Diabetes Self-Management Blog

Editor’s Note: This is the second post in our miniseries about diabetes drugs. Tune in on August 21 for the next installment.

metforminMetformin (brand names Glucophage, Glucophage XR, Riomet, Fortamet, Glumetza) is a member of a class of medicines known as biguanides. This type of medicine was first introduced into clinical practice in the 1950’s with a drug called phenformin. Unfortunately, phenformin was found to be associated with lactic acidosis, a serious and often fatal condition, and was removed from the U.S. market in 1977.

This situation most likely slowed the approval of metformin, which was not used in the U.S. until 1995. (By comparison, metformin has been used in Europe since the 1960’s.) The U.S. Food and Drug Administration (FDA) required large safety studies of metformin, the results of which demonstrated that the development of lactic acidosis as a result of metformin therapy is very rare. (A finding that has been confirmed in many other clinical trials to date.) Of note, the FDA officer involved in removing phenformin from the market recently wrote an article highlighting the safety of metformin.

Metformin works primarily by decreasing the amount of glucose made by the liver. It does this by activating a protein known as AMP-activated protein kinase, or AMPK. This protein acts much like an “energy sensor,” setting off cellular activities that result in glucose storage, enhanced entry of glucose into cells, and decreased creation of fatty acids and cholesterol.

A secondary effect of the enhanced entry of glucose into cells is improved glucose uptake and increased storage of glycogen (a form of glucose) by the muscles. Additionally, the decrease in fatty acid levels brought about by metformin may indirectly improve insulin resistance and beta cell function. As a result, both glucose and insulin levels in people with Type 2 diabetes decrease with metformin therapy.

The joint guidelines issued by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) for the treatment of people with Type 2 diabetes call for metformin to be used as the first-line drug therapy along with lifestyle interventions (a healthful diet and exercise). Large reviews of multiple studies have shown decreases in HbA1c (an indication of blood glucose control over the previous 2–3 months) from 1% to 2% in people using metformin. In the large United Kingdom Prospective Diabetes Study (UKPDS), metformin was associated with better health outcomes than various other therapies, including chlorpropamide (brand name Diabinese), glibenclamide, also known as glyburide, (DiaBeta and others), or insulin, and was additionally associated with less weight gain and fewer episodes of hypoglycemia (low blood glucose). In fact, the UKPDS is one of the major studies that lead the ADA and EASD to place metformin as the first-line therapy.

Metformin is available as a stand-alone pill and is also available in combination pills with several other types of oral medicines. Various studies have evaluated metformin in combination with glyburide, nateglinide (Starlix), pioglitazone (Actos), insulin, and acarbose (Precose). In all of these studies, there were better health outcomes associated with the combined therapies compared to each of the therapies used alone. Notably, the combination of metformin and insulin not only demonstrated a reduction in HbA1c in studies, but also a reduction in the insulin dose.

Moreover, in various trials using metformin, triglyceride (a type of blood fat) levels have been reduced by approximately 10% to 20%, with an additional reduction in LDL (“bad”) cholesterol.

Metformin has also been used for the treatment of polycystic ovary syndrome (PCOS), although this is not an FDA-approved use.

Metformin is eliminated from the body by the kidneys and has a half-life of 6 hours, meaning that roughly 94% of the drug is removed from the body in 24 hours. It is prescribed in doses from 500 milligrams to 2,000 milligrams and is given 1–3 times daily. It is usually started at a dose of 500 milligrams and slowly raised every one to two weeks to the maximum dose that can be tolerated without side effects. (Doses above 2,000 milligrams have not been shown to be any more effective than a 2,000-milligram dose.)

The major side effects of metformin are gastrointestinal and include an increase in the frequency of bowel movements, diarrhea, nausea, and abdominal pain. These effects may be reduced by taking metformin with meals, as well as by starting off at a low dose that is slowly increased. Some evidence suggests that using an extended-release form of metformin may also decrease gastrointestinal side effects.

Minor side effects of this medicine include a metallic taste and decreased absorption of vitamin B12. As mentioned above, the development of lactic acidosis with this medicine is rare and has been estimated at roughly 4–9 cases per 100,000 people. To prevent the occurrence of lactic acidosis, the use of metformin is not recommended for those older than 80 years old, and for people who have mild kidney dysfunction, congestive heart failure, or a previous history of acidosis, among several other conditions.

Click here for other installments of “Diabetes Drugs.”

