I Hate Metformin (A Rantlet)

meowser-48.jpg posted by meowser

I wish I was a voice-file-editing wizard, because in order to get the full impact of the title and what it means to me, it needs to be read in one of those Yosemite Sam type of growls: “Ahhhhhh HAAAATES metfohmin.” Because I really do hate metformin (brand name: Glucophage) the way Yosemite Sam hated Bugs Bunny, and with a lot more justification. Metformin is not cute. It is not witty. It does not have soft pettable-if-only-it-were-real fur. It does not kiss its enemies full on the lips and then spin its ears to fly away. It’s just a big old nightmare, that’s all.

For those of you who are met-n00bs, lucky you, a bit of background on what this drug is. It’s supposed to be an insulin sensitizer, so it’s typically given to people with type 2 diabetes who are not yet insulin dependent, so they can make the best possible use of what little insulin their pancreases are able to come up with at this stage of the disease. But in recent years (I was first prescribed it in 1997), it’s also been commonly dispensed to women with polycystic ovarian syndrome, which I have, because one of the markers for PCOS is elevated fasting insulin. That means my pancreas is working way too hard, and for the time being, the net result is that my blood sugars, even after eating, tend to run a little on the low side. But if the pancreas continues to overwork itself, it could eventually burn itself out and bang, diabetes. That’s the theory, anyway, and hence metformin is supposed to slow down the overproduction of insulin so I’ll have more of it later on when I need it.

But I’ve never been able to stay on it. (Okay, here comes the grody part; that’s what you love me for, right?) Because here’s what else it does to me, besides sensitize my cells to insulin: It turns my digestive tract into a long, snakey blender set permanently on puree. I’m sure if you asked most people whether they’d rather have explosive diarrhea or be fat, they’d pick the diarrhea, but not me. Explosive diarrhea is my idea of an unacceptable side effect. I mean, really, think about it. You can’t go ANYWHERE without knowing exactly where the nearest toilet is, and when you get there it had better be unoccupied. Last I looked it was still legal to be fat in a supermarket (at least for the time being); I’m pretty sure it’s totally illegal to take a dump in the middle of a produce aisle. Yeah, I could wear an adult diaper, and I’m well aware that there’s no way around that for a lot of people, but you still have to change the damn diaper as soon as you know you’ve, er, used it. Which still amounts to finding and gaining access to the blasted toilet ASAP before people start complaining about the smell. Call me shallow, but I’d rather put off the adult-diaper stage of my life for as long as I can swing it.

So for years, the cycle has been that I’d stay on the met for as long as I could stand it, then discontinue and tell my doctor I can’t tolerate it. Then the doctor says, “Well, you really should take it,” so I’d start taking it again, and become Ms. Poopy Shorts again, and the doctor would give me shit (snerk) about discontinuing again, and the typical thing they tell you to do is take some Imodium or something to stop the flying poop. Well, I have a couple of problems with that. One, I firmly believe that if something is racing to exit your body, there’s probably a good reason for it, and messing with that every day could cause all kinds of problems later. For another, I really dislike the “take more drugs to counteract the side effects of the drugs you’re taking” syndrome. I already do that with psych meds, and it blows mountain-lion-sized hairball chunks. Because, where does it end? That’s why, whenever I create a medical report for someone older than about 60, they’re always on about 20 different drugs and getting more added every time they show up at the doctor’s. Iatrogenic illness, what a party.

And lately, especially after my month-long bout with antibiotics, which can do a number on your gut all by themselves, it’s gotten much, much worse. Let’s just say that at one point there was a race to a public bathroom and…I lost. Fortunately, this happened at the shrink’s office, and she had a pretty good sense of humor about the whole thing. Her belief is that I have all this wacky shit (snerk snerk) going on in my digestive tract (and my endocrine system) because I’ve spent my life under a ridiculous amount of stress due to untreated/unrecognized Asperger’s, and that “you’ll get your body back” when I finally decompress from it all (when, I ask?).

But you know, I’ve checked around the t00bz, and I ain’t the only one set on perma-puree by this not-so-little white pill, believe you me. It seems like more people than not actually do have digestive iss-yews with metformin, but since the result of all that time spent making personal deposits in Bank of the Sewer is often weight loss…oh yay, bring it on! ANYTHING to weigh a few pounds less! I don’t get neurotypical people sometimes, would they really rather crap their pants than buy them a size bigger? Evidently they would. Therefore, none of the pharmaceutical companies, to my knowledge, are offering any real alternative to the Big Met. I asked my gyno about that, since she has PCOS herself and I thought she might have some answers, but no, even she doesn’t know of any other than “take Imodium, and if that doesn’t work, then forget about it.”

So about a month ago, I decided to forget about it. That’s how I know for sure that the metformin was the guilty party; I discontinued for a week, the flying poop went away, and went back on it and the flying poop came back. Hard to get any more certain than that. After that I stayed off it for good, and decided I would substitute cinnamon extract, apple cider vinegar (dissolve in water or club soda, wait five minutes for the smell to dissipate, and add a splash of juice for flavoring), and alpha-lipoic acid, and just keep checking my fasting insulin to make sure it wasn’t creeping up on me.

