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The low incidence of DVT after sclerotherapy (less than 1 per 10,000 sessions 38 ) is the ultimate evidence that thrombosis is an epiphenomenon of the sclerosing process, not a goal

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Routine testing of vitamin B12 levels in metformin-treated patients should be considered. Because metformin often causes digestive tract upset, many patients are also put on a proton pump inhibitor (PPIs) such as esomeprazole ( Nexium ), lansoprazole ( Prevacid ) or omeprazole ( Prilosec )

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A blood test can also check for the presence of antibodies against intrinsic factor, which may indicate an autoimmune reaction