As your body adjusts to metformin, intestinal side effects like nausea and diarrhea should decrease over time. If they persist, speak to your healthcare provider about lowering the dose or switching medications altogether.
Insider spoke with many patients who experienced embarrassing episodes of watery, floodgate-style diarrhea that subsided once they stopped taking medication. Such symptoms can cause discomfort, anxiety and require drastic lifestyle adjustments like forgoing restaurants altogether.
Foods That Cause Diarrhea With Metformin
1. Sugar
Metformin’s primary function is to manage glucose metabolism, so it’s vital that you avoid sugary foods and beverages that will harm insulin resistance, promote weight gain, and lead to diarrhea with Metformin use.
Avoid soda, fruit juice, candy, chocolates, rich desserts and simple or refined carbohydrates in favor of whole grains, lean proteins, healthy fats and vegetables for your daily nutritional needs.
Consuming a high-fiber diet may reduce strain on your digestive system and ease diarrhea symptoms. Try the BRAT diet (bananas, rice, apples, toast), along with plenty of water consumption.
Diabetic neuropathy, a common complication of diabetes, can alter the frequency and consistency of bowel movements resulting in diarrhea. Diabetic neuropathy may also lead to gastroparesis – the slow moving food and fluid through your digestive tract – slowing it down even further.
2. Fatty Foods
Foods high in fat such as nuts, fatty meats, oily fish, avocados and butter may prevent metformin from being properly absorbed by your digestive tract, leading to diarrhea. Fatty foods may also stimulate gut contractions that lead to discomfort for some individuals taking metformin.
Caffeine can also contribute to diarrhea caused by metformin; its stimulant properties cause stomach cramping and speed up muscle contractions in your digestive tract that lead to diarrhea.
Foods containing added sugar alcohols such as xylitol and sorbitol may lead to diarrhea as they are poorly absorbed by the digestive tract. Such products often include low-carb/sugar-free foods, baked goods and sauces that contain these sugar alcohols.
Diarrhea caused by metformin can often be alleviated with lifestyle modifications, like drinking plenty of fluids and eating fiber-rich foods. If symptoms persist, speaking to your physician about decreasing the dosage could also help. This is especially important if it includes abdominal pain, bloody or tarry stools, fever or numbness in feet or hands.
3. Alcohol
Alcohol is a chemical substance derived from the fermentation of sugars and yeast, found in various drinks like beer, wine and liquor. Consuming excessive quantities can cause serious health concerns; specifically it increases risk for various forms of cancer such as mouth, throat, esophagus liver and breast cancer as well as decrease vitamin B-12 absorption leading to anemia.
Alcohol while taking metformin can increase your risk of hypoglycemia (low blood sugar levels). Furthermore, alcohol may exacerbate side effects like stomach pain, dizziness or fatigue associated with taking this medication.
Metformin can reduce your blood sugar by blocking your liver from producing glucose. As a byproduct, however, your body produces lactic acid, which may become toxic over time and increase your risk of lactic acidosis – potentially life-threatening condition that increases when mixed with alcohol.
Therefore it’s wise to refrain from drinking while taking metformin, unless otherwise directed by your healthcare provider.
4. Grapefruit
Grapefruit, a large citrus fruit bred from crossing pomelo with sweet orange, offers many health advantages.
Rich in vitamin C and rich in dietary fiber and other vital nutrients, grapefruit also contains flavonoid naringenin which has been shown to improve insulin resistance and slow diabetes progression – the NHS suggests eating up to 133 g of fresh grapefruit or 200 ml of juice daily for maximum benefit.
But if you are taking metformin, drinking grapefruit could cause its absorption to be compromised. Furanocoumarin, an ingredient present in grapefruit that blocks CYP3A4, an enzyme responsible for breaking down and metabolizing medications including metformin.
As a result, too much metformin may remain in your system longer, increasing to potentially toxic levels over time.
If you are experiencing diarrhea while taking metformin, speak to your physician immediately. He or she may switch you over to different diabetic medication, such as sodium-glucose cotransporter 2 inhibitors such as canagliflozin (Invokana) and dapagliflozin (Farxiga), which eliminate glucose from your body via kidneys and urine rather than via the intestines.
Managing Diarrhea Caused by Metformin: Tips and Strategies
Metformin, a commonly prescribed medication for type 2 diabetes, can lead to diarrhea as a side effect. To effectively manage diarrhea caused by metformin, consider the following strategies:
Take Metformin with a Meal
Taking metformin with food can help alleviate gastrointestinal side effects, including diarrhea. By combining the medication with a meal, you can reduce the likelihood of experiencing this particular side effect.
Switch to an Extended-Release Formulation
Consulting your healthcare provider about the possibility of switching to an extended-release (ER) formulation of metformin is worth considering. ER formulations often result in fewer gastrointestinal side effects, including diarrhea.
Gradually Adjust Your Dose
Working closely with your healthcare provider, gradually adjusting your metformin dose may help minimize diarrhea. This approach allows your body to acclimate to the medication more effectively.
Monitor Your Diet
Certain foods can exacerbate diarrhea while taking metformin. Foods like raw vegetables, onion, garlic, dairy products, gas-producing foods, and oily or junk foods can worsen symptoms. It is advisable to avoid high-fat, sugary, and fried foods, as they may trigger or intensify gastrointestinal discomfort.
Eat Smaller Meals and Eat Slowly
Opting for smaller, more frequent meals and eating at a slower pace can assist in mitigating diarrhea symptoms. This approach helps to alleviate the strain on your digestive system.
Stay Hydrated
Maintaining adequate hydration is crucial when managing diarrhea. Opt for ice-cold or clear drinks such as unsweetened tea or water to help manage the condition effectively.
Consider Over-the-Counter Anti-Diarrheal Medication
In certain instances, your healthcare provider may recommend over-the-counter anti-diarrheal medication to help manage diarrhea caused by metformin. This can provide temporary relief while you work on adjusting your treatment plan.
Consult Your Healthcare Provider
If diarrhea persists or worsens, it is essential to consult your healthcare provider. They can assess the situation and consider adjusting your metformin dosage or exploring alternative treatments for your diabetes management.
Understanding the Duration of Diarrhea Caused by Metformin
Diarrhea caused by metformin is a common side effect associated with this medication used for type 2 diabetes. The duration of diarrhea varies from person to person. In most cases, it is a short-term side effect that typically resolves within a few days or weeks as the body adjusts to the medication.
However, there are instances where individuals may experience diarrhea for an extended period.
A study published in the American College of Clinical Pharmacy identified that metformin can cause chronic diarrhea, characterized by loose stools lasting at least four weeks, with three to four loose stools per day. Another study reported cases of late-onset chronic diarrhea in patients who had previously tolerated metformin well. In both studies, discontinuing metformin resolved the diarrhea.
If you are experiencing diarrhea caused by metformin, it is crucial to discuss it with your healthcare provider. They can determine if metformin is the cause and offer appropriate guidance.
Switching to an extended-release formulation or reducing carbohydrate intake may help alleviate gastrointestinal side effects. Collaborating with your healthcare provider will ensure the best approach to managing your symptoms while effectively treating your diabetes.
