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There is biological plausibility for how the low glutamate diet may be able to affect not only excitotoxicity, but also corresponding oxidative stress and inflammation that may be potentiating these symptoms

Cotillard A, Kennedy SP, Kong LC, Prifti E, Pons N, Le Chatelier E, et al

We suggest that multicenter RCTs be undertaken to investigate the above issues

DOI: 10.1007/s10571-016-0450-4 61

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Moreover, the risk of vitamin B12 deficiency also increases with increased metformin dose and duration of its use