doi: 10.1097/JIM.0000000000000129 156 KingMRAndersonNJDeciuMGuernseyLSCundiffMHajizadehSet al
Aroda VR, Edelstein SL, Goldberg RB et al (2016) Long-term metformin use and vitamin B12 deficiency in the Diabetes Prevention Program Outcomes Study
That might mean less receptor desensitization over time
remain upright for at least two hours Stay well hydrated throughout the day with water Reduce alcohol consumption, which can irritate the digestive system Consider probiotic supplements or probiotic-rich foods (yoghurt, kefir, sauerkraut), though evidence for their effectiveness in this context is limited Some patients find relief with over-the-counter remedies such as peppermint tea , which may help soothe the digestive tract (though it can worsen reflux in some people), or simethicone , an anti-foaming agent that may help reduce gas and bloating
Often it improves once your intake stabilises, weight loss rate slows, and you build consistent movement/strength training