Metformin Problems?

[bigalxyz]

Hello forum.

T2D, diagnosed 2011. However my blood sugar control has improved enormously since then (thanks to weight loss, change of diet, more exercise, etc.) - HbA1c now hovers just over 5%.

I'm still taking 1000mg/day metformin though.

In the last year or so I've started having stomach aches/cramps (I had these for a while back in 2011 when I first started taking metformin, but they faded after a few weeks).

I'm also noticing that when I exert myself I get weak and shaky. Walking is fine - I could walk 20 miles without much trouble - but things like mowing the lawn, DIY jobs, etc. where I'm having to use a bit more force/strength - these are proving tricky. I have to stop after a short while, feeling a bit weak & wobbly. And yet I'm never in the least bit out of breath.

Wondering if metformin is the culprit here. GP seems unsure. Tempted to stop taking for a little while to see if the symptoms improve. Should I be taking it anyway with such a good HbA1c number?

Thanks,
Alan.

 

[Keesha]

Go see your GP and get his advice on reduction of medication. That is what the GP is for, to advise and approve. Never reduce or increase medication without doctor's approval.


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[bigalxyz]

Well...yes, I'm aware of what GPs are for. If only I could get an appointment with less than about two weeks' notice. If I could speak to him today, I would. But I can't. So I'm here instead!

 

[Oldvatr]

Hello forum.

T2D, diagnosed 2011. However my blood sugar control has improved enormously since then (thanks to weight loss, change of diet, more exercise, etc.) - HbA1c now hovers just over 5%.

I'm still taking 1000mg/day metformin though.

In the last year or so I've started having stomach aches/cramps (I had these for a while back in 2011 when I first started taking metformin, but they faded after a few weeks).

I'm also noticing that when I exert myself I get weak and shaky. Walking is fine - I could walk 20 miles without much trouble - but things like mowing the lawn, DIY jobs, etc. where I'm having to use a bit more force/strength - these are proving tricky. I have to stop after a short while, feeling a bit weak & wobbly. And yet I'm never in the least bit out of breath.

Wondering if metformin is the culprit here. GP seems unsure. Tempted to stop taking for a little while to see if the symptoms improve. Should I be taking it anyway with such a good HbA1c number?

Thanks,
Alan.

Have you checked your sugar levels when you go weak and wobbly? If it is only occurring as a result of increased exercise there may be other explanations. Your HBA1c is roughly 5.4 mmol/l on a bgl meter, so you would not need to drop much to start feeling a hypo coming on. I know people say that you cannot get a hypo when on Metformin only, but others report here that it can happen to even non diabetics too, so my Q? is not too far fetched.

What diet are you following? If it is a LC type diet then it could be you are running low on glucogen from the carbs, and if it is also low fat then you may not be compensating through ketosis (fat burning).

There are many other medical conditions that could give the shakes so it may not be the Metformin. Do you take any other meds such as BP meds. or statin? ACE inhibitors?

I have not heard of Metformin directly causing the symptoms you describe (although they are listed in the uncommon side effects and rare event sections of the advice leaflet), so you should go visit the doctor to maybe get some bloodwork done to look at the overall picture. i.e. Ferratin levels, vitamin deficiencies?platelet counts etc. just to make sure. A unilateral cessation of meds is not advised unless you have good cause to suspect them,

 

[bigalxyz]

Thx - proper reply later but just checked BG a minute ago, at 6.7. Ate a couple of hours ago (minimal carbs though). I'm having a shaky spell now after painting my spare bedroom for an hour or so.

 

[13lizanne]

Could you be suffering from low blood pressure? Are you on medication to lower b.p perhaps. When I lost weight and increased exercise I had symptoms like yours (after prolonged exercise) and that turned out to be low BP. I had been taking Ramipril to lower bp when I was heavier which was no longer needed!

 

[bigalxyz]

Long story here...I had a heart attack about a year ago (aged 45!). 1 stent fitted. Situation stable, recurrence unlikely, and I'm taking lots of meds. Atorvastatin. Ramipril. Aspirin. Bisoprolol. Eplerenone.

However...

The problems I described pre-date this, so I don't think it can be a result of the new cocktail of meds I'm taking.

Loads of blood tests recently, all normal. BP typically 120/80. Pulse very steady. On paper I'm in really good shape!

 

[bigalxyz]

It's a strange thing. Last month I went to Corfu for a week's walking holiday. Long days hiking up some pretty steep climbs. A fairly stiff test of my fitness but I didn't have any particular problems (a bit tired after the end of a long day in the sunshine but that seems pretty normal to me). On some level I'm pretty fit. And yet if I mow the lawn my arms ache like mad and quiver afterwards.

 

[bigalxyz]

In reply to one of the comments about my diet...most of the time I tend to not eat much in the way of carbohydrates and virtually zero sugar. Half the supermarket is off limits. Never eat cakes, biscuits, sweets, crisps. Rarely eat white bread, potatoes, rice, pasta. Occasionally I let it slip a bit, but not often - although I don't tend to notice much difference if I do.

