Cutting back Metformin

[Outlier]

I know the Forum doesn't give medical advice, and quite rightly so. I am not asking for this. But I am looking to reduce my Metformin - currently 500mg twice daily - once I believe my blood glucose allows for it. Maybe I can even come off meds completely. So for those of you who have achieved this - is it better to cut back the morning or the evening dose, or doesn't it matter?

Nursie doesn't want this and GP doesn't either (I wonder if the practice makes money here?) My fasting bloods have gone down from 12s to 5s and 6s. All achieved by no-carb diet and of course the Metformin. Nursie's response was that if I went on double the Metformin I could have a more varied diet. Not on the same page - not even the same book.

 

[klogs17]

I have reduced the 2000mg to 1500 by cutting back on 500mg in the morning (without any advice from GP or nurse). Couldn’t tolerate the stomach issues. The reduction didn’t make a difference to my BG readings, just very slight increase in appetite before dinner. On the fence about the other morning 500mg until after my first review.

 

[Erin]

I've never had any problem with metformin, at least not perceptibly. Why do you want to reduce or discontinue it?

 

[Member496333]

Metformin is said to have a cumulative effect in the body rather than being dose dependent. If this is accurate then it probably doesn’t matter, but I would take the evening dose and hope that it goes some way to discourage dawn phenomenon the next day.

 

[Pipp]

Nursie's response was that if I went on double the Metformin I could have a more varied diet. Not on the same page - not even the same book.

Flawed way of thinking by some HCPs. I have had a phlebotomist tell me to ask for newer medications that make you “pee all the sugar out”. She had T2 and had a load of chocolates on her desk, but chose the “heavy medication , eat anything route”.
Your choice. There are some reported advantages to Metformin, though.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212476/

 

[Dr Snoddy]

Over a 4 year period I successively halved my dose of Metformin from 2000mg to 1000mg to 500g. I took the low dose in the morning. I had concerns about my B12 levels as the high dose depleted it immediately and I had to supplement. Also, excess Metformin is continuously excreted and I was concerned about kidney function.
I got to the point where I felt that Metformin was more of a psychological crutch than anything else so I stopped taking it over 2 years ago. My blood glucose levels have remained in the normal range and my weight has remained stable. ( A miracle in itself!)
I am aware that various studies have shown that Metformin may have a range of other metabolic benefits and should I need it in the future I would take it again.

 

[bulkbiker]

I know the Forum doesn't give medical advice, and quite rightly so. I am not asking for this. But I am looking to reduce my Metformin - currently 500mg twice daily - once I believe my blood glucose allows for it. Maybe I can even come off meds completely. So for those of you who have achieved this - is it better to cut back the morning or the evening dose, or doesn't it matter?

Nursie doesn't want this and GP doesn't either (I wonder if the practice makes money here?) My fasting bloods have gone down from 12s to 5s and 6s. All achieved by no-carb diet and of course the Metformin. Nursie's response was that if I went on double the Metformin I could have a more varied diet. Not on the same page - not even the same book.

Personally I stopped using after 3 weeks of toilet hell.
My body my choice what to put into it (for the time being at least).

If you want to cut down then what do you have to lose?
Not medical advice but you can always re introduce later if you want.

Your decision and no-one else's.

 

[Erin]

Metformin is said to have a cumulative effect in the body rather than being dose dependent. If this is accurate then it probably doesn’t matter, but I would take the evening dose and hope that it goes some way to discourage dawn phenomenon the next day.

"cumulative effect" what is cumulating and is it bad?

 

[Member496333]

"cumulative effect" what is cumulating and is it bad?

It builds up in the system and discourages the liver from releasing too much glucose when fasted. Doesn’t really have an effect from one tablet to the next. Or rather, if you measured your after-meal glucose and it was high, taking Metformin would have no measurable effect.

That is my understanding anyway.

 

[Erin]

It builds up in the system and discourages the liver from releasing too much glucose when fasted. Doesn’t really have an effect from one tablet to the next. Or rather, if you measured your after-meal glucose and it was high, taking Metformin would have no measurable effect.

That is my understanding anyway.

Picky picky picky

 

[bulkbiker]

I've never had any problem with metformin, at least not perceptibly. Why do you want to reduce or discontinue it?

Some of us don't want to take unnecessary medication.
Some of us prefer to save drugs for future use if they are not necessary currently.
All medications have side effects so not taking them reduces risk.
Society as a whole, and GP's especially, is treating symptoms and not root causes. Once root causes are addressed medication is no longer necessary.

 

[Outlier]

Thank you Bulkbiker - that's exactly it.

 

[Erin]

Some of us don't want to take unnecessary medication.
Some of us prefer to save drugs for future use if they are not necessary currently.
All medications have side effects so not taking them reduces risk.
Society as a whole, and GP's especially, is treating symptoms and not root causes. Once root causes are addressed medication is no longer necessary.

You say you suffered on Metformin? How?

 

[bulkbiker]

You say you suffered on Metformin? How?

Unable to leave the house due to incredibly loose bowels on regular and irregularly explosively loose bowels on extended release.

Got fed up with cleaning the underside of the toilet seat and my pants.

Well you did ask.

 

[Riva_Roxaban]

After two years on it I stopped taking Metformin 500 mg twice a day. So after three or four hba1c blood tests in the medium 30 mmol / mol region, I discussed it with my GP and I stopped taking the one 500 mg tablet I had with my evening meal.

After another discussion with my GP six months later with no noticeable changes with my hba1c, I stopped the morning 500 mg tablet that I took at breakfast.

Unlike others on the forum I never had any problems with Metformin IR or XR.

 

[Erin]

Unable to leave the house due to incredibly loose bowels on regular and irregularly explosively loose bowels on extended release.

Got fed up with cleaning the underside of the toilet seat and my pants.

Well you did ask.

Sorry; I wish I did not have the opposite.

 

[ickihun]

"cumulative effect" what is cumulating and is it bad?

Yes it works with the liver function. Hence the liver is a very resilient organ so it takes awhile to get whether a negative or positive effect from it.

 

[ickihun]

Just keep in mind metformin was tested and released as a good diabetic drug on a eat well diet. No a low carb one.
We are mostly in fresh diabetic zones where low carb is concerned and old medications not tested on the ideal diet for IR.

 

[Oldvatr]

I have been on Metformin (standard, not extended) for over 30 years with minimal problems. I did reduce from the 2,000mg a day down to 500 mg a day when i went on Low Carb diet some 6 years ago, and it had a minor rise in bgl (about 1 mmol/l) My consultant recently stopped it altogether because i have a poor kidney function issue, and it is contraindicated if you have a low eGFR value. There is the possibility of lactic acidosis with poor kidney function. However, there are some cardio benefits from the med, and it is often given to T1D for that reason, not for sugar control.

You can go cold turkey with this med. Your choice, If the GP gets a kickback for prescribing this, it will be peanuts since the drug is cheep, cheep, cheep. There are also generics too so it is off patent now.