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Comments
  1. Excellent article. I am a metformin user and found that a good nutrition and exercise program in combination with the drug is the answer for me. Metformin alone and a sedentary lifestyle just did not work for me. Lots of great information concisely presented! Thanks!

    Posted by Bob |
  2. If you take Metformin with any type of stomach disorder, i.e. anyone who takes Nexium, Prilosec and the like have a very high probability of having real trouble with the drug. It caused severe stomach pain, nausea to the point of vomiting, and then hard heavy bowel pain as it went on through the body. People need to be told about these possible side effects.

    Posted by Mary Strayer |
  3. After taking 500mg of Metformin for a few months, my doctor doubled my daily dose. Within 3-4 days of this change, I began to have significant pains in my lower back and in all limbs, to the point that I was unable to sleep due to the pain. After another week of this, I dropped back to the previous doze, and the severe pain went away. A few months later, upon the advice of my doctor, I again tried to go back to 1000mg, with the same side effect, and the same results. This was repeated one more time. My doctor indicates that this should not be happening and may not be related to Metformin.

    Is this a unique side effect, or one of the known possible side effects? Are there any items that correlate well with this side effect?

    Any feedback would be appreciated.

    Posted by Ron |
  4. The symptoms that you are reporting may be consistent just with metformin itself. There are no reported cases of interactions of metformin and PPIs (acid blocking drugs) like Prilosec as far as I could find in the literature. There also is no known plausible mechanism for their interaction. This does not mean that it could not be possible. If your health-care provider believes that there might be an interaction occurring, he could report this to the FDA Medwatch program.

    The symptoms of back pain you experienced with metformin have not been commonly reported in the medical literature. Of course the classic challenge and re-challenge approach that you tried with metformin is highly suggestive that your symptoms might be related to metformin. Once again, if your health-care provider believes that there might be an interaction occurring, he could report this to the FDA Medwatch program.

    For details about metformin, see http://packageinserts.bms.com/pi/pi_glucophage.pdf

    Posted by Mark T. Marino |
  5. I was first diagnosed with diabetes at age 12. I was diet controlled until perimenapause. I am extremely medication sensitive and failed the first medication trial of Avandia. I have an allergy to sulfa so that immediately eliminated a large number of medications. My doctor started me on Metformin 500 mg/d and as the years have gone on I am now at the max 1000mg bid. This drug has been my miracle drug. Up until last year it was used solely. I have had no side effects from this drug. I must also reveal that I am very good about my responsibility when it comes to diet and exercise.
    One caution for aging diabetics- keep a close eye and attention to gum disease. I have just had total mouth gum surgery and my a1c has gone done 1 point!

    Posted by Nancy Russell |
  6. I have been taking Metformin (1000mg @ 1 pill 2x daily) for the last few years and have had difficulty getting the A1C down below 7.5. About 5-6 months ago my doc added Glipizide (5mg @ 1 pill 2x daily)and my last A1C dropped to 6.0. I’m waiting for my next test.

    Posted by Daniel G. Emilio |
  7. Ron,

    I wonder if the higher doses brought on episodes of kidney stones. I have experienced this from time to time.

    Ask your doctor to check your kidneys out? Especially if the pain you experience is in the love-handle area.

    Cheers

    Posted by Melody |
  8. I AM ALSO ON METFORMIN AND HAVE THE BACK PAIN AND UPSET STOMACH. THE UPSET STOMACH WAS CURED THANKS TO MY HUSBAND, AND GINGER ROOT CAPSULES WHICH YOU CAN BUY AT WAL-MART .THE BACK PAIN I AM STILL WORKING ON. MY DR. TELLS ME THAT IT IS NOT THE MEDS CAUSING THIS PROBLEM THAT IT IS IN MY HEAD. I AM GOING TO LOOK FOR AN HERBALIST

    Posted by betty from las vegas |
  9. I have been a diabetic for the last 3 years and have been on metformin 500mg twice a day. Not much of an exerciser but better diet control has seen me keep my A1C at just below 6.0. I don’t like the mild nausea like symptoms brought on by the drug but its a small price to pay.

    Posted by Bathmanathan |
  10. I have been a diabetic for the last 3 years and I’ve tried a bunch of different glucometers. I found a site that actually compares the available products and reviews them. Pretty interesting:

    Posted by bg233 |
  11. I was diagnosed in November of 2007 with an A1c of 11.3 and a fasting bg of 285.

    My doc started me on 1,000mg of Metformin twice a day. He added 4mg of Glimepiride twice daily shortly after because although the Metformin had stabilized my BG, it hadn’t dropped it enough.