And then a funny thing happened: I started getting way more productive at work. I get paid by the line, and my line counts the last couple of weeks have increased by over 50%. And they have incentive bonuses that kick in over a certain number of lines, so that means a substantial increase in pay. Now granted, I wasn’t earning squat before and this won’t make me affluent by any means, but dayyyum, I’ll take it. Am I certain that booting metformin out of my life is what did the trick? I don’t know, but I’d have to say it didn’t hurt.

And I don’t know about you, but I like things that don’t hurt.

58 Responses to “I Hate Metformin (A Rantlet)”

  1. deannacorbeil Says:

    Ohhh my! Do I know what you’re talking about!! I took Metformin for several years for PCOS and had the same issues. And when you’re a home health nurse in a rural area, it’s often tough to find a public bathroom. I finally just quit taking it a couple of years ago. I haven’t had any of the appropriate lab work done in a while, as we moved a couple of years ago. I finally got the nerve to go see a new ob/gyn a couple of weeks ago, thinking I’d talk to her about it. However, after she almost immediately launched into the fat lecture, I didn’t even bother.

  2. Nicole Says:

    Very funny entry, and timely for me since I actually ate one of the things that does me in on Met today and nearly got a speeding ticket trying to get home in time. The thing about Met for me is that I can pretty well predict what is going to make me have the unpleasant side effect, and I can therefore mostly avoid those things. After several years on and off of Met, I should know that if I eat at Pizza Hut, I’d better not be setting off on a long car journey. However, I know that a lot of people don’t have the nasties *only* with certain foods, and that would make it nigh well intolerable. I feel better when I’m on it, and I guess that means it works for me.

  3. stina Says:

    I am so with you. I have cut my dosage in half, and that has helped a lot, but I don’t know if it sensitizes me enough or what at that dose. But seriously, that stuff is just a front for the people at Immodium – a slicker for the poop chute. Pure misery. Every public transportation trip is like taunting fate.

  4. vesta44 Says:

    On the diabetes lists I belong to, I’ve heard a lot about the explosive diarrhea and/or gas that comes with taking Metformin (DH [type 2 diabetes] gets the gas, still, and he’s been taking Metformin for almost 15 years, and he’s now on insulin too). I’ve heard that if you can get the extended release Metformin, it’s not nearly as bad with those side effects (but all I have is anecdotal evidence for that). But if the cinnamon/apple cider vinegar/ALA are working for you, why bother to go back? DH also takes the ALA, it helps with neuropathy (he still has the numbness from it, but the burning pain is gone). We tried the cinnamon/cider vinegar and it didn’t do anything for his blood sugar, but I think that is one of those YMMV things – it works for some, not for others. And, according to his case manager, when your blood sugar is higher than normal, it tends to make you tired and sleepy, so there’s that………….
    I think sometimes (maybe even a lot of times) treatment is a trial and error proposition – you try this, that, and the other in order to see what works best for your body, and then that’s what you go with, what works best for you, not what is said to work best for most people.

  5. Ashley Says:

    I’m really lucky because Met has been a wonder drug for me. I have PCOS with really strong symptoms of insulin resistance (though my fasting insulin is only borderline), and I have absolutely 0 side effects with it. None. And it made all my problems go away.

    It’s kinda scary how much I think this is a wonder drug, but for me it was.

    I hope the cinnamon, etc. work well for you.

  6. wellroundedtype2 Says:

    Okay, so I’m one of those people who likes Metformin, but I haven’t had the E.D. in quite some time. I’m pretty sure it sped up my lactose intolerance.
    If you can’t take it, you can’t take it, and that’s the bottom line (he he – yuck).
    I wonder if the metformin makes me spacey sometimes, though. Hmmm.
    Of course, I don’t just have PCOS or prediabetes, I have full-on type 2 diabetes. With the metformin plus some long acting insulin, I’ve got a beautiful A1C.

    I’m glad you are feeling better.

  7. meowser Says:

    Hey, if the stuff works for you, more power to you. It’s my theory that drugs stay on the market because they work for somebody; it’s just that they don’t work for everybody (or even necessarily most people) they’re prescribed to.

  8. meowser Says:

    And yeah, I know PCOS is a relatively “new” diagnostic category (although I’m sure it’s existed for as long as there have been human ovaries, they just didn’t know what to call it), but that’s still no good excuse for nobody getting cracking on developing an insulin sensitizer that works for those of us PCOS-ers who can’t tolerate the met. (And gee, you think there might be two different drugs for people who produce too much insulin and people who don’t produce enough? Dare I dream?)

  9. lilacsigil Says:

    Diarrhoea and faecal incontinence are common and well-known side-effects of taking metformin, not something that you should have to explain over and over again. How frustrating (but not surprising) that the doctors are putting your test results over your actual day-to-day life.

  10. alocin Says:

    I have just started taking Metformin, even though I apparently don’t have PCOS, just something that’s very like it… and it has been awful. I’ve never had diarrhoea in my life before, and I spent last weekend bolting for the loo, with a bucket with me for what was coming out the other end. It does seem to be settling down – and unsurprisingly I’ve lost a few kilos on it (happens when you’re spending days alternating both ends over the loo on a permanent rotation). I’m so glad to read about someone else’s experience with it – as I don’t have Type 2 diabetes, and my insulin levels and hormone levels etc are apparently all fine but I have a theory that my ob-gyn has just gone “Hmm, missing periods, a bit fat and some hair on the upper lip – oh, let’s just whack her on some metformin and see if that recovers that missing period.”

