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Dihexa should be considered a research-stage compound with entirely unknown human safety profile

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2,3 Discontinue hormonal contraception for a minimum of 3 months prior to assessment of biochemical hyperandrogenism

Since B 12 deficiency results in MMA accumulation before B 12 reduction is seen in the serum [132], methylmalonic acid is a better indicator and preferred marker reflecting B 12 status before B 12 deficiency appears [120]

The advice is to investigate and treat the vitamin B12 deficiency in the normal way, following clinical guidelines, and to continue the metformin