Metformin - first line of defense -- but why does it make some so sick?

Treatment
#1

Continuing the discussion from Doctor visit update – Still in limbo – Endo #3 the charm?:

Please no metformin. I could not take it. Or the ER version. Bathroom all day and night. The endo did mention Victoza as a possibility. I am terrified of hypos.

But why does it make some people so sick? I thought I was literally going to die–when I wasn’t hugging the toilet and I was sitting on it. Sometimes I had the garbage can in front of me as a precautionary measure. The original endo was really mad at me because neither form of metformin didn’t work and my A1C was 7.1, but it just wasn’t good for me.

Yet other people swear by it as a miracle drug. I just don’t get it. :confused:

#2

It was a good drug for me. I wouldn’t even need bolus insulin with it. But the explosive diarrhea (reg form) and throwing up (ER version) wasn’t a good thing.

#3

Roxanne - did your doctor ever say why it gives off those side effects? I cannot find out anything, and my original endo was no help. The second opinion endo just said I should never have been placed on it.

But I like to why things happen–you know usually with side effects, there is a reason why it happens, but I either I’m looking in the wrong places or there isn’t literature that gives a definitive answer.

#4

Kate25,
I didn’t have as strong a reaction as you to Metformin, it made me slightly nauseous all the time but Victoza caused me all sorts of problems. It made me nauseous to the point of not wanting to eat and it completely killed my appetite, to the point where I had to force myself to eat even though I wasn’t feeling hungry and felt like vomiting most of the time.

I don’t know if the fact that I’m T1 has anything to do with my reaction to those meds but I tried using them before I was correctly diagnosed.

#5

No, i did take it for 8 months with little side effects. Just came on slowly, but when endo found out I had diarrhea for 15 hours, that’s when he said quit it cold turkey. After awhile I asked the endo to prescribe ER version and I lasted 3 weeks on that.

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#6

Thanks for the feedback Wheelman. The second opinion endo threw out Victoza as an alternative to insulin. I don’t know what endo #3 will suggest. However, I’ve heard good and bad about Victoza; and, the bad have all been similar to your experiences which don’t sound appealing either.

I just dread going through a laundry list of trial and error medications. Been there and done that with my RA medications. But…sounds like I’m going to have to put my ‘big girl panties’ on and suck it up. :persevere:

#7

the doctor gave me a 500 mg metformin pill. i cut it in half and only took these approx 250 mg dose for a week. then i bumped up to 500. the only side effect i had was one night when i had very bad cramping in both calves. i skipped taking metformin the next day. then i increased my water intake. no problems with any side effects now on 500 mg a day.

#8

I have been on metformin for a long-time. Gastrointestinal side effects are very common when starting on the drug. In fact the prescribing information reports that half the patients reporting side effects noted that diarrhea and nausea/vomiting were the most common side effects. Nearly 10% patients reported diarrhea and nearly 7% had nausea/vomiting. And it is reasonable to think that these are underreported, perhaps significantly. Another sources reports these side effects initially in as much as 30% of patients.

That being said, most of these problems occur when starting insulin. A medscape article gives some good suggestions on how to minimize the impact of these effects. Starting the medication at low doses and slowly increasing. If diarrhea or nausea/vomiting are reported the medication level can be reduced until the symptoms subside. Some people report better luck taking metformin with food. And it is important to note that many (if not most) people find that the become tolerant of metformin and these symptoms no longer appear. That being said, these symptoms can reappear over the long-term.

I understand how bad these side effects can be. I’ve experienced them. But if you can soldier through and make adjustments to get through the roughest patch at the beginning, metformin is perhaps the best and safest first line medication for insulin resistance.

#9

Yep did that too. Then he told me to take the half a pill every other day. Same side effects for both versions. That’s one of the reasons I think he got so mad at me because his wonder pill didn’t work. But as this site says YDMV (your diabetes may vary). Maybe your not supposed to mix steroids and metformin?

So far I can’t find any literature on why some people have adverse reactions to metformin and others shine on it. I know some diabetics feel like they failed because they have to start insulin. I feel like I failed because I couldn’t take metformin.

#10

Well, I also think it is true that many doctors don’t actually care about the side effects like this and just expect patients to accept it. A good doctor will be sensitive to this, start patient slowly and adjust things. Quality of life does matter. You may just be someone who cannot tolerate metformin.

#11

Yes all that was discussed to about when to take the medication. I really tried to suffer through taking the medication. But The GI problems were bad. The original endo really pushed for me to stay on the medication and go to a GI doctor. His comment was, the medication is good it must be your digestive tract.
After I threw the pills away, no more GI problems. Everything worked as normal. Food stayed on stomach----no coming up and no expressway coming out immediately after eating. And I was still eating a low carb diet.

#12

I had horrendous gas pain and cramping when I started on Metformin. Ugh! Titrated up much more slowly than the doctor wanted 'cos I wasn’t sure I could manage, especially with all the extra visits to the bathroom. Now I’ve dropped my dose from 2000 mg to 1500 mg and may drop to 1000 mg because with the increased activity level of spring and summer, I find my BG drops too easily (even after adjusting boluses).

#13

My original endo just made me feel like I was a failure for not being able to take it. That’s when I discovered Starbucks–their protein bistro box (1 boiled egg, grapes, cheese, skip the apples cause I’m allergic) was the only thing I could keep on my stomach for lunch. I had always eat salads and chicken or beef for lunch and I couldn’t keep it in.

Sometimes I think maybe I should have stuck it out and went to the GI doctor. My mom’s side of the family has IBS and my mom has Gastroparesis from her long-term diabetes (we found that out after my metformin moment).

But stopping the medication, I don’t have the digestive problem as I did taking the medication. On occasion, I’ll have an ‘expressway’ moment (eat and it goes straight through), but I never regurgitate anything or be nauseated anymore.

#14

@Kate25, you might consider healing whatever is causing extreme sensitivity in your GI tract and then trying the metformin again. Though, personally, I interpret side effects with any drug to mean my body finds the drug toxic, and I look for natural alternatives.