    By April of 2008 my A1c was down to 6.0! Three tests since then (I’m due for another blood test in October) have been: 6.0, 5.7 & 6.0. My average bg ranges from low 80’s to low 90’s.

    I have had NO complications of any sort.

    Posted by Phil |
  12. I have been a diabetic for 16 years. When I was first diagnosed with diabetes, I was put on Gliberide but it didn’t work. Now, I’m on 500 mg Metformin along with 1 mg Glimepiride, take 30 units (twice per day) of Humalog 75/25, and my A1c is down to 6.9. On some days, insulin injections can be painful at times and I do change injection sites. Another thing I dislike with the insulin injection is weight gain. I’m hoping in the near future, an insulin patch will be on the market.

    Posted by Kimmie K. |
  13. I have been taking Metformin along with Lantus injections for several years. I am pleased with the results, but I would like to know why the makers of Metformin cannot do something about the terrible odor that the medicine gives off. Each time the bottle is opened the smell is awful. I hope they are working on this problem.

    Posted by Peggy Mason |
  14. Thank u so much for your article on Metformin. I have been taking this medication since being diagnosed in 2006/August. I was grosely overweight and since changing my eating habits, etc., I have lost 54 lbs. and feel emensely better. My dose of Metformin is the ER at 500mg. of which I take 3x per day.

    Thank goodness for this medication. It interacts well with my other meds. and my blood work is stellar.

    Thank you for your article.

    Pat

    Posted by Patricia B. Davino |
  15. I was diagnosed with type 2 diabetes in 1999, and I controlled it with diet and exercise, and seemed to be doing well with my tight control, until 2008, when my son got married and graduated from law school, good stress, but stress as you know increases blood sugar readings. Nunmbers in the 6 range, doctor put me on Metformin 500×2 daily. Initially numbers dropped to 6.0, then after several months went up to 6.7. I also had an episode of blood in my urine in Feb 08, diagnosed with urinary tract infection, wonder if it was kidney stones. Not sure if metformin was the culprit with the incident.

    Posted by Bev |
  16. I’m on 2000 mg of the XL Metformin. I always take it with dinner, all at one time but am now wondering if I should split it up. Any suggestions?

    Posted by Debbie |
  17. This is a great article about Metformin. I am consuming a combination of Metformin 250mg plus Glibenclamide 1.25mg under trade name “Glucovence” from Merck, in the past 2 years. If the Metformin is consumed less than 500mg on daily basis, do you think that will bring any effective result in controlling the blood glucose? Thank you for your reply.

    Posted by Phillips Gunawan |
  18. Peggy, my Metformin does not have an odor in the least bit. You might try asking your pharmacist or physician about the smell your pills give off upon opening the bottle. You could have a bad batch. Good luck!

    Posted by Kim |
  19. There is a clear dose response relationship with metformin, which means that the higher the dose, the greater the effect, on average. So on average, 500 mg once a day will provide less of an effect on HbA1c than 2,000 mg once a day. While the average response is important in clinical trials, what is most important is how the drug works for any individual. A general principle to follow is to take the lowest dose that provides the desired result, since this obtains the desired clinical results while minimizing side effects and potentially cost. When metformin is used in combination, the doses are often lower than those needed when the drug is used alone. So if your HbA1c, fasting blood glucose, and other tests are fine, there would be no need to change; if not, then consider reevaluation by your health-care provider.

    I am attaching the link to studies that evaluated different metformin dosing regimens. In general, there is not much evidence for the superiority of once a day versus several times a day. Most physicians prescribe split doses to reduce gastrointestinal side effects, but on the other hand, multiple daily doses tend to reduce compliance (it is sometimes hard to remember to take multiple daily doses).

    http://www.japi.org/may2005/O-441.pdf.

