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In some cases, high-dose daily oral B12 supplements (typically 1000 g daily) can also be used as an effective alternative or addition for maintenance therapy [9] [10]
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)
Patients with hypertension, coronary artery disease, or a personal history of arrhythmias face elevated risk
The mechanism of thioredoxin reductase from human placenta is similar to the mechanisms of lipoamide dehydrogenase and glutathione reductase and is distinct from the mechanism of thioredoxin reductase from Escherichia coli
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