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Check vitamin B12 levels in people treated with metformin who have symptoms suggestive of vitamin B12 deficiency This will also include patients found to have megaloblastic anaemia (raised mean corpuscular volume [MVC]), who may be asymptomatic (MHRA, 2022)

Results: 3035% increase in whole blood glutathione levels Improved lymphocyte and erythrocyte glutathione status Decreased oxidative stress markers Enhanced natural killer (NK) cell function 2

Factors Influencing Duration in the Body Dosage: Higher doses may remain in circulation slightly longer, though the difference can be marginal

Cell death regulation by MAMs: from molecular mechanisms to therapeutic implications in cardiovascular diseases

Feb 2015;8(2):30-42

This suggests that NP4 could effectively promote the polarization of M2-type macrophages towards M1-type macrophages, thereby alleviating immune suppression