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Metformin: Benefits, Side Effects

a paprika; metformin's benefits are maximized with healthy eating

 

Metformin, brand name Glucophage

You may be taking or considering metformin if you have Type II diabetes, “prediabetes,” or, though the scientific evidence for its use isn’t so solid, polycystic ovary syndrome.

Metformin works in several ways. It helps certain parts of the body respond properly to insulin, reduces how much glucose is released into the bloodstream, and does a few other things.

Most of what we know about Metformin is good. It doesn’t seem to cause weight gain, and in fact, may cause slight weight loss. It’s affordable. And it has 4 decades of use, meaning we know a lot more about it than many other medications.

One study showed that use of metformin over several years reduced mortality – or death -rates related to diabetes by an impressive 36%.

Side effects of metformin

Metformin’s side effects are mostly mild and treatable, though there is a the rare chance of a problem called lactic acidosis. About 30% of users experience some sort of side effect, including indigestion and diarrhea.

Taking metformin with a meal is one way to reduce problems, as well as taking an extended release version. The immediate release form has about a 17% rate of diarrhea, for instance, while the extended release has only about 8%.

Some have complained that metformin makes them smell bad.

Lactic acidosis is a very rare side effect that is fatal about 50% of the time. Estimates of how often it occurs range from 1/30,000 patient-years to a bit higher.  But assuming you meet the criteria for using metformin, most likely you shouldn’t worry about it.

Most doctors strongly feel that the benefits of metformin outweigh the risks of lactic acidosis.  As one doctor puts it, “Of 10,000 diabetic patients treated for 10 years with metformin, only 10 will die from lactic acidosis. [Based on a large study] of those 10,000 patients… metformin would [have prevented] 500 diabetes related deaths.”

Because of how effective metformin seems to be, some doctors argue for more aggressive use of the medication than is currently done.

Most common metformin side effects: nausea, metallic taste in mouth, some weight loss, vomiting and abdominal bloating.  Cramping or a feeling of fullness is also fairly common.

Talk to your doctor: if you feel excessively weak, have heartbeat changes or irregularities, chest pain, or signs of an allergic reaction.  Some people experience hypoglycemia, or too low blood sugar, on Metformin, which is also important to watch for.  Signs include chills, weakness and dizziness.

You may need to stop use if you are going to get an X-ray or scan that involves injection of die into your body.

This list does not include everything; see manufacturer’s insert for more.

Notes

Metformin can cause Vitamin B12 and folic acid deficiencies, so make sure to be eating a well balanced diet.  Additionally, remember that the initial and ideal treatment for type II diabetes is exercise and improved diet.

And it’s important to take metformin as your doctor directs.  It takes a while to start working and needs to be taken as recommended.

There are several conditions which mean you shouldn’t take metformin, like kidney problems. It’s possible that a significant amount of the lactic acidosis occurs in people who, according to the strict guidelines, shouldn’t have been taking the medication.

A miraculous technique

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This post was written by on Wednesday, September 9, 2009. This author has written 223 posts on this blog and has 4985441 total posts views.


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57 comments

  1. So I was diagnosed with PCOS back in November 2010 and my doc put me on 1500 mg Metformin a day. I only took it for a week and quit, two days ago I started taking it again and I feel horrible :( I feel like I’m prego :-/ but I’m not…

  2. Dosage is quite large no wonder you don’t feel well. You should build up tolerance by starting at about 1/2 of 500 mg pill twice a day for a month and then move up to 500 mg twice a day and so on. Always consult with your doctor about the effects of before you stop or start any medication. A graduated build-up might be a better way to go.

  3. I am 52 and got Type II diabetics for Christmas. Five years ago I weighed 283. Today I weigh 218. I have been taking Metformin for about 2 months now. I take 1000 MG in the morning and 1000 MG at night. I eat NO sugar, NO milk, and only one banana per day. I do eat some cheese as the cheese making process uses up all the sugars in milk. I can tolerate 10 grams of sugar at a meal. An average carrot has 7 grams of sugar. I have the equivalent of one slice of bread in carbs per meal, around 25 grams. I have not had any major issues with Metformin. I “ramped up” from 500 mg per day to my stable dose of 2000 mg per day. Leaf spinach and sugar free gelatin with sugar free whipped topping are my best friends these days. I feel SO much better with my diabetics now diagnosed and taking Metformin. If I skip breakfest AND take my Metformin, I WILL crash in the afternoon. Skipping breakfast is NOT an option on Metformin. A five saltines or other sugar free crackers on the even number hours keeps me going strong. I feel like I did twenty years ago. I also take 5mg of blood pressure medication and that knocks me out. I take it only right before bed because when I take it, IT”S BED TIME! Some of the issues I have seen here might be related to other medications that you received when you started the Metformin. Take it at meal time. Don’t over eat. If Metformin and you don’t get along, talk to your provider, they have other options available. If your diabetic just keep this in mind: Is risking insulin injections, blindness, cardiac problems, amputation, and kidney failure worth eating that piece of pie or regular ice cream? Not for me it isn’t. Eating a big dessert is like sucking on a hand grenade!

  4. Paul, you are inspiring! I love you train of thought on life and what it’s worth, If only more people could believe like you do. Keep up the great work and live strong as you’re doing!

  5. METFORMIN : HAS A BLACK BOX WARNING. If a DIABETIC TAKES METFORMIN ALONE, MD, OR INSURANCE “RESTRICTED” amount of TEST STRIPS (2 to 4) & not able to check blood sugar level as the BODY LANGUAGE is TELLing A PERSON>>>>>>>>>
    Then A DIABETIC CAN END UP WITH UNNECESSARY COMPLICATIONS:
    RETINOPATHY, signs of STROKE, HEART ATTACK, AMPUTATIONS & the patient will be in ER or/ AND diagnosed as an ACTUAL HEART ATTACH or my DIE.
    CHECKing THOSE BLOOD SUGAR LEVELS AGGRESSIVELY WHEN ON METFORMIN is important.

    My HUSBAND WENT BLIND DUE TO
    NON-AGGRESSIVE TREATMENT ,CARE & MEDS. & FINALLY AFTER WORKING DILIGENTLY WITH An EXPERIENCED DIABETES ADVOCATE GETTING THE MD TO PRESCRIB A SULPHONUREA HAS NOW GOTTEN SMOOTHED OUT & gotten him “OFF ” of METFORMIN……. PLUS… HA1C is now 6.1 (HALALUYA….! ) WHEN IN DOUBT TEST & TEST AGAIN IN 5 mins.” to see if “blood sugar is going up or down. (SAVE A LIFE & COMPLICATIONS) & how often this happens. The MD will have abetter IDEA of how to ASDJUST MEDICATIONS or CORRECT DIET or exercise.

    I am an experienced Juvenile DIABETIC of 45 yrs & ADVOCATES FOR various organizations. Married 3 grown children 8 grands, NO HOSPITALIZATIONS
    for any complications in 45 yrs. thank you SUZIE -Q

  6. Metformin causes so many side effects it’s scary. A new herbally-based medication, Sucanon, has been tested on more than 7000 people, showing no adverse effects. It helps the body make better use of its own insulin, it will be available for sale in Canada and USA.

  7. Robert DeGaetano

    If you are on Metformin for more than 5 years you have a 30 to 40 percent chance of developing a b12 deficiency. The longer you are on Metformin and the higher the dose the more likely you’ll suffer from this infliction with its’ severe and irreversible neurological damage. If you are on Metformin and suffer from peripheral neuropathy have your b12 levels checked. Unlike diabetic neuropathy ,peripheral neuropathy caused by metformin is treatable with calcium or in later stages b12 injections.

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