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In a study of 69 type 2 diabetic patients, the combination of BBR with silymarin (a known P-gp inhibitor) resulted in a more significant reduction in HbA1c compared to BBR alone [166]

These changes do not happen to everyone

Symptoms of vitamin B12 deficiency: extreme tiredness a lack of energy pins and needles a sore and red tongue mouth ulcers muscle weakness problems with your vision psychological problems, which can range from mild depression or anxiety to confusion and dementia problems with memory, understanding and judgement Causes of a vitamin B12 deficiency: pernicious anaemia a lack of these vitamins in your diet medicine certain medicines, including anticonvulsants and proton pump inhibitors (PPIs), can affect how much of these vitamins your body absorbs

Pregnancy registries collect information about how a drug affects pregnancy

136 (6 Suppl): 1636S1640S