Worried about gastric side effects of Metformin

You really need to be sure that you can cope with Metformin in your circumstances - it would be fine if you are fine with it - but for me it was a month or so of absolute hell as I was incontinent day and night and sleeping wrapped in two towels, unable to leave the house with any confidence in the mornings, going out without eating, then in the afternoon, having taken the Metformin at lunch time I could not even go downstairs. I was taking it with Atorvastatin and had aches and pains as well, plus problems with memory, depression. I threw the tablets away and have relied on diet only since then.

The GP might want you on medication but it’s up to you (and there are other options). Mine prescribed Metformin but even the slow release made me horribly ill so I stopped it and was changed to Linagliptin, am now diet controlled. Could you have another HbA1C in early July and see if the low carb is having an impact?

I went straight on to Gliclazide, not had any gastric issues with that.

My friend is on Metformin… he really had trouble to begin with.

masueuk said:

Hi
My HbA1c was tested 31 March at 82, 2018 it was 65 prior to that it was 45. Since I have cut carbs out massively but GP wants me on medication. I work from my car so toilets are few and far between, sometimes never finding one all day, so having gastric urgency terrifies me. What would you do? Keep trying to lower it without meds or risk extreme reactions with no toilet?

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Okay…
So, it is your choice whether you do or do not take drugs. But uncontrolled blood levels are not good. You said you have cut carbs since your reading of 82, is that correct? If so maybe one option is to tell your doctor that you have actively made dietary changes and you would like to be retested in 3 months time to see how those are impacting rather than going straight into drugs

for metformin, yes for sone it can have dietary issues, slow release often is better but for some it isn’t tolerated: I was on slow release for over a decade with no issues so as you can see there are different impacts for different people and unfortunately we don’t know which side you will fall on

but have you told your doctor that you are concerned because of your situation? Is it possible to not work from your car for a little while to try for the tolerance? I know this isn’t necessarily possible, just trying to think of options

There are also alternatives to met that have different side effects but hopefully your doctor could take that into account. Met is the first line treatment but as I said, you may have other options

hopefully your doc is able to have these open conversations

I would use what you were born with, Type 2 diabetes is not a metformin deficiency, I feel it should be a last result. Personally I dropped my fasting blood glucose from 20+ to 16 in 1 week, without knowing what I was doing.

My opinion is biased as this drug caused me kidney issues, but there have been so many issues (well documented on this site), not just gastric. Based on this I feel metformin gets a badge of "safe" on shaky ground. A ten minute walk after each meal has been proven to out-perform metformin, so why take a less effective tablet. The "benefits" of metformin such as liver dump control, insulin sensitivity, weight management, are easily covered by low carb / keto / carnivore dietary patterns and optionally boosted with resistance exercise.

Here's the latest scare with a version of this drug:
Diabetes Drug Recalled Due to Risk of Cancer (aarp.org)

Hello and welcome @masueuk ,

I'm another T2 who was on Metformin with no real issues. When I started I was put on Metformin. I had some stomach pains when I was taking it in the morning so I took it in the evening and then had no more issues at all. My position was that high blood sugar levels were problematic and I was going to make a big effort to get them under control. Once that was achieved I stayed there for a while and have no stopped metformin. Were my levels to go up again I would restart metformin to give me an assist while I tackled the levels again.

However, it is very much your choice. Testing regularly will help you make decisions as to whether a little bit of extra help is needed or whether you are able to do it on diet alone.

There is really no one right way to tackle diabetes as long as you are keeping your levels under control. The right way is one that you can maintain. Some are able and willing to do it on diet alone other need/prefer to have some assistance with medication/insulin. This forum is for all.

I am also realistic about the fact that we have to fit work into our lives. I rapidly went to 2 meals a day as I couldn't find a low carb breakfast that I could eat at work- my alternatives were too rich for me or not really socially acceptable at work. I then went to one meal a day as work was so busy. I'm trying to go back to2 meals a day but my work makes that a challenge. My levels usually only drop after I eat so it's something I need to do but... (I can find many excuses )

Good luck!

