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64 In a randomized, double-blind pilot study that assessed the impact of adding silymarin (420 mg/day) to standard chemotherapy on the clinical response of advanced malignancies following three cycles of cisplatin-based chemotherapy, a tendency of decreased metastasis rate in the chemotherapy plus silymarin group was reported though there was no significant variance in tumor size

While this often leads to desired effects such as long-lasting activity, it can also give rise to significant issues later in the drug discovery pipeline, e.g

If a deficiency is detected, your doctor may recommend vitamin B12 injections, which are often more effective than oral supplements due to metformins impact on stomach absorption