    Clinical Therapeutics Volume 25, Issue 2, February 2003, Pages 515–529

    Posted by Mark Marino |
  20. I have recently tried metformin again probably for about the 4th time… this time I had a severe reaction…Have gone back to Glimepride and a low carb diet…When I first got diabetes my doctor gave me this diet….After having a reading of 410, at the end of three months, he took me off all blood sugar, and blood pressure medicine….That lasted a couple of years until all of my bad eating habits and lack of stuctual exercize slowly came back…Well with quite a bit of stress that I have this year I am at that level and worse again(13)…these numbers were about two to three weeks ago ..now after deciding that I really needed to take charge of my life again and knowing that we cannnot afford to probably do the medicne that will probably take of the problam the most efficiently…..I have brought my sugar levels back down to the acceptable range and after acouple more weeks hope to put them right were they belong and with the Lord’s help in giving me strength to do this just maybe get off of the pills all together….Okay this is basicly the diet my old doctor gave me…THIS IS TO STAY OFF INSULIN AND TO GET OFF PILLS…… just about all the vegetables I want …no white foods, such as rice, potatoes, pasta, bread ….no food with sugar….lean beef with little fat (small portions), lean pork….. Best of all poultry and fish ( you can eat almost as much as you like of these) …but remember this: white flour seems to be bad for a diebetic…actually there was nothing on the diet about fruit…but I found out that you have to have fruit…what I’ve found out: apples are the best as far as controlling your sugar, than mellens and just all of the rest have quite a bit of sugar…Healthy snacks are cauliflower and low moisture motzerella cheese..These are probably the only white foods are that are exceptable…leafy vegetables seem to be the best for reversing the diebetes, poultry, and turkey in paticular, fish and chicken are also good..I have more problem with the white stuff staying in the body longer than anything…..THIS DIET IS FOR PEOPLE THAT ARE NOT ON INSULIN…If you are on insulin you need to talk to your doctor.

    Posted by Pat |
  21. I had been taking Metformin successfully for nearly 4 years, when its effectiveness started to decrease and my blood sugar started to rise during the overnight fasting period. (I’m told this is quite common–that Metformin often loses its strength when taken in high doses over a long period. I take max dose of 4 500-m tablets a day.) My biggest problem is a very high “dawn effect” wherein my blood sugar peaks during sleep at night, so I need a counteractive during that time. I kept taking Metformin, but Glimepiride (generic Amaryl) was prescribed with it–one at breakfast, one at dinner and a double whammy at midnight when I retire (always with milk/food). That’s done the trick, and my latest A1C is 6.7, back below 7. Metformin users may be dismayed to find it not working like it used to. This is common over a period. The next step is to add an insulin-producing stimulant to it. Don’t worry–Metformin plus a supplement will often work.

    Posted by John (Greenman) |
  22. Metformin does have a fishy smell. The only one out there that did not…is no longer available. It was by Apotek and it is gone.

    I gag at the thought of it let alone the smell. It makes me want to toss the medication in the toilet. It makes me angry that I’m forced to swallow something so vile. Why can’t they make it more palatable? It’s disgusting. The major pharmacies that I have contacted looking for Apotek said it is what it is…no options. They understand but there are no suggested solutions accept hold the nose and gulp it down. I want to vomit…I want to cry…I want to scream. It’s not fair!! Arghhhhhhhhhhh!

    Posted by Bonnie Bell |
  23. I have been taking Metfomin for a couple of years. My blood sugar has been reasonable. However, about four months ago the Metforman began reeking with odor and concurrently my blood sugar went up and has remained about 30 to 40 points higher with no change in healthy diet. I am concerned not only about the smell but the effectiveness of the product. Something is wrong. My prescription comes from TEVA based in Israel. Where are the different capsuls made? What is being done about correcting the issue?

    Posted by D. Combs |
  24. HELLO I WAS DIAGNOSED IN JAN 08 WITH IT, BETTER SAID I ALREADY NEW I HAD IT WHEN I WENT TO THE DR. HAD ALL THE SYMPTOMS.

    WELL I DID GREAT RIGHT AWAY MY A1C WAS 5.2 5.4 5.7 5.8 IN JAN 10 WAS MY LAST ONE IN MARCH I HAD SOME STRESS AND SO AND MY METFORMIN DID NOT WORK ANYMORE. I STILL EAT THE SAME AND DO THE SAME BUT I JUST CAN’T CET MY READING DOWN! MY DR. JUST PUT ME ON THE EXTENDED RELEASE 500 2X DAY, AND I WAS TAKING 1000 REG. 2XDAY , DID ANYONE EXPIRENCE THE SAME PROBLEM I HAD , OR IS IT GOING TO BE GOING DOWN AGAIN.

    THANK YOU

    BUT I LOVED METFORMIN ALL THIS TIME IT WORKED

    Posted by DOBIGRAC |
  25. My question is upon reading one of your letters that said metformin should not be taken from people that are over 80 years. do you have a comment on that?

