Another Metformin Question

1

Hi, all! As of this week, I'm "officially" on Metformin, 500mg after dinner. (I know, some people say it's too low to be a therapeutic dose...give me a minute.)

I've been taking the Met for a week and a half, and the biggest thing I've noticed is that I stopped feeling highs. I still get them, I just don't feel like I could sleep forever from being 160. That was an immediate benefit, and one I'm quite happy with.

I've noticed that my BG stays high for much, much longer now than it did before I went off grains, and that might or might not be part of the progression from the IR. It's definitely not caused by the Met, but now that I'm eating carbs again, I've noticed that. The only foods the Met seemed to help with regarding highs are milk and minor carb sources, but those were borderline issues to begin with.

My question, though, is actually about lows. Technically, I know that Met isn't supposed to cause lows. I also know that most people aren't "typical" and that we can get weird side effects.

On Monday morning, I hung out in the 70's after breakfast. I thought it was a fluke since I walked around the city a lot. Exercise hasn't been causing lows for me for the past ten months or so, but it used to, with a vengeance. I thought maybe it was coming back.

Even without exercise, though, I'm finding myself hanging out in the 70's. Technically, it isn't low, but I feel like I have to eat something to keep from dropping.

I've also noticed that my fastings are lower (70's and low 80's rather than the mid to high 90's I've been seeing for the past few months).

Though my c-peptide is lower now than it was four months ago (4.6, down from 9.6), it's still high, which means IR. I'm guessing my c-peptide went down because I lost 12 pounds (it only went above 3 when I gained 10 pounds this past summer). Therefore, I should be on Met or some other oral med, since I can't handle the highs.

Has this happened to anyone? As the Met builds up in my system, should I worry about lows more? How long does it take for Met to build up completely?

2

Oh, and while I'm at it, does anyone get dry mouth from Metformin? It's definitely not BG related, but it's SOOOOO bad...

3

The gospel is that Metformin can't cause a low by itself. It does, among other things, suppress liver dumps, so if some other factor is pushing you down, the Met could interfere with (retard) the body's response. But YDMV, as always.

4

I went off them for four months. It's mostly because I'm a college student and no carbs is just not doable. But it's more than that--I'v discovered lots of low-carb foods that I really love and I can mostly do without carbs, but I was finding that even without major carb sources I was still getting highs. The longer I was off carbs, the less foods were available to me. It may just be me, but I'd rather be on meds and able to eat like a human being than starve!

5

Here we go again and gospels ( nee theories)

Latest findings have found that metformin in sufficient dose in blood wiil antagonize the glucagon from pancreas and cut off glucose release at and from liver.
I have seen the end effect out over last 5 years as well. The liver does this on the first sufficient dose of standard met to build up high enough strength in the blood and lasts as long as that dose remains in blood. WHile this is going on, if your body should need a bigger liver dump/load of glucose, the metformin will stop that and one can get a low. I have done and seen that multiple times on CGMS.

The standard theory and data also suggest that insulin resistance is supposedly cut back in the other insulin responding cells and works better when the metformin residue in those cells builds up and that takes time.

From my seat, this residual met has no action on the liver and its cut back of liver excess glucose release.

I am proposing nothing, recommending nothing and only commenting on my data on my body.

6

You still need to reduce carbs even if you are on Metformin. I still get highs and lows and have been on Metformin for 3 years.

7

DNS is right, metformin itself doesn't lower blood sugar. And the vast majority of pre-diabetics and T2s (not on insulin or sulfonylureas) will not have any concern for lows since their counterregulation system will work even when taking metformin.

8

Yes I agree. I dropped my diet to 1200 calories per day.

Metformin just helps cut back excess calories released by liver.

If your liver is properly signalling on the insulin/glucocon then met is probably little help.

In my case liver was throwing so much extra glucose in itw as blowing up my diet.

In my view; energy balance really needs to be met - energy burnt equals energy eaten plus that thrown in by liver.

9

Brian (bsc):

I am more nauanced that that.

If liver is properly signalling on insulin and glucocon then I agree one will probably not see any assistance.

ON other breath, though; if liver is adding glucose when it shouldn't metformin will definitely cut back on one of the sources of excess glucose.

And that is at source.

Otherwise the only way to cut back is to reduce carbs or add insulin.( by whatever means and you end up loading the skeletal muscles.

10

I'm reducing carbs, it's just that now I can eat more than zero at a time.

11

The liver eventually runs dry and needs topping off like the proverbial rain barrel under the rain spout from the roof catching the water. As one eats; the liver grabs a lion share of glucose and then uses that to evenly feed out that glucose to keep body running smoothly and not going dry in between meals.( when working correctly). ( A fifo buffer - first in first out buffer where the input can be bursty and intermittent and the output can be slow, consistent and constantly running).