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In the randomized placebo-controlled HOME trial of 390 adults with type 2 diabetes (de Jager and colleagues, Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency, BMJ, 2010), metformin lowered serum B12 by a mean of 19 percent over 4.3 years

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In essence, the balance between survival and death depends on neuroprotection and energy state of the tissue

Poor diet, lack of sleep, overworking the mind and body, heavy metal exposure, medications, pesticides, strong household and personal care products can wreak havoc on organs, blood vessels and cells in general causing such problems as premature aging, reduced function, slowing or lowering energy, stiffening joints and causing memory to decline among other issues

10.1016/j.ejphar.2017.07.009 Eur