    If the digestive distress keeps on going, I’ll be following your example and ditching it quick-smart, and if the ob-gyn has an issue with that, I’ll be ditching her too. I’ve been fortunate enough to be very healthy all my life, and to be taking tablets that make me sick does seem ridiculous

  11. ambertides Says:

    I had the same problem and did the same on-and-off for about a decade. Regular Met was less painful for me than either the brand name or the generic XR, but it was still pretty awful and the kicker was it didn’t help any of my PCOS symptoms any of the times I was on it.

  12. living400lbs Says:

    In the diabetes education class I accompanied a friend to, they emphasized this side effect of metformin and noted that the extended release can reduce or eliminate the stomach distress. But really? I don’t see taking it if it’s not providing benefit for you.

    (But then, I don’t do any hormonal birth control because they either make me need antidepressants or make me need more antidepressants. NoThanksKBye!

  13. The Bald Soprano Says:

    Man, my doctors acknowledge the gas side effect but totally deny the diarrhea side effect. I thought that I was the only one who had it! (It’s manageable at the dose I’m taking, but my endo doubled it suddenly and it made me unable to function…) I still feel better with the metformin than I did without it, but if they try to force me to double the dose (because I’m still fat) again, I’ll just say ‘no thanks’ until I’m actually diabetic.

    I’m wondering if they’ll ever test Byetta for folks with PCOS.

  14. Rachel Says:

    My doctor just referred me to have a unpleasant test to determine PCOS, in which case she said she would prescribe Metformin. She told me that it only causes about a 10-15 pound weight loss (and I now wonder how much of that is fluid and fecal matter), but that if you’re already eating healthy and exercising appropriately, that it would make those things effective for weight management. I’ve been putting off the test partly because it’s so unpleasant, but also because of all the chaos of end-of-quarter school stuff, but now I’m wondering if I should even have it done at all if Metformin is really that bad. Is it like Alli, in which the kinds of food you eat precipitate diarrhea? I really don’t eat a lot of greasy or fried foods, but I do have a sweet tooth. What kinds of foods most triggers it?

  15. Meowser Says:

    Rachel, if you can believe this, I had my worst symptoms with raw vegetables. Yeah, go fig, insoluble fiber causes big time trouble with me if I don’t have soluble fiber along with it. Took me a while to figure that one out. But I also have irritable bowels, and my triggers might be different from yours.

  16. O.C. Says:

    I’m another person who hasn’t had trouble with metformin. I’ve gone off it a time or two, usually because of insurance problems, and have seen my symptoms come back with a vengeance. I take 2000mg of the extended release, spaced out between breakfast and lunch. It’s a shame that it hasn’t worked for you, Meowser, and like you say, even worse that there aren’t other options! But I do hope that women who haven’t tried it for their PCOS don’t get scared off without trying it, because it does work well for some of us.

  17. marcelle42 Says:

    Is THAT how metformin causes weight loss? O_o Not put off by your story, but just noticing my own lingering belief that I think I have PCOS (though I’ve been tested and found negative, I’m still unsure), and thought maybe eventually I’d end up on metformin and lose weight. Even though I’m FA, I have now just realized I was holding out that hope. Crazy brain. But that is seriously not what I had in mind when I was considering metformin-induced weight loss. And, like you, would much rather be fat than have chronic explosive diarrhea.

    Boo to your doctor for thinking that’s a tolerable way to live. I hope the alternative treatment helps you out.

    • KellyK Says:

      Marcelle42, I tested negative once too, then tested positive just recently. I think that for some people, the cysts only show up at certain points in your cycle and/or don’t show up if you’re on the pill.

      Which is not to say “run off for another highly unpleasant test, because you never know.”

  18. J Says:

    I have been prescribed 1500mg a day, but the doc is starting me out on 500 for a week. I took my second pill last night before bed, and my tummy is a little icky this morning but that may be the chinese i had last night. I hope I do ok!

  19. Maritzia Says:

    If you want to try an alternative to metformin, you can try taking inositol (an otc supplement). They found that metformin works by making the body produce more inositol, so my doctor tried treating his patients with inositol directly and had great results. You can still get the increased gut motility, but you have more control over your dose. Start with 500 mg per day and increase one a day until the shitty part starts (snerk). The good thing about this is that you can split your dose up over the day so you can take more without the side effects. I take a huge dose (we’re talking 9 grams a day…I’m way seriously hormone resistant), but my husband can only tolerate about 1500 mg, and he has to take it in 3 doses over the day. By breaking it up into 3 doses, he can get the effect of the meds without getting all poopy (snerk).

    They did warn you to be sure to use some kind of birth control on the metformin if you don’t want to get pregnant didn’t they? Lots of PCOS patients who thought they couldn’t get pregnant got a big surprise when they started metformin and they suddenly started ovulating. Same goes for using inositol for PCOS. And yes, inositol treats not just the insulin resistance, but the PCOS, too. It makes your body more sensitive to all your hormones (as does metformin). So if you’re on thyroid, you may end up having to decrease your thyroid dose.