    Posted by harry h.kim |
  26. I was diognose with type 2 diabetes in 2006.
    metfomin 500mg twice daily has been my medication
    In 2009 my sugar seemed to be uncontroled and high
    i was given

    Posted by pat |
  27. My question is i got lower back pain and miscariaged pregnancy, could it be the 1000mg er
    metfomin with 10mg glipizide i was taking at that
    time?I have had type 2 for 5 years now.

    Posted by pat |
  28. The data on people who are older than 80 years of age is based on the facts that kidney function decreases with age and the elimination of metformin depends on kidney function. The package insert (see link below) states,

    “Limited data from controlled pharmacokinetic studies of GLUCOPHAGE (metformin hydrochloride)
    in healthy elderly subjects suggest that total plasma clearance of metformin is decreased, the
    half-life is prolonged, and Cmax is increased, compared to healthy young subjects. From these
    data, it appears that the change in metformin pharmacokinetics with aging is primarily accounted
    for by a change in renal function (see Table 1). GLUCOPHAGE (metformin hydrochloride) Tablets
    and GLUCOPHAGE XR (metformin hydrochloride) Extended-Release Tablets treatment should not
    be initiated in patients ≥80 years of age unless measurement of creatinine clearance demonstrates
    that renal function is not reduced”.

    With that in mind your physician should determine if your kidney function is not reduced and take that into consideration as to the risks and benefits of prescribing metformin. I have also attached an interesting article on the safety aspects of metformin that questions the current guidelines on prescribing this medicine. The commentary cites several studies on the use of metformin. You may want to have your physician review this article along with several of the studies that it cites prior to making any decision.

    http://packageinserts.bms.com/pi/pi_glucophage.pdf
    http://www.cmaj.ca/cgi/reprint/173/5/502

    Posted by Mark T. Marino |
  29. I am sorry to hear about your miscarriage. Unfortunately Type 2 diabetes is associated with a higher risk of fetal loss and congenital abnormalities, and that risk is directly related to glucose control (i.e. the higher HbA1c, the higher the risk). Most physicians recommend insulin as the therapy of choice for pregnant women but there is good evidence that glyburide has minimal transfer across the placenta and can be used during pregnancy. Some evidence also suggests that metformin can be used during pregnancy. It is probably best to closely coordinate with your physician and obstetrician during the time period you are planning on becoming pregnant so that your glucose levels can be monitored closely and adequate therapy can be provided. See the journal articles below for more details.

    http://spectrum.diabetesjournals.org/content/20/2/101.full.pdf+html

    http://care.diabetesjournals.org/content/30/Supplement_2/S251.full.pdf+html

    Posted by Mark T. Marino |
  30. I had a severe case of hives after taking metformin in the first week of usage. Most doctors haven’t seen that reaction before. Would like to try again, but doctors allow it. Has anyone had this reaction? Peggy

    Posted by Peggy |
  31. I STARTED HAVING PAIN IN THE LEGS AROUND THE KNEE
    WHEN THEY CHANGE MY GENERIC METFORMIN TO ANOTHER MANUFACTURER. THE PAIN IS LIKE A TOOTHACHE AND MANIFEST ITSELF WHEN YOU TRY TO SLEEP AT NIGHT.

    Posted by MARGARET WADE |
  32. I started having leg pain or “restless legs” at night after being on metformin for two weeks. My doctor said that was not a typical side effect.I felt like I was crazy until I stopped taking it and the pain went away. Just wanted you to know that you are not alone in having leg pain with the Metformin. I am on Actos now and not getting a lot of help from that. I am getting frustrated with these diabetes meds and hope I find one that works. I was just diagnosed about three months ago.

    Posted by C.Friedman |
  33. I was on metformin for almost 2 months before I had hives. The hives were awful. I stopped taking the metformin for 3 days and they seem to be getting smaller but still itchy. No idea how long these will take to go away.
    I too had severe gastric trouble. Diarrhea almost daily at 425mg Metformin 2x daily. Always with food.

    I agree with the no whites- no rice, pasta, bread or flour with white flour. PERIOD. I am controlling my sugar with tons of veggies and lean meats with small amounts of fruit each meal. My sugar started at 402 April 7th - since then I lost 28 pounds - now because of the hives I am off metformin and sugars are ranging 89-120 - I feel great. No more blurry vision and no more gastric problems.

    It is a metabolic problem. It can be treated with FOOD. Food is the culprit and the cure. I have read everything I can on this subject in the past 2 months. I am NOT talking about type 1…I am talking about type 2. If you change your eating habits and take care to exercise daily - you can flip it!

