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Likewise, symptoms of vitamin B12 can also resemble anemia or fatigue, causing some people to think that they are simply tired

Diana Isaacs, PharmD, clarifies: "Metformin doesn't usually cause hypoglycemia on its own unless it's taken in combination with insulin or other diabetes medications like sulfonylureas..." Diana Isaacs, PharmD, Cleveland Clinic Other factors, like skipping meals, insufficient carbohydrate intake, or excessive exercise, can also trigger low blood sugar