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The exact proportion depends on protein intake, training stimulus, and individual factors, but estimates from the STEP trials suggest that 25 to 40 percent of weight lost may be fat-free mass in patients without specific muscle-preservation strategies

[7] The Medicines and Healthcare products Regulatory Agency (MHRA) has issued a Drug Safety Update recommending periodic B12 monitoring in patients on long-term metformin therapy

Economic Analysis The Programs for the Assessment of Technology in Health (PATH) was commissioned by Health Quality Ontario to evaluate the budget impact of switching from intramuscular injections of vitamin B12 to high-dose oral supplements for patients aged 18 years and older with confirmed B12 deficiency

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