Mbaker said:

I would use what you were born with, Type 2 diabetes is not a metformin deficiency, I feel it should be a last result. Personally I dropped my fasting blood glucose from 20+ to 16 in 1 week, without knowing what I was doing.

My opinion is biased as this drug caused me kidney issues, but there have been so many issues (well documented on this site), not just gastric. Based on this I feel metformin gets a badge of "safe" on shaky ground. A ten minute walk after each meal has been proven to out-perform metformin, so why take a less effective tablet. The "benefits" of metformin such as liver dump control, insulin sensitivity, weight management, are easily covered by low carb / keto / carnivore dietary patterns and optionally boosted with resistance exercise.

Here's the latest scare with a version of this drug:
Diabetes Drug Recalled Due to Risk of Cancer (aarp.org)

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As I understand it That recall is a contamination of the drug and not related to the drug itself. Metformin itself is reported mostly as a benign drug that has generally low side effects and some beneficial impacts over and above the drop in hba1c it delivers

now, don’t get me wrong, I am not a drug pusher and Being able to manage without drugs seems better to me, and hopefully the lower carb option works. No one should suffer from side effects but I know occasionally they are unavoidable but personally, I measure them against the impact they have to address the issues I may have. As I said before, uncontrolled blood levels need addressing and ideally dietary are best but sometimes they need temporary or longer term help

for many if not most people on met, they do not have issues but going in eyes open is highly important, it can have gastric and other issues (as posters have indicated) that you should take into account. Any drug can have side effects, but so can anything you put into your body. So the discussions and knowledge shared on this forum is so important.

masueuk said:

I work from my car so toilets are few and far between, sometimes never finding one all day, so having gastric urgency terrifies me.

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If you'd like to have a try with the metformin, why not start at the start of a weekend or another couple of days off to see what happens without the risk of panic on the road?
If you do get the side effects you can stop again and you'll be fine before your working week starts again.

I'm another one who is on metformin without issue, provided I take it with a meal. I did do some experimenting to see what would happen if I took it without food, that didn't work out too well for me.
But it's not like it was a disaster: I took it late afternoon without food and the next morning I woke at 6AM (middle of the night for me) with a strong urge. Back and forth to the toilet for the next 4 hours, but by noon things had settled again, teaching me to not take it without food again.

Andydragon said:

As I understand it That recall is a contamination of the drug and not related to the drug itself. Metformin itself is reported mostly as a benign drug that has generally low side effects and some beneficial impacts over and above the drop in hba1c it delivers

now, don’t get me wrong, I am not a drug pusher and Being able to manage without drugs seems better to me, and hopefully the lower carb option works. No one should suffer from side effects but I know occasionally they are unavoidable but personally, I measure them against the impact they have to address the issues I may have. As I said before, uncontrolled blood levels need addressing and ideally dietary are best but sometimes they need temporary or longer term help

for many if not most people on met, they do not have issues but going in eyes open is highly important, it can have gastric and other issues (as posters have indicated) that you should take into account. Any drug can have side effects, but so can anything you put into your body. So the discussions and knowledge shared on this forum is so important.

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There are many more side issues, such as reducing B12 in around 1 in 3, in some causes nerve damage, it alters the gut microbiome, it is contra indicated with liver and kidneys problems - if these risks are acceptable, that's the choice compared to a ten minute walk with only good side effects. The suppression of natural processes such as gluconeogenesis I think is similar madness as some statins restricting coenzyme q10; should we not consider leaving bodily function to normal boundaries.

masueuk said:

Sadly I have to work from my car as I'm a field interviewer. I'll try to discuss it and think being retested after3 months 8s a good idea.

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Well done on crushing the carbs as this is the best way to actually reverse the condition rather than just manage symptoms. It s a safe and effective drug so perhaps you could try it for a 'holiday' over 3 days if you did get the chance for that Doctor chat.