  20. Ally Says:

    I’ve been on Met for a year for PCOS, and all it’s done is regulate my cycle. (Since my tubes ended up being blocked anyway, it didn’t help me get knocked up.) Not only does it give me the runs, I have to make sure to take my multivitamin every day or else I get anemic. I spent the first three months on Met wondering why I felt so spacey and tired. Once I ate a big ol’ steak and started taking my vits, it went away. I’ve found that I’m craving red meat a lot more now, where before I ate chicken almost exclusively. And not that it matters, but I haven’t lost pound 1 on Met – in fact, I’ve probably gained. Mileage definitely varies!

  21. Anoif Says:

    Man, that -sucks-. Please accept my deepest sympathies.

    That said, your article brightened my day. I love snark. 🙂 And the mental image of someone squatting in the produce aisle is priceless. I’m probably a sick, horrible person.

    There are diet pills that cause the same sorts of symptoms. I talked my mother out of them a couple years ago. She was like “omg this keeps you from absorbing fat” and I was like “yes, and it also causes ‘fecal urgency’ and ‘oily stools'”

    … so there’s two more of us for the “I’d rather be fat” club. 🙂

  22. buttercup Says:

    I had some issues for the first two days I was on metformin, then they resolved. I guess I’m one of the lucky ones! I am also not a fan of “take this for the side effects of the one you’re taking for the side effects of the one your taking for the side effects of the one you’re taking for your condition” thing, but fortunately, neither is my doctor. She told me straight up that if I couldn’t tolerate metformin, we’d look at alternatives.

  23. emmy Says:

    Yep. On met, I feel like I’m going to blast off of the toilet every morning (That was an overshare, I know)

    It may be hard to talk your doctors into prescribing a newer drug, but there are clinical trials going on using Byetta (a different diabetes drug) for PCOS, and they seem to be getting really good results. (My mom works with one of the doctors conducting the trial.) I haven’t been able to talk any of my doctors into the switch yet, but I’m not giving up. Byetta is an injectable, but I would so rather poke myself with a needle every day than have blender guts. I have kind of irritable bowels when I’m not on Met, so the level of pure misery I’m having on this stuff is indescribable. And my gyno seems to really want me on 2000 mg a day. I can handle about 500. One wonders if he realizes my prescriptions last 4 times as long as they should.

  24. Catherine Cantieri Says:

    Hey, meowser! Longtime reader, firsttime commenter.

    I too have the PCOS, and I too have found that metformin has those charming side-effects. What’s helped me is, ironically, taking a prenatal vitamin with my 500 mg metformin. Apparently, the iron and B vitamins in the prenatal vitamin “bind you all up” (as my grandma would have said) so there’s fewer of the colon blow incidents.

    That, and I’ve learned to stay away from salad.

    Just a thought, by no means a diagnosis or a demand. Much love for all you do.

  25. Medea Says:

    I had the same deal–PCOS, metformin, HUGE GI problems. I know you’re not looking for suggestions, but in the spirit of “if you ever have to go on it again”: I do a combination of two things that almost completely eliminated the diarrhea (still have mildly loose stool, but that’s a far cry from “OMG findabathroomNOW!”): use the extended release version and always take it with a cup or so of kefir. I use Lifeway brand kefir since that’s what my grocery store carries, but I’ve heard that other kinds work just as well. Just a thought.

    Also, it is SO nice to see that I wasn’t the only one…my doc kind of gave me the impression that I was the only person in the universe with that side effect…

  26. lynnie Says:

    I was able to tolerate by cutting to only a half dose before the birth of my daughter, and I credit metformin for helping me get pregnant. After seven years of infertility, six months on metformin and I got regular periods and also pregnant! So I don’t hate the stuff, but I can’t take it anymore. Something happened to my body either because of aging or having the baby or both- but whatever it is, I can’t tolerate metformin at all now. I can only take it if I never plan to leave my house again. I’m with you – I’d rather be fat than crap my pants.

  27. brilliantmindbrokenbody Says:

    My mother had trouble with met, too – partly the GI stuff, but also oversensitization. She had to cut her dose in half, and then into quarters, to get both under control. I can’t remember how much she ended up on, but it was a lot less than they started her with.

    Since I became obviously ill (August ’07), I’ve been tested for diabetes sooo many times – it felt like for a while, every time they sent me in for bloodwork (which was often), they tacked on a blood sugar test ‘just in case’, because I have a family history of diabetes…nevermind that no one has been hit before their mid-40s and I’m all of 25.


  28. welshwmn3 Says:

    Metformin and I have a love/hate relationship. Some of my migraines are triggered by too much carbs (and by too much, I mean well below the RDA — I eat 100 grams of carbs not on metformin and I get a migraine the next day). On metformin, while I still have to be careful of my carbs (I can eat 150-200 depending on the day), I can eat more carbs without risking a migraine.

    But yeah, I have a daily date with my bathroom. I keep a LOT of reading material in the bathroom so I won’t be bored.

    The good thing about my reaction, is I know about when it’s going to be every day, so once it’s done, I’m usually good for the rest of the day. *Usually* being the operative word here.

  29. Ashley Says:

    Metformin also doesn’t always cause weight loss. I didn’t lose a pound on it until I got pregnant (3 months into being on Met and Met only) and only lost weight because I had hyperemesis. It did make me feel better though.

  30. Brigid Says:

    Oh man, I’m so sorry it makes you sick. I take it for PCOS and got really sick about halfway through the first week, but it mostly cleared up. My lactose intolerance seems to be worse than it ever was before, however.

