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Increased metformin exposure was hypothesized to be associated with lower levels of B12 and more severe peripheral neuropathy [51]

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[DOI] [PubMed] [Google Scholar] 93.Rauchschwalbe SK, Zuhlsdorf MT, Wensing G, Kuhlmann J

It is not: A proven life-extension therapy A cure for cognitive decline A substitute for foundational health behaviors Appropriate for everyone It appears most beneficial for: High-functioning adults experiencing age-related metabolic or cognitive decline Patients with documented NAD+ depletion or methylation dysfunction Individuals who've optimized lifestyle factors and are seeking targeted cellular support Those willing to invest in multi-session protocols with proper medical oversight The evidence base will continue to evolve