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If folate deficiency is suspected, it is reasonable to give oral folic acid (0.4 1 mg/day) without doing laboratory investigation for deficiency at least until the hemoglobin and mean corpuscular volume normalizes (or longer if the underlying cause cannot be eliminated)

Parry Strong A, Haeusler S, Weatherall M, Krebs J (2016) Sublingual vitamin B12 compared to intramuscular injection in patients with type 2 diabetes treated with metformin: a randomized trial

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From our perspective IGF-1, GH, and insulin conform a finely regulated axis that inform cells about the nutritional status of the organism so that they can either undergo apoptosis/senescence/quiescence or, to the contrary, grow and differentiate