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It has been reported that an average of 630% of patients could show vitamin B12 deficiency due to metformin use.[] As per UK MHRA, decreased vitamin B12 levels, or vitamin B12 deficiency, are now considered to be a common side effect in patients on metformin treatment, especially in those receiving a higher dose or longer treatment duration and in those with existing risk factors

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Research has demonstrated that these age-related functional declines can be partially reversed through NAD+ restoration, with studies showing that NAD+ precursor supplementation in aged animals can restore mitochondrial function, improve cognitive performance, and extend both healthspan and lifespan