    Posted by T. Heiser |
  34. I have had type 2 since 1993. I was able to keep it in control for many years with exercise and diet. I am not exercising as much as i use to and my blood sugar has gone up primarily in the mornings. When i take my reading in the afternoon it is down considerably. My doctor has increased my evening dosage to 2-500mg at night and 1-500mg in the am and this hasn’t seemed to work. Do you have any suggestions?
    Frank

    Posted by Frank LoPresti |
  35. I WAS on Metforman and have never been sicker in my life!! My quack of a Specialist kept saying that I was not taking enough. He increased it to 5 times a day………AND my blood sugar kept rising. He said that was ok and that I was “handling” it. HANDLING???? NOT!!! I couldn’t eat - lost 68 pounds and did nothing but vomit. The skin came off my hands and feet (down to the muscles…..) Gee, do you think I was alergic to it - duh!!! At the time I was not on insulin. After landing in the hospital w/ a blood sugar of “600″………… NOW I’m on insulin and have a NEW Dr. who is great. I’m suing the last one and have reported him the the Mecical and Insurance board!!!! NO METFORMAN FOR ME………. Wish everyone luck who have no side effects.

    Posted by Lynda |
  36. BACK PAIN AROUND L4 UNILATERAL
    DEFINATELY A POSITIVE RAISE LEG TEST BILATERAL BUT MORE SEVERE IN A SPECIFIC SIDE.
    A POSITIVE PSOAS SIGN AS WELL
    CANY PIN POINT OR ATTRIBUTE THE PAIN TO ANYTHING ELSE, ANY MOVEMENT HIP, COUGH, PLANTAR FLEXION AND EXTENSION EXACERBATE THE PAIN. I DONT HAVE URINARY FREQ, I THINK AT TIMES THAT MAYBE JUST MAYBE I HAVE A CALCULI STUCK IN THE PELVIC BRIM RIGHT THERE AT L4, BUT THEN I DONT HAVE ANY OTHER SX….
    AT TIMES I DO FEEL LIKE… MAYBE APPENDIX, BUT AS I SAID… NO GI SX I CAN CORELATE…
    I CAN SAY THAT THE PAIN IS CONSTANT AND DOES GET SOME RELIEF WITH MOTRIN.. DEFINATELY DEBILITATING… I AS AN MD USED TO BE SKEPTICAL OF MANY BACK PAIN… WELL THERE WE GO…
    METFORMIN AND BACK PAIN… I AM CONVINCED THAT IT DOES PRODUCE SOME BACK PAIN

    Posted by OBGYN |
  37. Amazing comments on metformin.

    This drug plus exercise works wonders. I find for me
    that best performance involves taking 500 mg doses
    around the clock and specifically at 10:00 pm and 12:00am midnight. This cuts off dawm effect from 12:30am thru 5:30 am so that morning glucose is close to last nights glucose. Without these two doses, am glucose would be 238 to 258 and body saturated with glucose requiring 2 mile walk to dump out glucose in am each and every day - morning.

    My body numbers are usually 2.5 hours to get up to strength on 500mg dose and lasts 2 hours and 1/2 hour to leave effectivity. This is on standard metformin and ER has not worked.,

    I also take 500mg doses at 5:00am; 12:00 pm lunch and 7:00om evening.

    Each time a dose is up to strength in blood on liver, sugar leakage stops, liver behaves itself,
    and blood glcose goes down as consumed.

    a1c before using this strategy was 13.3 last may 2010 and by november 2010 was 6.9 and daily average was 155. On my meter was 166 through period.

    One large dose does not work and waste of pills.
    According to salk institute, there is a switch in liver called crtc2 switch that controls fasting and make sugar in liver. On type 2 diabetics, switch is jammed on always make sugar. Their research has found that metformin will turn switch back to fasting.

    I also use insulin - humolog 75/25 - one shot of 23 units at 5:00 am and a shot of lantus at night
    of 23 units average. I also take starlix 120mg at 12:00 noon and 5:00pm but synchronized to meal start.

    my diet before and after strategy was 1300 calories and could not lose any weight and after approach weight down to 285 lbs from 330. I could not lose any weight even with extensive exercise pre strategy approach.

    Also, I extensively watch out for BS lows and use glucose tabs to stop liver from doing sugar add that when it did that was 278 to 311.

    Hemorages cleared my eyes, kidney stabalized and lngs and function improved.

    Am still doing 1/2 to 1.5 miles a day walking.

