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The antibodies used in standard drug panels will not bind to metformin, making cross-reactivity extremely unlikely

It also suggests checking whether the practice assesses family history of medullary thyroid cancer or multiple endocrine neoplasia type 2, performs thyroid function testing, and orders cardiovascular assessment when indicated

(PubMed) Lee DH, Lim JS, Song K, Boo Y, Jacobs DR, Jr

These inflammatory markers also indicate translocation of gut bacteria and toxins from the GI tract into the blood (191), which may result in systemic inflammation in ME/CFS (183)