Metformin is an increasingly popular diabetes medication. It works by decreasing both how much glucose your liver makes and absorbs from food sources, leading to weight loss while potentially causing gut-related side effects like diarrhea that can be frustrating and embarrassing.
Irma, who is 84-years old, told Insider that severe, floodgate-style diarrhea became part of her daily life when she started taking the drug. Over-the-counter stomach remedies provided no relief.
The Link Between Metformin and Diarrhea:
What is Metformin?
Metformin is an oral antidiabetic medication that works by decreasing both how much sugar your liver produces and absorbs from the digestive tract, as well as slowing how quickly fat breaks down in your body.
As such, Metformin may help with weight loss while also being prescribed in combination with other treatments to manage diabetes or prediabetes; some women also find pregnancy related glucose levels decreased through taking Metformin during gestation.
As with most medicines, Metformin may cause side effects; these tend to be mild and will fade as your body adjusts to it. Nausea, gas, stomach pain and bloating are often experienced when first beginning metformin; reducing this discomfort by starting at a low dose and gradually increasing it may also help.
For optimal results it should be taken at your largest meal of the day for maximum effectiveness and should never be combined with alcohol as this could increase your risk of lactoacidosis; you should inform your physician of all prescription and over-the-counter medicines used as well as any vitamins or herbal supplements consumed while taking metformin.
How Does Metformin Work?
Researchers have recently determined that metformin can reduce blood sugar levels by blocking an enzyme known as AMP-activated protein kinase, which regulates production of new glucose by the liver while simultaneously slowing digestion in the gut.
Due to these adverse side effects, people taking immediate-release metformin formulations (IR) may experience stomach upset and diarrhea more frequently than those who take extended-release formulations (ER). Therefore, it’s essential that you discuss your body’s reaction with your healthcare provider so they can assist with managing symptoms accordingly.
Metformin-induced diarrhea usually subsides after several weeks as your body adjusts to taking the drug, but if your diarrhea becomes severe or debilitating or interferes with quality-of-life issues, reach out to your healthcare provider as they may suggest adjusting dose or switching to extended release formula or switching out diabetes medications altogether.
Why Is Metformin Associated With Diarrhea?
Metformin is frequently prescribed as the first diabetes medication for those diagnosed with type 2 diabetes, due to its many advantages. Unfortunately, however, some individuals can experience side effects like diarrhea that can negatively impact their quality of life.
Diarrhea from metformin is more prevalent during its first weeks of use, but most people find that this gastrointestinal side effect subsides over time. Adjusting dose or changing to an extended-release tablet that slowly releases medication may help manage metformin side effects like diarrhea.
Simple lifestyle modifications can also help relieve gastrointestinal discomfort, such as increasing fluid consumption and eating foods high in fiber.
Diabetics who experience severe diarrhea that dehydrates them should consult their doctor about changing or switching medication; there are various FDA-approved SGLT2 inhibitors like canagliflozin [Invokana] and dapagliflozin [Farxiga], which help eliminate glucose via kidneys rather than gut, available that could serve as replacements for metformin.
What Can I Do About Diarrhea From Metformin?
If you’re taking metformin and experiencing chronic diarrhea, speak to your physician about adjusting the medication dosage accordingly. In some instances, diarrhea may cease by itself after a short recalibration period has ended.
Your doctor may suggest eating fiber-rich foods to ease digestive strain. Examples include bananas, rice, toast and tea.
Diets rich in fiber may help improve overall gut health and help decrease metformin-related diarrhea. Your physician may suggest either decreasing the dosage of metformin or switching to another diabetes treatment medication altogether.
As with most adverse reactions of metformin medication, diarrhea usually only lasts briefly; if it becomes persistent and hinders your quality of life, consult your physician about reducing or discontinuing use. They’ll help find an alternative therapy suitable to you.
How Common Is Diarrhea as a Side Effect of Metformin?
Diarrhea is a common side effect experienced by many individuals who take metformin, occurring in up to 75% of users. A systematic review, meta-analysis, and meta-regression of randomized controlled trials have indicated that diarrhea, nausea, and vomiting are frequent adverse events associated with metformin treatment, affecting approximately 20% of patients.
It’s worth noting that these side effects can sometimes impact medication adherence. Although most gastrointestinal issues related to metformin tend to subside within the initial weeks of treatment, some people may still experience persistent chronic diarrhea even after long-term use.
In one particular case study, a patient reported symptoms such as nausea, abdominal cramping, and explosive watery diarrhea leading to occasional incontinence following several years on the medication. The precise mechanism behind metformin-induced diarrhea remains uncertain; however, researchers have proposed various explanations for this occurrence.
To potentially prevent or manage this side effect effectively, healthcare providers recommend taking metformin alongside meals or considering an extended-release formulation while gradually adjusting the dosage under professional guidance.
