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Vitamin B12 deficiency associated with metformin use is thought to be multifactorial

The primary metabolite, phosphoramide mustard, is a nitrogen mustard molecule considered the most therapeutically effective metabolite owing to its significant ability to induce DNA damage by intercalating between the two strands (Vredenburg et al

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The Food and Nutrition Board (FNB) has recommended a daily intake of 0304 mg riboflavin/d for infants, 0509 mg riboflavin/d for children, 13 mg riboflavin/d for adolescents, and 14 mg riboflavin/d during pregnancy and 16 mg riboflavin/d during lactation for adults ( Reference Gallagher, Mahan, Escott-Stump, Raymond and Krause 16 )

The body sees it as a foreign substance, so its effects are cut short by metabolic or immunologic processes

Analysis of vessel density and vessel branching were done using AngioTool version 0.6a (02.18.14), an open source windows executable software which provides automated measures of vessel area and number of junctions 42