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An Observation About Metformin

Discussion in 'Metformin/Biguanides' started by MrsGruffy, Jul 28, 2018.

  1. MrsGruffy

    MrsGruffy Type 2 · Well-Known Member

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    I take 1000 mg of Metformin SR twice a day. I've been intermittently fasting for the last month or so, and I've stumbled on an interesting reaction, which may be unique to me, or perhaps more universal. You're supposed to take Metformin with food. My DE told me that there were two reasons for this - the first is that you will experience less gastrointestinal "discomforts" if it is taken with food, and the second is that it will help control your PP insulin response.

    Firstly, I have to say that I tolerated Metformin very well from the beginning. I had a gurgly belly for the first week or two, but no nausea and only one experience of spectacular diarrhoea. I had a bit of a dilemma when I started IF, because I only eat once a day, and that happens usually in the middle of the day, which doesn't coincide with my Metformin doses. So initially I would take the Metformin with my morning and evening coffee, which contains about a tablespoon of cream. I did not find that I experienced any gastrointestinal ill effects.

    However, in an attempt to be stricter in my fasting, I decided to cold brew some green tea in the refrigerator overnight and replace my morning and evening coffee with green tea, and in fact, drink green tea instead of any coffee at all. I cold brewed about 2 litres of green tea for each day. Every single time I took the Metformin with green tea, I would get nauseous about 20 minutes after I'd taken it, and have to have a lie down for 20 minutes until it subsided. I really did think I would be sick, but didn't actually throw up, but the feeling was intensely unpleasant. I also tried conventionally brewing green tea with nearly boiling water, and had the same experience as cold brewed.

    So I had to make a choice, because I couldn't cope with feeling so ill after the Metformin. I decided to go back to the coffee with cream and continue with Metformin. The morning and evening nausea immediately stopped. Since the green tea did not cause nausea at any other time I drank it (several times a day without taking Metformin), I think the most likely thing is that taking Metformin with some fat probably prevents the nausea in my case.

    Incidentally, while my BG now runs mostly in the 4s, I have not had any hypoglycaemic events in the month or more I've been taking Metformin while fasting. Of course, your mileage may vary! Be cautious if you decide to try this for yourself. I increased the frequency of checking my BG while fasting and taking Metformin just to be sure that I wasn't going too low at any time. I also eat LCHF for my one meal a day.

    The reason I'm posting this is that most people would have received advice to eat a low fat diet once they were diagnosed with T2D as I was. I just wonder if people would have less trouble with the unpleasant side effects of Metformin if they were to take it with something high in fat?
     
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  2. Guzzler

    Guzzler Type 2 · Master

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    As Metformin has a cumulative effect at the beginning I'm not sure it does have that much of an influence on post prandial readings. This is in my case and as I intend to reduce then stop taking Met by the end of the year in an effort to reduce my overall list of prescription medications I will be in a better position to judge.
     
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  3. MrsGruffy

    MrsGruffy Type 2 · Well-Known Member

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    I'll be watching for your observations @Guzzler - I would very much like to do the same, but each time I try to bring it up with my 'team', it's like I've asked if it's ok to cut off my arms and beat myself up with the soggy ends.
     
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  4. bulkbiker

    bulkbiker Type 2 · Master

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    I would suggest its certainly not universal as I have always eaten a fairly high fat diet but could not tolerate metformin in either of its guises. I simply stopped taking it on my own. Never looked back.
     
  5. Guzzler

    Guzzler Type 2 · Master

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    My opinion on who it is that decides my treatment regime is that the choices are mine. I cannot demand a drug that my HCPs may think is inappropriate but neither can they demand that I take a particular drug or treatment. They are calling for patients to take more responsibility for their own health so here's me taking that advice to heart.
     
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  6. Freema

    Freema Type 2 · Expert

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    Cream is known to protect stomach so maybe that’s what’s going on Smashed bananas are said also to protect the stomach , it maybe coats a bit and then the metformin can be led to the intestines and the stomach problem has been passed

    I only had peeing problems on metformin having to go to the toilet 5 times during the night which made me take the whole dose in the morning
     
  7. Guzzler

    Guzzler Type 2 · Master

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    Not having delved into it, I suspect that taking Met with food to lessen the unfortunate side effects worked because the food would 'carry' the drug further down the intestinal tract. As I have to take Lanzoprazole then this would, in theory, do the same as coating the stomach with food. However, as I am one of the lucky few who has none of the classic side effects I am not enamoured with the idea of testing out this theory by taking Met on an empty stomach. :)
     
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  8. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    I tried all ways to take Metformin, fasting with water, with a meal and coffee - early, late - until I took it out to the bin and threw it in I was unable to function.
     
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  9. Freema

    Freema Type 2 · Expert

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    actually, I could eat metformin on an empty stomach with no bad feelings... I remember many years ago my stomach was not that good and I could get very nauseous from just eating a vitamin pill and very little food with, nowadays I can almost eat in on an empty stomach.. I have no idea why my stomach has changed that much... maybe due to hormone fluctuations at that time of chronic stress.. the fact is I can eat almost all pills on an empty stomach nowadays
     
  10. ickihun

    ickihun Type 2 · Master

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    A brilliant observation. I used to take my metformin with a latte bought from the concourse of Victoria Train station. Knowing I wouldn't get a chance til 6hrs after getting out of bed. I liked my metformin spread evenly through my shift work day.
    I took metformin with anything but not just a black coffee or water filled breakfast.
    Metformin doesnt like sugary foods, not for side affect but for efficiency. Sweet alcohol especially. But then the diet for type2s doesn't include these kinds of food or drink.
    I know I was lighter on no insulin medication which wasn't needed years ago. Metformin is still complimentary to insulin even for some type1s. Insulin acts differently to fatty foods. Metformin isn't insulin.
    Metformin for me changes the condensity of my tummy fat. Allowing it to be broken down easier.
     
  11. Alexandra100

    Alexandra100 Prefer not to say · Well-Known Member

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    Lowered bgs?
     
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