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Cellular defenses against damage from reactive oxygen species

[PubMed: 36806430] (42 year old woman presented 4 hours after an intentional overdose of 6000 mg of ALA and 7.5 gm of acetaminophen with refractory seizures, metabolic acidosis [pH 7.29, lactate 8.79 mmoL], with progressive multiple organ failure and cardiac arrhythmias resulting in death within 26 hours [CPK 848 rising to 14,447 U/L, ALT 15 to 53 U/L, AST 15 to 122 U/L, INR 1.1 to 3.0, creatinine 0.6 to 3.4])

Prolonged therapy and higher doses of metformin correlate with decreased serum B12 levels, contributing to neuropathy, anemia, and cognitive impairment in diabetic patients