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.

Related articles:

1. Bydureon Diabetes Drug, Side Effects
2. 10 Tips for Living With Type 1 Diabetes
3. What are the symptoms of Diabetes?

Just for fun:

1. 20 Fun Facts About Alcohol
2. The 10 Worst Diseases Ever

Have you had a Total Knee Replacement surgery (TKR) and are experiencing pain?  Unfortunately, you’re not alone.

At least one out of eight patients report pain a year after surgery, and some studies say this its almost one out of five.

The pain tends to develop.  Patients report limited pain for the first three months, while strong pain medication is used.  For some, however, reducing the pain medication doesn’t coincide with a decrease in pain, which may even increase.

Local treatments

Analgesics, or painkillers, are often used for TKR associated pain.  Many prefer not to take oral medications that are systemic in nature and so choose local treatments.

Localized patches that dispense pain medication are an option.  Capsaicin and other creams are also commonly used.

Massaging the painful area may help prevent desensitization.

Alternative therapies for pain

Meditation and other alternative treatments like hypnosis have shown some – but limited – help with pain management.

“Antidepressants” for pain

Your doctor may consider prescribing a medication commonly known as an anti-depressant.  While they certainly serve that function, they also have pain reducing effects in doses lower than those used for depression.

Tricylcic antidepressants tend to be more effective than SSRIs like Prozac, but they also tend to have more side effects.

Diagnosing

Figuring out what is causing the pain takes proper diagnosis.  Unfortunately, that means more imaging and testing.

Some questions to help figure out what’s going on:

1) Is the pain sharp or chronic?
2) Does it occur during a specific activity?
3) Did the pain exist before surgery?

Sharp pain, for instance, tends to indicate a mechanical issue, while chronic pain may indicate infection or other issues.  Signs of infection include chills and fever, and should be treated immediately.

Neuroma

One of many possible complications is the presence of a neuroma, or an overgrowth of nervous tissue.  Treatment consists of selective denervation and has a high success rate of around 86%.  Side effects are common, too, unfortunately, but tend to subside over 3-6 weeks.

Sources:

The management of patients with painful total knee replacement

Evaluation of patients with a painful total knee replacement