    I share this only as FYI and do not try any modifications of your diabetes routine without the express review and approval of your diabetes/doctor-expert.

    Posted by jim snell |
  38. I have experienced a back pain condition similar to that decribed by Ron when going from 500 to 1000 mg. Not sure if the pain is back or kidney related, but is a stinging pain not a muscle pain on the sides. I have had an L5 S1 fusion, so quite familiar with back pain. No other meds taken. Input?

    Posted by Steve |
  39. I am 49 and was diagnosed type 2 in April of 2007 with an A1c of 13.5. I took and still take 500 mg Metformin twice a day, took the 8 hour course through the hospital for diabetes control and eating healthy. Within a month of starting on Metformin, I had high blood pressure (which I had never ever had before) and went on 80 mg. Diovan and 12.5 mg hctz. I also experienced diarrhea and stomach upset with the medicines I was taking but I watched my mother give herself injections for years and didn’t want to go that route, so I put up with it and eventually it lessened. I went from explosive diarrhea 2 of every 3 days, to now, just diarrhea occasionally. I lost 85 pounds in just 6 months. My A1c’s have ranged from 5.6 to 7.0 in the last 3 years. Now, all of a sudden, it seems Metformin has quit working for me? This morning I had two cups of coffee with 1/2 and 1/2 and 2 hard boiled eggs. My blood sugar reading jumped from 109 (still higher than it should be for me on rising) to 239. What have I done to cause this? What can I do to correct it? Any ideas?
    BTW, I exercise daily; we have a small farm and caring for pygmy goats and sheep twice a day, especially in winter, has always been sufficient until now. I am fully into peri menopause, and so I am consulting an herbalist but I always tell my doctor what herbs I am currently taking and he is in full agreement with all of them so far. I, too, experience the muscle and joint aches the others have talked about, but until reading the others posts had put it down to age and arthritis and stress, etc. I HATE taking medications, even put off taking tylenol until absolutely necessary, but I understand the importance of taking my prescriptions. I just don’t want this to get out of hand, or anything. I welcome any and all suggestions.

    Posted by Michelle G |
  40. metfomin is best pill for me. have 6 year now. like people need give time work.

    Posted by parrish |
  41. I use Metformin twice a day and it is wonderful. Before I started on it I had a blood glucose level of 183 and now it is down to 102.

    Posted by KELLY |
  42. I have never experienced a problem with my metformin smelling bad.. You may want to look into that.

    Posted by KELLY |
  43. Michelle… Do you drink regular coffee or the decaffeinated? It does make a difference. Diabetics cannot have regular coffee. I always use decaf with 2 packets of sweetner and creamer.

    Posted by KELLY |
  44. Metformin is real miracle drug.

    Discussion on AMPK is waste of time.

    i have taken metformin for over 5 years and detailed monitoring with CGMS clearly shows Metformin shuts down excess glucose production by livefr and blocks sympathetic unwarranted liver dumps.

    Taking on large dose is tupid and unhelpful.

    I take a dose 1 hour before a meal so that is up to strength before gut completes digestion and BG heads down again.

    This stops all sympathetic liver dumps - even when BG at fingettips is at 140 to 200+.

    At 10:00 pm and 12:00am midnight; I take a 500 mg dose of metformin and dawn effect shut down all night. No 238 + BG in am.

    Data today is showing Metformin is correcting signalling failure of liver to switch to fasting mode when gut outputting glucose, insulin present and liver ignores.

    Fed up with mis information and misleading comments about metformin.

    Hemorages in eyes cleaned up. A1C dropped from 13.3 to 6.9.

    Single large daily dose waste of medicine and useless. ER pills do not work for me and unhappy with Teva products.

    Lets get on with it please.

    Posted by jim snell |
  45. I have been on Metformin since diagnosed with Type 2 three years ago. I haven’t had any problems controlling my glucose levels until recently….my A1C went from 6.7 to 11 something. My doctor said my Metformin was no longer working and I had just lost 20 pounds so we both thought this A1C would be really good….I was sadly diappointed!! Is it common for Metformin to stop working? My doctor said he normally on keeps his patients on Metformin for the first few months after being diagnosed, but since it had been working for me we kept it the same, now I’m worried that it’s me and not the meds. I am totally stress and disappointed in myself.