    Thanks for explaining the PCOS/blood sugar/insulin thing. I appreciate how you phrased it.

  31. Meowser Says:

    Oh yeah, I’m on Mircette (well, generic Mircette) too. Couldn’t live without it, it controls the menstrual torment I get (five-alarm cramps not relievable by any amount of ibuprofen, migraines, mood swings, acne) like a dream.

    Maritzia, thanks for the information about the inositol, I will definitely look into that.

    I don’t necessarily think one need refuse this drug if offered her for the first time, because everyone’s body is different. But I do believe that if the patient is complaining about severe side effects the complaints should be taken seriously.

  32. Michelle Says:

    I too have PCOS and have been treating it relatively successfully with the guidance of a naturopath. Cinnamon, EFA blends and a healthy low carbohydrate diet have kept my fasting glucose at a still elevated but normal level and i’m able to have about 8 periods a year without being on hormonal birth control. I would encourage you to seek out a discussion with a naturopath if you can, especially if the conventional treatment hasn’t been working well for you. Good luck!

  33. Fellmama Says:

    I fall somewhere in the middle on the metformin spectrum–it certainly causes me to have, erm, squishier trips to the bathroom, but it isn’t anything like you describe. Most of the time, that is; if I don’t eat enough fiber Bad Things Happen

    Since I’ve been taking it–about a year and a half–I’ve lost ~12 pounds, but on my frame that’s nothing. My doctors would love to credit the metformin, but I honestly don’t think it’s had much of an effect. I think healthier eating and falling in love during that time were the primary causes. (Of course, now that I’ve had my heart broken we’ll see if I keep losing weight, eh?)

  34. A nonny mouse Says:

    Taking R-lipoic acid, not alpha, really really helped my insulin and BG levels stabilize. They’re normal now. I take 600mg a day spaced out at 200mg a pop. Cinnamon and chromium didn’t do anything for me, but magnesium does. I take 6000mg a day also spaced out for 3 x 2000mg doses. I use magnesium malate as it has proven to be the most gentle on my digestive system. It is apparently good for muscle pain and relaxation too, but I don’t really have that so I’m just going by what friends have said.

    It took a little while to get the right combination going for me, but r-lipoic and magnesium was the winner.

  35. Mim Says:

    I’m on met ER because I also had diarrhea on regular. Not just inconvenient but *painful* with cramps n stuff. The extended release is an orangy pill–huuuge, smells weird, but definitely a big improvement. also am on a smallish dose.
    Met made a big difference for me in terms of energy, especially mental energy. I feel less foggy on it.

    I have no idea if it’s effective in preventing type 2 diabetes or whether inositol (am gonna look into that, thanks above) or other natura lsubstances treatments are easier/better. But ER makes a big difference for many people who do not want to run to the bathroom all day, every day. Even if you never go back on, and/or have good results self-treating (which would be awesome), your doctor should know that!!!! I don’t want to type in all caps, but it frustrates the hell outta me when prescribing doctors are too lazy to check whether other dosages/formulations have a lower incidence of the side effects that their patients are saying *happen* and *are bad enough to make them discontinue*!!!!!!! that should have been the first suggestion, not regular with the runs, or nothing! yyyaaaaaargh!

  36. observer Says:

    Metformin…I know. 😦 I USED to be on the stuff for type 2 diabetes, with the same results, for about a year before I got off the stuff and had the doctor prescribe a sulfonylurea instead.

    You are spending your life in the “john” every time you are on met? Not surprised: Digestive/intestinal distress (to put it politely) is common, and is likely the main reason anyone loses weight on the stuff since food does not stick around long enough to be digested properly/absorbed.

    Have you had your B12 levels checked? I also ended up with a B12 deficiency for which I am still taking supplements. This is because “met” also does wonders for B12 absorption…in the wrong direction. In plain English, B12 deficiencies are common.

    I also question the reasons given by the doctors as to why metformin works: “Insulin resistance” may well not exist at all and the reason it works is the same reason a met user needs their own porta-potty. If one does not absorb nutrients such as vitamin B12, what makes the doctors think that glucose would be absorbed any better? Or, come to think of it, “cholesterol”; recent research indicates that metformin also lowers cholesterol levels…and guess why? Oh, the doctors and researchers, if asked, would likely state it’s likely due to the liver having its ability to produce glucose and blood lipids suppressed, but that’s not the only reason, I betcha’. After all, if one poops out glucose (and lipids), guess what happens to the levels in the blood, especially if the liver is, in effect, poisoned to keep it from doing the job it would normally do. “Poisoned” is really not too strong a word: Liver damage happens a lot in long-term met users, and is contraindicated for use in the elderly (especially over 80 years old) for that reason. It’s also the reason that liver function tests are called for on a regular basis for met users.

    P.S.: Why do they think that metformin is any safer, really, than the predecessor biguinides that were removed from the market for dangerous–and sometimes fatal–side effects? “Safe” is relative;long-term starvation by met-induced diarrhea cannot be good for anyone.

    P.S.S.: Is it the met that results in weight loss? Or is it the ridiculously hypocaloric diets prescribed along with the stuff to force weight loss along with the glucose lowering and whatever else comes for the ride?

