Type 2 Metformin dose when dieting

[sawyatt]

Hi, I’ve been taking 2000mg of slow release metformin (500mg x 4 daily)but now I’m on a low carb eating plan, I’m having to dash to the loo a couple of hours after my main meal in the evening. As I’m not eating very much at all during the day I’m wondering if the upset stomach is due to taking too much metformin now for the amount of food I’m taking in. Grateful for any views on this!

 

[bulkbiker]

Might be ... I had dreadful gastric problems when on it.. maybe try cutting down for a day or so and see if the problems go away.. Or you could call the GP or nurse and ask "permission".

 

[briped]

As I’m not eating very much at all during the day I’m wondering if the upset stomach is due to taking too much metformin now for the amount of food I’m taking in.

I would, and actually I did cut back on my metformin 2-3 days ago, and for the very same reason as you. I refused to take my evening pill as I needed to be able to sleep at night. Cut back from 3 to two a day, and kept a close eye on my BGs. It's early days yet, but I still only see 4s, so it must be ok, but do check with your GP or DN.
I'm on keto and eat very little too.

 

[sawyatt]

Thank you for replying - it’s always reassuring when someone has the same issues (not that you want them to!) I think I’ll try cutting back and see what happens - then I’ll know more when I see the doc in Feb. I think it’s probably the pills as I’m taking 2 on an empty stomach and the other 2 with only a small amount of food. Doc said it doesn’t matter as they’re slow release but I’m not so sure ...

 

[Major Buckmaster]

Thank you for replying - it’s always reassuring when someone has the same issues (not that you want them to!) I think I’ll try cutting back and see what happens - then I’ll know more when I see the doc in Feb. I think it’s probably the pills as I’m taking 2 on an empty stomach and the other 2 with only a small amount of food. Doc said it doesn’t matter as they’re slow release but I’m not so sure ...

I’m the same. I can take it in the morning and I’m fine. With my evening meal I don’t seem to tolerate it so I don’t always take it on the evening now so I’m down to 2 in the morning.

 

[briped]

Doc said it doesn’t matter as they’re slow release but I’m not so sure ...

We can't get the slow release in Denmark where I am, I found out, but I've read posts from many members saying they can't tolerate the SR either, so you're not alone.
Do you have a BG meter so you can keep an eye on your levels at home? If not it's a great idea to get one, especially if it looks as if you'll be cutting your dose in half. You don't want to be running too high and being in the know is the best place to be. Also, depending on when in Feb you have your next appointment, do contact the doc and let him/her know what's going on.
The reason why I felt confident just doing it on my own like a naugthy girl is because I eat less than 20g of carbs a day, and my numbers are low, mostly in their 4s now, and also because I was diagnosed in ancient times (2005) and know how my body reacts to metformin, sort of. I've no idea if you're in a similar place, so what is a solution for me might not be for you.

 

[sawyatt]

We can't get the slow release in Denmark where I am, I found out, but I've read posts from many members saying they can't tolerate the SR either, so you're not alone.
Do you have a BG meter so you can keep an eye on your levels at home? If not it's a great idea to get one, especially if it looks as if you'll be cutting your dose in half. You don't want to be running too high and being in the know is the best place to be. Also, depending on when in Feb you have your next appointment, do contact the doc and let him/her know what's going on.
The reason why I felt confident just doing it on my own like a naugthy girl is because I eat less than 20g of carbs a day, and my numbers are low, mostly in their 4s now, and also because I was diagnosed in ancient times (2005) and know how my body reacts to metformin, sort of. I've no idea if you're in a similar place, so what is a solution for me might not be for you.

Thank you for replying. Yes I do have a meter - my readings are usually in the 6s or 7s two hours post meal, sometimes 5s but rarely 4s. That’s why I changed my diet drastically. Since then I’ve not tested as the strips have been hard to get - I keep trying! My doc wanted to add another tablet into the mix hence my ‘pull myself together and get a grip’ talk to myself! I’ll probably have to reduce my carbs further as I’m on about 40-50 a day, but I have lost 12lbs in 3 weeks so something’s going right!

 

[sawyatt]

I’m the same. I can take it in the morning and I’m fine. With my evening meal I don’t seem to tolerate it so I don’t always take it on the evening now so I’m down to 2 in the morning.

Thank you for replying. That’s exactly it! I’m fine until after my evening meal too which is my biggest meal of the day (I cant change that due to my work). Just don’t want to spend every evening/night in the loo! It’s worse if I have spicy food or too many veggies which on a low carb diet is hard not to do! (Especially if you don’t eat meat!) oh well, at least the weight’s coming off which should help!

 

[Daibell]

Metformin SR should solve the problem if you can obtain it. If not I would talk to the GP and agree reducing the dose or stopping altogether. Metformin helps a bit but isn't a miracle cure.

 

[briped]

Thank you for replying. Yes I do have a meter - my readings are usually in the 6s or 7s two hours post meal, sometimes 5s but rarely 4s. That’s why I changed my diet drastically. Since then I’ve not tested as the strips have been hard to get - I keep trying! My doc wanted to add another tablet into the mix hence my ‘pull myself together and get a grip’ talk to myself! I’ll probably have to reduce my carbs further as I’m on about 40-50 a day, but I have lost 12lbs in 3 weeks so something’s going right!

