Does lactic acidosis come on suddenly?

[kaazoom]

I recently had my Hba1c tests and it was over 9 . The doctor increased my metformin from 1 tablet twice a day to 2 tablets twice a day. I was told to start by increasing the morning dose and after 2 weeks increase my evening dose. I have had a lot of stomach discomfort, and terrible indigestion since increasing the does. I work up the other morning in extreme pain like I was having a heart attack. The pain went after taking antacids. Indigestion is something I get every now and then, but it is usually due to eating something I should avoid. This day I don't think I had eaten anything that would cause it. But I had increased my evening dose of metformin, so I was and am on 4 tablets a day. I have had more general discomfort than usual, muscle pains and more breathlessness.The difficult is I have other health problems so knowing which one is caused by which is a nightmare.

I also tend to let myself get dehydrated at night as I have bladder problems which I having investigations for at the moment. If I don't stop drinking about at about 7pm I end up waking numerous times to go to the loo. The only drink I have after 7pm is a few sips of water to help swallow my medications.

Sorry for being so long winded. My main question is does lactic acidosis come on suddenly, or does it build up over days or weeks?

Paul

 

[destiny0321]

Hi. If you find your metformin could be causing problems which it did with me runs,breathing problems and generally really poorly go back to your gp I did and I was put on me form in slow release which is much gentler on the stomach hope this helps you destiny

Sent from the Diabetes Forum App

 

[kaazoom]

Thanks.
I've got to see my GP next week about something else so I will talk to him about it. I don't think I have lactic acidosis, I was curious about whether it was sudden or gradual onset. I saw something on the TV yesterday that said patients are risking their health because they don't read the information sheets that come with their medication. So I had a look at mine. It gave a number of symptoms to watch out for including severe indigestion,muscle spasms etc it said if you have any of these symptoms when taking Metformin to go immediately to the nearest hospital A&E because these symptoms can be signs of lactic acidosis. I don't think what I'm experiencing is severe enough for A&E.

I had muscle spasms, pains and a number of the other symptoms list prior to my diabetes diagnose due to other illnesses, and they can vary in severity. They seem to have got somewhat worse since my metformin was increased, but it could just be coincidence. The indigestion and stomach problems are particularly bad. My feeling is my body is taking time to adapt to them. i will ask my doctor if I can change to a slow release version.

Paul

 

[fuzzybear]

Hi
I went to the GP this week and she has stopped my Metformin because of the symptoms I have been experiencing over the last month or so.
I have felt very bloated, nausea constantly, windy!, loose stools, lack of appetite, fatigue, aching muscles and back pain.
The GP thinks that this may be caused by the Metformin and although she didn't mention Lactic acidosis , I am wondering if this is what I have.
I have had a full blood test today so I should get the results by the end of the week!
I was on x2 tablets per day. My BS this AM after fasting 12 hrs was 7.1.
I am concerned now that I am not having any Diabetic meds! I was taking the slow release tablets.
Why isn't everyone put onto these at the onset of their diagnosis?

 

[AndBreathe]

I'm not too familiar with lactoacidosis, I'm pleased to say, but I seem to recall @Andrew Colvin experienced it some time ago. I have tagged him, hoping he might drop in to give you an insight.

 

[fuzzybear]

I'm not too familiar with lactoacidosis, I'm pleased to say, but I seem to recall @Andrew Colvin experienced it some time ago. I have tagged him, hoping he might drop in to give you an insight.

Thanks for the info, I will check in for any updates. Keep up the good work!

 

[phoenix]

According to this it is a rare side effect http://www.patient.co.uk/doctor/lactic-acidosis
'*The reputation of the biguanide metformin for causing lactic acidosis may be overstated, and largely based on experience with its more toxic predecessor phenformin. It can cause lactic acidosis in overdose or if continued in those with diabetes who are severely ill and become dehydrated, but seems to be well tolerated on the whole, with many of the current cautions for conditions such as heart failure probably being overzealous and denying a safe and useful therapy to many patients.[5] A Cochrane systematic review found no evidence of an association with lactic acidosis or hyperlactataemia in study-based use'
Lactic acidosis is a very serious condition and people are very ill . The symptoms according to wiki are much like diabetic ketoacidosis, which is a form of acidosis caused by a lack of insulin ( acidosis means that the blood becoming too acidic) Symptoms include deep and rapid breathing, vomiting, and abdominal pain. A site dealing specifically with Metformin induced lactic acidosis http://www.medsafe.govt.nz/profs/PUarticles/5.htm adds altered level of consciousness, thirst and lack of appetite.

However, I really think that sharp chest pains are something that you should take seriously and speak to your doctor about.

 

[andcol]

The symptoms I had was burning throughout all of my blood vessels, some shortness of breath and constant cramping of my muscles. The only thing that seemed to help was to do some heavy exercise which would cause the heart to burn up the lactic acid as fuel but then the muscles would generate more acid and it would come back in a vengeance. This built up over about 5 days getting worse and most of the symptoms disappeared in about a day after stopping metformin. I then tried slow release and within a day it came back but at a smaller level but I refused to give it time to see if it improved/got worse and the doctor told me to stop it immediately when I rang the surgery.

I do remember thinking on the last night I took met that I was going to die as I was in that much pain and shaking/shivering.