    I say this is a diet pill in disguise and any “benefits” are indistinguishable from the results of starvation. Even in the case of PCOS. Think about it: How many starving women get pregnant? What else do women on met for PCOS do to try to become fertile? Could those treatments be the real reason they get preggie and the met has nothing to do with…excuse me…s*it…

    IMHO, if your doctor tries to foist this poor excuse for medical treatment on you again, tell him (or her)–politely, of course–to take a long walk off a short pier.

  37. observer Says:

    Wellroundedtype2? Your “beautiful A1c” would be achievable with insulin alone. There is really no need for any pills once a diabetic is on insulin, IMHO. After all, it’s too little insulin that’s the problem in diabetics, and once the pancreas can’t produce the amount THAT PERSON needs, only hormone replacement therapy (insulin injections) will “do”.

    All the “met” is for is to try to keep us fatties from gaining weight while adding to the “bottom line” at the drug companies. Nothing more.

    Also, the extended release version is NOT less likely to create the “trots”: I was on extended release met. Got the “trots” anyway.

  38. peggynature Says:

    Man, for all the medical charts I’ve seen where people were on Metformin, I had no idea about this side effect.

    What a (literal) pain in the ass. No way I’d put up with that (literal) shit.

  39. Sara A. Says:

    Thank you so much for this post!

    I have PCOS and one of the many reasons I left my last endocrinologist is the crap she gave me for going off my metformin. At the time I was working retail and she put me on this drug. For the first week I was supposed to take one 1000 mg pill with dinner. I was fine that week even though I am mildly lactose intolerant and that increased a little. If I could tolerate it I was supposed to start taking one in the morning and one at night the next week. So I started taking the higher dose and I literally could not work three days that week from the stomach cramps and diarrhea. I called my mother, since I was in a different timezone from the doctor at the time, and spoke to her about it. She said to stop the metformin or go back to the lower dose. I went back to the lower dose and spent my weekend in bed. So I went off of it completely but my body wouldn’t tolerate any fatty food or lactose for the rest of the summer.

    When I got back to DC and to my doctor I spoke to her about this and she started to lecture me about how with my PCOS and my mother’s type 2 diabetes and my family history I HAVE to be on metformin. I would rather get actual diabetes than shit my pants. Call me shortsighted, but I still have issues with lactose.

  40. Kat Says:

    I was on Metformin for a short time. It also gave me diarrhea, but more frightening was that it made me get VERY cold…like freezing, cover up with a blanket cold…and I’m very hot natured. Getting very cold on Metformin could be a sign of lactic acidosis…which can be fatal.

    My doc is a great guy about my weight and everything else, but he thought I was being a hypochondriac about metformin making me cold. I can’t fake cold…sorry doc. I refused to take it anymore.

    I’m on Byetta…which I love. It alone brought my blood sugar levels down dramatically. I’m also taking Amaryl. Go back this month to see how my A1C is doing. Crossing my fingers.

    Hang in there Meowser.

    • mark Says:

      I thought I was the only one to feel this. I started on only 500 mg a day, and I was freezing cold at times. It also made me feel very nervous and inner jitters. Almost like my blood sugar was too low, which of course it was over 100, so it was not too low. My doc said the cold feeling had nothing to do with the metformin. When I stopped taking it, the chills and other symptoms went away. A month later I tried it again, and the chills came back. hmmmm. I had to turn the heat up to 75 and wear a sweater! Sometimes I took a hot bath.

      • mark Says:

        This all started only after 3 days of being on it. Then the stomach cramping and diarhea started. I cannot tolerate this stuff. It sounds too good to be true, but I cannot take it. I have not been diagnosed with diabetes. I am insulin resistant. I get very bad shakes around 4 or 5 if I dont eat. It kind of makes it nearly impossible to lose weight. I saw a family dr and endocrinologist. I am currently going the excercise route. Still go thrrough the day feeling mostly great in the morning, sometime intense fog in the morning. I get these mini episodes of feeling slightly woozy-hard to describe-a little lightheaded and anxious. Lasts for a few seconds or so. Doc says it is anxiety, I say bull!

  41. observer Says:

    Lactic acidosis was a major problem with other biguinides, and is why they were removed from the market (or rarely used today). Metformin can create the same problem.

    And why use it, even to treat diabetes? Metformin, as anti-hyperglycemics go, is a rather weak one:

    As an anecdote, when I was on met, my highest dose was 700 mg a day (extended release). On glymepiride (brand name “Amaryl”)–a sulfonylurea–the dose I am currently on is ONE mg a day. On top of that, I get better control with the sulfonylurea. Without the nasty side effects; the occasional “low” I can treat by eating something; a med can also be adjusted if it comes to that.

    Of course, there is a much higher chance of hypoglycemia (too low blood sugar) when taking most diabetic meds, including sulfonylureas. That’s another reason met is a “first-line” medication: Metformin rarely causes this issue, which also demonstrates how weak it is for the original use of the medication: Diabetic blood sugar control. More effective treatments have hypoglycemia as an almost unavoidable periodic side effect since they all–including insulin–are no substitute for a properly functioning pancreas and metabolism. No artificially-induced treatment is.

    And if it’s so weak for diabetic treatment, what makes doctors think it’s of much use for anything else? At least, of enough use that the nasty side effects are outweighed in the long run?

