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However, as genotyping is not currently routinely available and serum vitamin B 12 measurement is cheap, our results reinforce the causal association of metformin treatment with vitamin B 12 deficiency and guideline recommendations for routine screening for vitamin B 12 deficiency in people treated with metformin
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Alternative approaches : Consideration of whether optimizing tirzepatide dosing, lifestyle interventions, or other evidence-based therapies might achieve goals without off-label combination therapy
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