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Serious adverse effects requiring clinical vigilance include: Lactic acidosis : A rare but potentially fatal complication of metformin, particularly in patients with renal impairment (eGFR 10%), symptomatic hyperglycemia, diagnostic uncertainty, or recurrent hypoglycemia

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The widely repeated claim that Dihexa is "seven orders of magnitude more potent than BDNF" traces to McCoy 2013 (PMID 23055539), the paper now under an Expression of Concern