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Examples include pernicious anemia, certain gastrointestinal surgeries, and some malabsorption syndromes

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In June 2022 the UK medicines regulator updated its advice: the MHRA now lists low vitamin B12 as a common side effect of metformin, meaning it can affect up to one in ten people taking it

Factors that influence outcomes include the extent of follicle miniaturization, the duration of hair loss, concurrent treatments being used, overall health status, and genetic factors that remain poorly understood

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The clinical trial data is specifically reassuring on this point: across six trials involving approximately 900 participants, glucose levels, insulin levels, and markers of insulin sensitivity remained unchanged from baseline