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In the 1970s, there was an ashtray on every patients nightstand, Dan Carnithan, a respiratory therapist, said

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peripheral neuropathy/subacute combined degeneration 2 mean corpuscular volume 3 autoimmune thyroid disease 4 sulphonylurea 5 proton pump inhibitor/ histamine 2 blocker Comparison of presenting features and medications of diabetic patients with vitamin B12 deficiency of undetermined aetiology: on metformin and not on metformin and 30% of patients not on metformin (p=0.588), peripheral neuropathy/subacute combined degeneration of cord in 1% of patients on metformin and 11% of patients not on metformin (p=0.007), and dementia in 9% of patients on metformin and 4% of patients not on metformin (p=0.376)

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and heavy metals such as nickel, tin and lead