What is Lactic Acidosis?

What is lactic acidosis? Is it fatal? what are the symptoms?
Is it true that Metformin users are prone to have lactic acidosis? I’ve been taking metformin for almost 5 months now (500mg, 3x a day), the one that I’m taking is not branded, its generic…
I’m experiencing abdominal pains, though the pain is tolerable… but I’m concern…
Please educate me… Thank you…

Lactic acidosis is when there is a build up of the toxic chemical lactic acid in your blood stream. It causes an acidosis, not unlike ketoacidosis, but caused by lactate versus ketone bodies.

There are 2 types of lactic acidosis, type 1 and 2. Type 1 is commonly seen in critical illness, when blood pressure drops because of infection, heart failure or other shock. Metformin can be associated with the other type of lactic acidosis (type 2), in the setting of kidney failure and heart failure. This is because the kidney is responsible for clearing the metabolites of metformin. When your kidneys cannot effectively do this, metformin causes lactate to be produced in the liver and causes the lactic acidosis. They are similar, but there is a distinction in how they are treated. Type 1 is because the muscles aren’t being perfused by blood and the muscle cells build up byproducts of their normal activities - lactate. Type 2 is because of the liver. They can exist together at the same time - for instance someone with kidney failure gets an infection. The metformin is ineffectively cleared by the kidney causing lactate production and in the muscle the infection causes the lactate to not be taken away to be cleared.

Lactic acidosis, caused by metformin, is exceedingly rare and almost never happens if your heart and kidney function are normal. However, in the wrong setting (kidney disease, heart failure, severe infection, CAT scans with contrast), metformin can cause serious illness from lactic acidosis, and even death. The symptoms would be those of the condition that caused the lactic acidosis - i.e. heart failure presents with shortness of breath and swelling of ankles, severe infection may cause fevers, chills, rashes, etc.

Despite this concern, metformin is the best initial therapy for most people with type 2 diabetes. It is inexpensive, effective, reduces the progression of type 2 DM, and is generally well tolerated. Just like any medicine with potential side effects, the doctor needs to look at all aspects of the patient’s health status before starting metformin. Abdominal discomfort is common with metformin and unlikely due to lactic acidosis. There is no difference in the risk of lactic acidosis or effectiveness of generic vs brand name Glucophage (metformin).

Hope this long-winded explanation helps.

I’ve been on metformin for months, no side effects yet.

AFAIK, it may damage your kidneys, but the odds are with you–it rarely happens.

…Oh, Mick already explained it, thanks!

If you are really concerned about it, just exercise and get a lot of fresh air. That should help prevent acidosis.