 

[Oldvatr]

It's a strange thing. Last month I went to Corfu for a week's walking holiday. Long days hiking up some pretty steep climbs. A fairly stiff test of my fitness but I didn't have any particular problems (a bit tired after the end of a long day in the sunshine but that seems pretty normal to me). On some level I'm pretty fit. And yet if I mow the lawn my arms ache like mad and quiver afterwards.

Sorry to hear you had a CVE last year. I am surprised they did not insist on a statin or two. Statins are reknowned for muscle aches and stiffness. Was this your choice? As a fellow CVE sufferer I was put on Clopidogrel and Lanzoprazole which is a stomach protector to reduce damage due the anticoagulant. This is as a replacement for the aspirin, and is a preferred treatment if long term use is required. You should ask your doctor about this, as you may be at risk from stomach ulcer.

The CVE itself can lead to scar tissue damage that could be causing your discomfort when exercising especially upper torso. It may be that a stressed ECG on a treadmill may give a better indication. But I am not a medical man, so could be talking out of mon derriere. I have exhausted the obvious possibilities. All I can say is that my own heart attack has left me with a legacy too, so now you have told us about yours, then this sounds like an avenue to explore more.

 

[bigalxyz]

Sorry to hear you had a CVE last year. I am surprised they did not insist on a statin or two. Statins are reknowned for muscle aches and stiffness. Was this your choice? As a fellow CVE sufferer I was put on Clopidogrel and Lanzoprazole which is a stomach protector to reduce damage due the anticoagulant. This is as a replacement for the aspirin, and is a preferred treatment if long term use is required. You should ask your doctor about this, as you may be at risk from stomach ulcer.

The CVE itself can lead to scar tissue damage that could be causing your discomfort when exercising especially upper torso. It may be that a stressed ECG on a treadmill may give a better indication. But I am not a medical man, so could be talking out of mon derriere. I have exhausted the obvious possibilities. All I can say is that my own heart attack has left me with a legacy too, so now you have told us about yours, then this sounds like an avenue to explore more.

Thanks. Statin - yes, atorvastatin 80mg/day. Cholesterol now hovers around 3 or 4 (for what it's worth!). I do sometimes get muscle aches/stiffness but nothing out of the ordinary I don't think, and I don't think it has got any worse since I started taking the statin.

I took ticagrelor (which I gather is an alternative to clopidogrel) for a year - nasty stuff, had a lot of trouble with bruising, cuts bleeding (shaving was a nightmare) and a trip to A&E with a nosebleed that lasted for 7 hours - and it affected my breathing as well - but the year was up at the end of May so I've stopped taking it now. I was prescribed lanzoprazole as well but I stopped taking that after a while - GP advised I could just take it "as & when" and I got on ok without it. The stomach upsets were already happening before the MI and the lanzoprazole didn't help anyway.

Also got an under-the-tongue spray thingy in case of attacks of angina, but since about 12 hours after the stent was fitted I haven't had any pain like that whatsoever, so that's sitting unopened in a drawer in my bedroom.

Slight scar tissue damage in the left ventricle showed up in recent echocardiogram but my GP explained that the affected area was small. Ejection fraction a bit low as well (but has improved quite a bit since my first scan just after the MI). Again though the problem on exertion was there before the MI so I don't think (?) I can blame that. Still, I'm bound to wonder if there's some kind of link to my general cardiac health, but I don't know much about this stuff.

 

[bigalxyz]

And my GP just shrugs and tells me I'm doing well. I think there's a gap between the health I aspire to have and the health he expects me to have.

 

[Oldvatr]

Thanks. Statin - yes, atorvastatin 80mg/day. Cholesterol now hovers around 3 or 4 (for what it's worth!). I do sometimes get muscle aches/stiffness but nothing out of the ordinary I don't think, and I don't think it has got any worse since I started taking the statin.

I took ticagrelor (which I gather is an alternative to clopidogrel) for a year - nasty stuff, had a lot of trouble with bruising, cuts bleeding (shaving was a nightmare) and a trip to A&E with a nosebleed that lasted for 7 hours - and it affected my breathing as well - but the year was up at the end of May so I've stopped taking it now. I was prescribed lanzoprazole as well but I stopped taking that after a while - GP advised I could just take it "as & when" and I got on ok without it. The stomach upsets were already happening before the MI and the lanzoprazole didn't help anyway.

Also got an under-the-tongue spray thingy in case of attacks of angina, but since about 12 hours after the stent was fitted I haven't had any pain like that whatsoever, so that's sitting unopened in a drawer in my bedroom.

Slight scar tissue damage in the left ventricle showed up in recent echocardiogram but my GP explained that the affected area was small. Ejection fraction a bit low as well (but has improved quite a bit since my first scan just after the MI). Again though the problem on exertion was there before the MI so I don't think (?) I can blame that. Still, I'm bound to wonder if there's some kind of link to my general cardiac health, but I don't know much about this stuff.

Ditto. Sounds like you were given a Warfarin thinner. I am on high dose of Clopidogrel but I have no trouble with finger pricking or gums bleeding and have not had any Sweeney Todd moments. Seems quite benign to me.