Oh, you're certainly doing something right. Congratulations on your weight loss - and BG loss I'm sure. You're doing really well, but I hope you'll get some more strips soon. Do you remember which other pill your doc wanted to throw into the mix? Some T2 meds give you a higher risk of hypos, so if you do decide to go this way, please do some research and see if the suggested med might be in that class. A keto diet is not a good idea on such a drug. It does sound as if the mention of another pill gave you a wake up call, though, so probably not relevant. For me it was the word 'insulin'. Oh, and even if you're on Low Carb, do make sure it's not way too low cal as well, as that'll put your body into starvation mode, and stall your weight loss. Been there, done that. As a rule of thumb, no less than 1000 a day.

 

[briped]

Metformin SR should solve the problem if you can obtain it.

OP is already on SR.

 

[ViolaChiri]

Hi, I’ve been taking 2000mg of slow release metformin (500mg x 4 daily)but now I’m on a low carb eating plan, I’m having to dash to the loo a couple of hours after my main meal in the evening. As I’m not eating very much at all during the day I’m wondering if the upset stomach is due to taking too much metformin now for the amount of food I’m taking in. Grateful for any views on this!

Hi I take the same dosage as you but take 1000mgx2 at night so take my medicine once a day and so far the slow release has been working well for me. Had similar issues as you when on the regular Metformin and I tolerated it for two months before I couldn't take it anymore and my doctor prescribed the extended release.

I am having my HbA1c results taken at the end of this month and I hope to have greatly improved and ask my doctor to reduce my dose to the minimum. Hope you can get a dosage that will work for you

 

[sawyatt]

Oh, you're certainly doing something right. Congratulations on your weight loss - and BG loss I'm sure. You're doing really well, but I hope you'll get some more strips soon. Do you remember which other pill your doc wanted to throw into the mix? Some T2 meds give you a higher risk of hypos, so if you do decide to go this way, please do some research and see if the suggested med might be in that class. A keto diet is not a good idea on such a drug. It does sound as if the mention of another pill gave you a wake up call, though, so probably not relevant. For me it was the word 'insulin'. Oh, and even if you're on Low Carb, do make sure it's not way too low cal as well, as that'll put your body into starvation mode, and stall your weight loss. Been there, done that. As a rule of thumb, no less than 1000 a day.

Hi, thanks for your reply - that’s very helpful. I’ve taken note! He wants to add byetta or saxogliptin or linagliptin. I’m really not keen on taking any drug that stimulates the pancreas as they carry a higher risk (albeit a slightly higher) of pancreatic cancer which seems to run in my family, so yes, it was a wake up call! A few years ago I was on gliclazide as well as metformin so I worked at being able to drop the gliclazide which was successful but since I’ve had a major flare up of my fibromyalgia symptoms I haven’t had as much exercise last year as I would normally which I’m sure has caused by hba1c to go from just under 7 to 8.6

 

[briped]

Hi, thanks for your reply - that’s very helpful. I’ve taken note! He wants to add byetta or saxogliptin or linagliptin. I’m really not keen on taking any drug that stimulates the pancreas as they carry a higher risk (albeit a slightly higher) of pancreatic cancer which seems to run in my family, so yes, it was a wake up call! A few years ago I was on gliclazide as well as metformin so I worked at being able to drop the gliclazide which was successful but since I’ve had a major flare up of my fibromyalgia symptoms I haven’t had as much exercise last year as I would normally which I’m sure has caused by hba1c to go from just under 7 to 8.6

Neither of the proposed meds are on the list so that's ok, but yes, pancreatic cancer is what I worry about too every morning when I inject myself with Victoza. How many carbs do you eat per day?
Edited to remove wrong link.

 

[sawyatt]

Neither of the proposed meds are on the list so that's ok, but yes, pancreatic cancer is what I worry about too every morning when I inject myself with Victoza. How many carbs do you eat per day?
Edited to remove wrong link.

Carbs - about 50grams and my calories are around 1000 daily give or take a couple of hundred.

 

[Major Buckmaster]

Thank you for replying. That’s exactly it! I’m fine until after my evening meal too which is my biggest meal of the day (I cant change that due to my work). Just don’t want to spend every evening/night in the loo! It’s worse if I have spicy food or too many veggies which on a low carb diet is hard not to do! (Especially if you don’t eat meat!) oh well, at least the weight’s coming off which should help!

I know its awful. I think if we can keep our BGs under control with the meds we are taking and maintain the diet then hopefully all should be well!

 

[briped]

Carbs - about 50grams and my calories are around 1000 daily give or take a couple of hundred.

Sounds as if you're doing really well. When did you go Low Carb? I'm wondering if your numbers won't come even further down in due course. I wouldn't be surprised.

 

[sawyatt]

Sounds as if you're doing really well. When did you go Low Carb? I'm wondering if your numbers won't come even further down in due course. I wouldn't be surprised.

Only started on 3 Jan. I guess it’ll take a while to adjust and there’s the hopefully on-going weight loss too. I just need to find some strips - most shops don’t seem to have them and I can’t afford a new meter. Even Amazon don’t have them at mo! I’ll just have to sort it out and maybe get a new meter at some point. I’ll see what my next hba1c is - I’m hoping it’ll be good enough to convince the docs to let me just keep to the metformin!

 

[briped]

me just keep to the metformin!

Or maybe let you ditch it altogether? Which meter do you have? Did you try eBay?