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Endocrinologa y Nutricin (English Edition) 59(8):487490 Reinstatler L et al (2012) Association of biochemical B 12 deficiency with metformin therapy and vitamin B 12 supplements: the National Health and Nutrition Examination Survey, 19992006

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These facts are in accordance with the perspective of this review which suggests the central and nuclear role of IGF-1 in metabolism

Although anemia is often a symptom, the condition is actually the end stage of an autoimmune inflammation of the stomach known as autoimmune atrophic gastritis, resulting in destruction of stomach cells by one's own antibodies (autoantibodies)