetes

Considering the latter possibility, treatments that were considered failures in previous clinical trials could be reanalyzed for potential efficacy in ALS, taking into account the duration of the disease at the start of therapy. Therefore, using diagnostic criteria that enables earlier identification of the disease and a change in the physicians attitude towards offering an early diagnosis and treatment could result in better ALS patient outcomes.

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While many individuals receive adequate Vitamin B12 from their diet, certain groups, like pregnant or nursing mothers, may require more to meet their nutritional needs