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Some patients feel as though they want more frequent injections, and occasionally we test levels to see if they are receiving adequate replacement, but Im not sure how strong the evidence is to support this. GPs should consider periodic vitamin B12 testing of higher-risk patients who take metformin, even if they dont display symptoms of deficiency, the UK medicines regulator said earlier this year

Common research dose 300-500 mcg/day in research planning context, drawn from the dose range used across the published Phase 1/2 trials

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IGF-1 reduces serum GH levels (via somatostatin negative feedback in the pituitary) which in turn suppresses GH actions in the liver, thus enhancing insulin actions in this organ [165]