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The substantial increase in plasma bile acid concentrations (primary, secondary, total and unconjugated bile acid concentrations) with metformin may be explained by the fact that metformin increased the abundance of probiotic bacteria, especially Lactobacillus , and thus their bile salt hydrolase (BSH) gene expression

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When to Seek Medical Attention According to prescribing information, patients should contact their healthcare provider immediately if experiencing: Severe abdominal pain that does not go away Signs of allergic reaction (swelling of face, lips, tongue, or throat