metformin is a molecule that can affect the ANP kind am piqué a so amp kinase pathway but it also has side effects including lactic acidosis b12 deficiency and others it seems to inhibit the first complex of the mitochondria at least partially and so we are getting metformin to affect glucose sensitivity or insulin sensitivity by affecting amp kinase but it has a side effect which is b12 deficiency lactic acidosis and potential mitochondrial things which may or may not be part of the actual effect of mitochondria long term actually the actual effect of metformin long term