  42. Dnelle Says:

    I had HORRIBLE side effects to the metformin in the form of exactly what you describe – i felt like butt and my butt felt like… well… like you described.

    I am taking Fortamet now, a different (and, yes, lucky me for being on insurance that’ll cover it), more expensive form of metformin, and it doesn’t bother my digestion at all.

    of course, i can’t really tell that it makes my body feel any better or worse in terms of blood sugar, but at least i can STAND to take what my doctor says i should take.

    if you can give it a go, and you really do want to get your body the metformin (i sometimes question this, but for now i’m complacent and letting my doctor tell me what’s best), try Fortamet.

    GOOD LUCK!!!!!

  43. DaisyDeadhead Says:

    Diarrhea has its own side effects, low potassium, lack of electrolytes (does the name KAREN CARPENTER mean anything to you?) and it messes up the bowel flora, as antibiotics do too. (I usually compare it to the effects of a flood on a suburban lawn–turns to muddy mush.) Don’t forget to take some probiotics, NATREN is probably the best one and is also dairy-free.

    It sounds like total poison to me. You did right.

    Cinnamon and Glucomannan will also improve fasting blood sugar, taken in supplement (high-dose) form. ALA is wonderful and I take it every day, but hey, even supplements have side effects. ALA reduces Biotin in the body, so go get some. Hair loss and split fingernails are no fun either (from lack of Biotin), but a piece of cake compared to the trots (as my family called it!)…

  44. DaisyDeadhead Says:

    Speaking in industry shorthand and I apologize for that!

    ALA= Alpha Lipoic Acid

  45. Hazel Says:

    Once you get through the initial yuck stage, Met can really change your life with PCO. I don’t get hungry all the time, faint, get the low-blood-sugar fades, and actually be hungry for a little while w/o passing out, (ie wait for meal when I am hungry. I found drinking a ton of water in the honeymoon stage and when I get an upset stomach really does the trick. I also chomped sugar ginger to help too.

    I don’t know if you all know this but any food with just carbs or a high amount of sugar triggers GI dumping with Metformin.

    Pretty much if you want it to work (w/o too much upsets) you have to try something like the Glycemic diet like diabetics use. It tells you what foods “gush” carbs and sugars and what foods “trickle” carbs and sugars.

    IF I stay on it, I do pretty well. But when I screw up, I get the GI upset. I still can eat fries, I just need a hamburger with them. Same with soda; just need a power meal of protien to counterattack it.

  46. Changes in the way diabetes is diagnosed – Part 2 « Angry Gray Rainbows Says:

    […] Provider: I’m not sure. Not before three months have past. Are you sure you don’t want any of this delicious metformin**? […]

  47. Dana Says:

    Are you sure you mean fasting insulin and not fasting glucose? I have yet to run across a testing device for insulin to use at home. Believe me, I’ve looked.

    Anyway–there are two ways to deal with prediabetes or type 2 diabetes. One way’s from the insulin side of the equation, the other’s from the glucose side. With insulin you can increase sensitivity with metformin or (maybe) exercise, or you can increase insulin levels. I don’t recommend the latter unless your pancreas has quit. In most cases a type 2’s pancreas works even after official diagnosis. Diabetes is diagnosed as abnormally high fasting or postprandial glucose paired with spillover of sugar into the urine. (The latter is how they diagnosed it in the ancient world, in fact. Don’t ask. Yucky.) The insulin level is almost irrelevant at that point because while insulin does an incredible amount of damage if constantly elevated, sometimes even causing cancer (it is a growth hormone, after all), glucose is even worse at high levels. That’s where you lose eyesight and kidneys and feet.

    So that’s the other approach to diabetes: cutting back glucose sources in the diet. You can make glucose from protein through gluconeogenesis, and as a bonus it doesn’t drive your insulin up, and while there are no essential carbs in existence, there are essential amino acids. You also need fats in your diet, and they’re a poor source of glucose. This is why low-carb eating has become popular among certain segments of the diabetic population. Aside from the fact you’re allowed to eat real food, it can be cheaper than a metformin prescription and having to buy more laundry detergent than usual.

    It’s also damn hard to do, and recommending it to anyone comes off as “lose weight, you fatty!” Believe me, I understand. But it *is* an option–if nothing else, you could experiment with cutting sugary and starchy crap out of your diet temporarily to see if your fasting blood sugar normalizes on its own. Bonus: No crapping your pants. It may help to point out that before insulin shots were invented, low-carbing was the ONLY way a diabetic could stay alive longer than a few years after diagnosis. If it ain’t broke… well… you know.

    Frankly I get sick and tired of both the usual responses to fatness: either “it’s your fault and you are a moral failure” or “there is nothing wrong with you and you are fine the way you are.” Although the latter sounds better, what they’re really doing is diagnosing you on no evidence whatsoever, in either case. It’s like watching someone cough up blood and either complaining about the noise or giving them a cough drop, rather than insisting they get a TB tine or a chest X-ray.

    I also hate the way fatness is framed as the cause of chronic disease. THAT is like saying a runny nose causes the flu. Equally unproductive.

    Interesting reading if you want to learn more about the “science” of obesity and why so much of it seems to be B.S.–because it is–check out Gary Taubes’s Good Calories, Bad Calories. Seriously, do. Check it out of the library, at least. I was startled to learn that 1400 calories a day was once considered semi-starvation when now it’s perfectly acceptable as a weight-loss plan. Sheesh.

