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Nevertheless, use of metformin may decrease vitamin B 12 status: a meta-analysis of four short-term intervention trials (up to 4 months duration) in patients with type 2 diabetes found that metformin use decreased serum cobalamin concentrations by 57 pmol/L, which could have clinical implications if such patients have suboptimal vitamin B 12 status (146)
Nevertheless, supplementation with 2 mg/d folic acid, 25 mg/d vitamin B6, and 400 g/d B12 during 6 months significantly decreased the homocysteine levels, severity, and disability of migraine attacks (60)
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