Type 2 Metformin and nausea

Alirose1 said:

I was diagnosed with Type 2 diabetes in early November and was prescribed Metformin. Initial dose was 500mg at night, then twice a day building up to what I was told was the therapeutic dose of 2000 mg a day.

I managed to get to 3 tablets a day but cannot tolerate 1000mg together so spoke to my diabetic nurse and am taking 1 x 500mg three times a day. However I feel constantly nauseous and do not want to eat at all. I cannot imagine how I will feel on 4 tablets a day.

Any help or suggestions would be appreciated.

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Hi @Alirose1 and welcome to the forums.

Are you taking the normal version of this drug or the extended release (XR) or slow release (SR) version? Many fare better on the latter. Unfortunately I don't think there are any remedies for this known issue.

Hi. Do ask for Metformin SR (Slow Release) which is much kinder. Metformin can interfere with taste and suppress appetite. I had a metallic taste when eating which lasted 6 months but not everyone has that. I've now being taking it for over 15 years with no current problems at all. Every dose increase has a smaller effect than before. Metformin never has that much effect and dosage isn't critical. 2000mg is the maximum dose which I was on for many years.

Alirose1 said:

I was diagnosed with Type 2 diabetes in early November and was prescribed Metformin. Initial dose was 500mg at night, then twice a day building up to what I was told was the therapeutic dose of 2000 mg a day.

I managed to get to 3 tablets a day but cannot tolerate 1000mg together so spoke to my diabetic nurse and am taking 1 x 500mg three times a day. However I feel constantly nauseous and do not want to eat at all. I cannot imagine how I will feel on 4 tablets a day.

Any help or suggestions would be appreciated.

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I had exactly the same issue with metformin - it was the constant nausea and loss of appetite that made me miserable rather than the other, perhaps more common issue affecting the other end of the digestive system.... although the world did fall out of my bum on more than one occasion. My less-than-stellar diabetes nurse cheerily told me that the loss of appetite would ‘help me lose weight’.

However if you drastically reduce your carbohydrate consumption then there is a good chance you can reduce or remove your need for medication altogether. I halved my dose from 2000mg to 1000mg after 3 months, then again to 500mg after another 3 months and now I don’t take any, and my BG is around 34. But I also found that I could tolerate 1000mg very well so obviously for some people there is a threshold above which they can’t go.

Prescribing Metformin appears to be a black art which is very much up to the prescriber and appears to bear no relationship with the diagnostic HbA1c level. If you look around this forum many members are on less than 2000mg a day - I believe this is the maximum therapeutic dose, not the minimum, so perhaps something to discuss with your GP.

I was prescribed metformin shortly after being diagnosed. I went up to 3000mg a day which I was told was the maximum dose. Never got rid of the horrible metallic taste and went right off eating. I then became ill with Vit B12 deficiency. My GP stopped the metformin - Vit deficiency resolved itself within a month.

Incidentally, if you look at the information for metformin on the nhs website, it says it is "unsuitable for uncontrolled diabetics". I find that rather amusing. I'm fairly sure that most doctors see uncontrolled diabetics and reach straight for the metformin.

Alirose1 said:

I was diagnosed with Type 2 diabetes in early November and was prescribed Metformin. Initial dose was 500mg at night, then twice a day building up to what I was told was the therapeutic dose of 2000 mg a day.

I managed to get to 3 tablets a day but cannot tolerate 1000mg together so spoke to my diabetic nurse and am taking 1 x 500mg three times a day. However I feel constantly nauseous and do not want to eat at all. I cannot imagine how I will feel on 4 tablets a day.

Any help or suggestions would be appreciated.

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Metformin didn't agree with me either, and the Netherlands didn't carry the slow release kind until years after diagnosis, by which time I was long past needing it. https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ <-- this might help you eliminate the need for it altogether. Mind you, if you check the leaflet, it'll likely say (unless something changed in the past few years), that a patient should try diet for three months first, and if that doesn't work, to start metformin. A lot of us here who've been on the stuff, just got put on met straight away, no diet-adjustment tried beforehand.

Good luck!
Jo

I was 1500 a day then was drinking normal juice for a couple of months then I went from 10 average to 16? Now Im on 1750? And im up to 18+? Something not right?any suggestions thanks

Gordon008 said:

I was 1500 a day then was drinking normal juice for a couple of months then I went from 10 average to 16? Now Im on 1750? And im up to 18+? Something not right?any suggestions thanks

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Hi there @Gordon008 and welcome to the forum.

In short it’s because metformin in its own will do little to reduce your blood sugars. Unlike insulin or some of the other medications used for diabetes, metformin works primarily by reducing the amount of sugar the liver releases into the blood stream and by improving insulin sensitivity. To effectively manage diabetes with metformin, it needs to be accompanied by dietary changes, primarily in the form of carbohydrate restriction.

I’d suggest you start a new thread to get some more detailed information about this.