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Some of the most common secondary causes include: Endometriosis This disorder occurs when tissue similar to the tissue that normally lines the inside of your uterus grows outside your uterus, often adhering to your bladder, ovaries, or even your bowels

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It is primarily researched for its interaction with nicotinamide N-methyltransferase (NNMT), an enzyme linked to energy balance and adipose tissue function

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