Metformin and LCHF diet

[Resurgam]

It is a little worrying that your levels are so high on what seems to be quite a low carb diet - my readings are a lot lower on more carbs, and I do think of myself as being quite sensitive to carbs.
It might be worth asking if you need insulin, or if you could have a test to ascertain the amount you are producing - just in case that is the problem.

 

[Shas3]

Even though it is SR metformin you should really be splitting the dose with 1g at breakfast and 1g tea. Half life is only about 6.5 hours so you could even go 500mg at breakfast, lunch, tea and night to maximise the benefit by keeping blood levels at theraputic levels at all times. It might help a bit but diet is key and low carb with as much exercise as you can manage is king of all.

I am not sure.. i was taking one 500 mg SR with breakfast and one at dinner. I used to have nausea and some dizziness during day. After dinner I don’t have same issues. I will be checking with doctor today. I thought Metformin was the easiest to tolerate and i am struggling with the even the slow release version . I was good for a 8 to 10 weeks... then i had a bad cold and all side effects seem to be playing up

 

[Muddikins]

Sorry, you are quite right it might not be the solution for your difficulties but it is correct in terms of how drug therapy works.
Side effects are sometimes caused, or at leat worsened, by the fact that when you take a drug, it is absorbed and causes a rise in blood concentration of the drug which is then metabolised over time causing that level to drop. The more rapid the rise and drop and the higher the rise and the further the drop the more likely the side effect. A steady state level of the drug in the blood stream is more likely to be tolerated and actually work better. The slow release formula aims to help by not causing the rapid rise but, in the case of metformin, half of it is still metabolised within six and a half hours so there is still a considerable rise and fall in blood concentration and that is further alleviated by splitting the dose. Splitting into two doses is the general recommendation but splitting into four produces much more of a steady amount of drug in the blood stream and theoretically fewer side effects due to the swings of blood level. Some slow release drugs do last 24 hours and some drugs are metabolised more slowly allowing for less frequent dosing but not metformin.
Like I said it may not work for you for myriad reasons but taking 2g once a day is the dosing strategy most likely to produce side effects and overcome the benefits of the slow release formula.
They put me on 500mg twice a day and wanted me to go to 1g but the running to the toilet side effect stopped me increasing my dose and helped me focus on a diet and lifestyle solution which fortunately has proved sufficient for me. I just take one a day now and I don't even know i have taken it anymore.
I hope your visit to the quack is profitable and you get the results you wish for today. Best of luck

 

[Shas3]

Sorry, you are quite right it might not be the solution for your difficulties but it is correct in terms of how drug therapy works.
Side effects are sometimes caused, or at leat worsened, by the fact that when you take a drug, it is absorbed and causes a rise in blood concentration of the drug which is then metabolised over time causing that level to drop. The more rapid the rise and drop and the higher the rise and the further the drop the more likely the side effect. A steady state level of the drug in the blood stream is more likely to be tolerated and actually work better. The slow release formula aims to help by not causing the rapid rise but, in the case of metformin, half of it is still metabolised within six and a half hours so there is still a considerable rise and fall in blood concentration and that is further alleviated by splitting the dose. Splitting into two doses is the general recommendation but splitting into four produces much more of a steady amount of drug in the blood stream and theoretically fewer side effects due to the swings of blood level. Some slow release drugs do last 24 hours and some drugs are metabolised more slowly allowing for less frequent dosing but not metformin.
Like I said it may not work for you for myriad reasons but taking 2g once a day is the dosing strategy most likely to produce side effects and overcome the benefits of the slow release formula.
They put me on 500mg twice a day and wanted me to go to 1g but the running to the toilet side effect stopped me increasing my dose and helped me focus on a diet and lifestyle solution which fortunately has proved sufficient for me. I just take one a day now and I don't even know i have taken it anymore.
I hope your visit to the quack is profitable and you get the results you wish for today. Best of luck

Thanks so much for your very comprehensive explanation

The visit to doctor was fine. He is ok with my progress though we have some way to go. He is ok with reducing my Metformin to one 500 mg per day but wants me to start a gliptin.. am still unsure. Of course I would like Metformin minimum + diet + lifestyle but he is not fully convinced I can reach goals... let’s see. Thanks again

 

[Olufisayo]

I am taking 2000mg of slow release metformin after my evening meal, I am eating less than 30 grams of carbs a day, I have been doing this for over a month, should I be able to get a blood glucose reading below 8.5 mmol?

I am believing you will. Have even taken apple cider vinegar? You can try taking it first in the morning and last thing at night in some water

 

[Resurgam]

I do suspect that diet is not going to do the job for the OP - eating so few carbs, taking Metformin and still having such high BG levels - bit of a red flag for 'unlucky' type two or maybe some other form of diabetes.