    (And… Hi from a former medical records clerk. Fascinating, isn’t it?)

  48. Loz Says:

    Interesting discussion.

    I had moderate stomach problems on the regular metformin, though nothing like what’s been suggested here. As a result, my endocrinologist switched me to the extended release. (This was in Australia.) Much, much, much better, although lots of vegetables and I still don’t get on too well. One salad – usually ok. Multiple salads over a few days – unpleasant. (I don’t like salad that much, so I’m not too upset about this!)

    How much of this is connected to the metformin is hard to tell, as I’ve always had a pretty sensitive stomach. Anyway, since my only real side effect is an inability to eat like Popeye, it’s worth it – for me. I had bad insulin resistance and had puffed up like a balloon, plus wretched family history, so I’m willing to take medication. With fewer warning signs or a worse response, I might make a different choice.

    Oh, regarding treatment/food/diet etc, probably worth adding that one of my problems with the regular Metformin was that the things that were “good” for controlling symptoms – low GI, slow release etc – were horrible for my stomach, while potatoes and toast were always good friends. So you really can’t win sometimes!

    And incidentally, once I’d “de-puffed” (the only way to describe it – we’re not talking normal weight gain), my weight’s been pretty stable for half a decade, at a bit over what’s advised for my very short height. Without me paying much attention to it, either way.

  49. myra91078 Says:

    Hello, I am actually in the (right now. I freaking hate metformin. I also take it on and off cause of the runs. I can only handle it so much! – tell ya I should own stock in immodium! I’m so sick of taking it though! I just started my metformin back up tonight and within 2 hours it put me in the bathroom and of course its always when its time for bed! I asked the doc about it because I’m sick of running to the bathroom and she says well that’s kind of it job! Well who the heck wants to take something that’s going to make their butt a permenant fixture in the bathroom. I think I may try what your doing. Could you email me specifics on how to do it and how much?? Myra91078@yahoo.com

  50. Debbie Collins Says:

    Metformin is making my hair fall out and as far as I know I dont have PCOS-its garbage.
    I am a nurse and I have given all this poison
    I am so sorry I ever went into medicine

  51. Jamie Says:

    well hello there ladies! I’ve had the SAME problems with Metformin as most. On and off it but I can’t last more then a week or week an a half on it before I’m so sick I can’t get out of bed. I feel so sorry for my hubby, I am a horrible person to be around when I’m sick and Metformin brought out the worse in me! I keep going back to my DR and she keeps saying “well you should be taking it just cut the pills in half and work your way up” and each time I tell her “I’ve tried and I just CANT stand it” and she comes back with “well you need to get the weight off or you’re hurting your body for when you get older” and so the cycle of DR visits starts all over again. I’ve been really good with what I eat and everything and normally if I took Adipex (weight loss drug) and tried really really hard I could take off alittle weight but the problems still end up coming back because of the PCOS and Insulin issues. I’m finally ready to approach this from a different angle but I’m lost and don’t know where to start. I’ve tried the weight loss to control everything and I’ve Metformin but I fail with the weight loss attemps and can’t stand Metfomin. Where can I start!?!?!? I’m trying to wrap my head around all of this but my DR isn’t being to helpful. I’m just glad I know that I’m not the only “whimppy” one as my DR has said when I say I just can’t STAND metformin.

  52. Danila Says:

    I can’t tolerate Metformin either. I felt like I was dying. My parents take it for diabetes and had no issue with it. But for me it was a constant cycle of cramping, throwing up, and diarrhea (and yes, once all unexpectedly at the same time, a true low point).

    For my PCOS my doctor switched to Januvia. I have absolutely no issues with it at all and it helped with the insulin resistance within days.

  53. ainitfunny Says:

    Ohmygosh! I was put on metformin six weeks ago and have been dealing with sudden utterly uncontrollable explosive diarrhea but was blaming it on the change to a “healthy, low calorie, low carb diet” (I rarely ate salad or raw veggies before). I NEVER suspected the glucophage could be causing it. I HAVE lost almost 30 pounds trying to faithfully keep blood sugar and calories down by strict dieting, but just a middle of the night cough in bed can bring on a sudden need for a shower, fresh clothes and bedding. Usually 30 min to an hour after taking the metformin and eating a meal, the uncontrollable explosive diarrhea hits with a subsequent second and third wave hitting 30-45 minutes apart afterwards. IMMODIUM doesn’t stop diarrhea, it only POSTPONES IT.

    Wow, THANKS for the heads up! I thought I must be unable to digest salads, raw veggies, and all “sugar free” sweetner substitutes except saccharine(sweet & low), but I found I was getting the squirts even without eating anything raw, salads or artificially sweetened.

    Hmm, I will have to let my doctor know I am REALLY having INCAPACITATING side effects from metformin. Maybe just strict dieting and weight loss will save me without having to take the metformin. I am too young for diapers. I still have a hundred pounds to lose before I get back to a size 12 and hopefully lose the type 2 diabetes.

  54. Rhonda Says:

    I just started taking met 500 mg a day last week. No potty issues but I am literally freezing to death. I havent been cold since hysterectomy 7 years ago. Anyone else just freezing cold w/met?

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