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27 Unfortunately, despite having many beneficial effects for overall health, metformin is not universally well tolerated with the adverse effects primarily reported to be the result of gastrointestinal (GI) intolerance

Mutations in DDHD2, encoding an intracellular phospholipase A1, cause a recessive form of complex hereditary spastic paraplegia

If those signs combine with chills, immediate medical intervention must be sought as sepsis progresses quite quickly and can cause more harm or be fatal

Published data suggests up to 2.6% incidence of B12 deficiency within a year of treatment, and this figure climbs in patients who have used these medications long term or combined them with very low calorie diets (3)