    Posted by Ashley |
  46. I am so glad I fond others having the same symptoms while using Metformin. I have been having terrible back pain, have been to the chiropractor several times with no relief. I went off the Metformin for 3 days and had absolutely no back pain in those 3 days. I went back on Metformin the 4th day and about 2 hours after I took the pill, my back pain came back. How can this be causing me back pain? I didn’t see back pain listed under possible side effects for this drug.

    Posted by Charlene |
  47. I just started taking metformin three days ago , my lower back towards the sides, mostly left side hurts extremely bad and it didnt start til I started taking metformin. My doctor ran blood tests prior to giving me metformin and my kidneys are healthy and normal. So then why am I hurting terribly bad on the lower back towards my side as soon as I started taking metformin.

    Posted by Danielle |
  48. my friend has been taking it and she was hospitalised in the emergency room for back pain and vomiting. the doctor said it was her stomach causing her back pain. the metformin had just been started when this happened.

    now several months later she has got used to taking the MR metformin and tried to put the dose up to 1000 under pressure from her doctor. yet again now she has the severe pain in her back on her left side and dreadful vomiting. this is a result of a pizza last night and an increased dose of the drug.

    i believe the metformin is problematic to her stomach and the pain might be referred pain? i wish she would just stick with the low dose and go back to her changed eating. she is in a terrible state. no point in going to the hospital again we know what they will say, NO FATTY FOODS, NO REFINED SUGAR, NO SPICY FOODS, NO ACID FOODS, NO ALCOHOL. it worked beautifully while she stuck to it and until this higher dose of metformin.

    THE RIGHT FOOD CAN MAKE YOU WELL!

    Posted by suki |
  49. i must butt in here and as a non - comprene vue who has been on metformin for a number of years and this is not medical advice which only your care taker can give and approve:

    Large doses of metformin in my opinion are unhelpful. Medical fact suggests that keeping a lower dose spread around in time achieves a better overall result than a big slammer all at once.

    The human body does not automatically spread a larger dose around in time, only taking timed spaced doses can do that. I wish I knew who came up with this - just load a massive dose.

    My liver is cut off when met comes up to strength in blood at a certain dose ( 500mg to 625mg) and any more is useless. So here I am loading timed spaced doses and I seem to be doing OK.

    Originally many moons ago, my doctor wanted me to load a single large dose of 1000mg and that made me feel funny. I went back to 500mg doses and felt much better.

    Posted by jim snell |
  50. my husband is 23 has diabetas type 2 his sugar was tested came back 292H i wanna help him he takes metformin2x a day 1000mg and glimipride and lisnpril the dr. said he gives him 3months and if the sugar isn’t better hes gonna have to be put on insulin i’m so scared i don’t want hime to die hes so young HELP ME PLease on how to change his diet he dosn’t eat candy etc hes mexican so its more that kind of food he eats oh and hes scared to have a baby with me cause he says that it will have diabetas to????? can that be why im not getting preg could it be his sugar level????? any adivce ASAP would help thanks

    Posted by mg |
  51. Thank goodness people are coming forward about Debilitating Low Back Pain with Metformin or Glucophage. A google search brings up little information on this. I’ve never experienced such deep ache pain in the low back. What’s interesting about this is if you perform neural mobilizations like flexing forward with neck, thoracic, lumbar you’ll exacerbate the pain which means it’s causing pressure on the spinal cord.

    1gram taken, 2hours later began confusion, thirst, frequent urination, deep ache in joints and tight muscles on the verge of spasms; but no spasms. Low Back Pain: 8/10.

    24 hours later: confusion present, short term memory affected, low back pain is 5-6 out of 10.

    48 hours later the back pain interrupted sleep 10 times in one night. Pain rated at 7-8 out of 10. Slight memory issues persisting which is giving me cause for anxiety. If the half life is 6 hours I should not have the drug in my system at all after 48 hours.

    72 hours later back pain is 2/10. Memory issues are minor.

    Posted by Jeff S |
  52. I see a coincidence in another post. I overate a meal late at night at roughly 48 hours. I believe the coincidence is eating heavily causes an exacerbation of the low back pain. My worst night was at 48 hours after over eating.

    If any healthcare practitioner cares about his or her patients perhaps they could objectively listen to their patients.

    Posted by Jeff S |
  53. i am allergic to nasids and sensetive to salciylate. when i tell dr’s this they look at me like–whose the dr here—-i am so fed up because i’ve had to research and find out every thing my self. i was in hospital for colon surgery, large palups removed. my sugar was skyhigh and they gave me insulin and 2000mgs of metform. i was sent home with a prescrition of metform i’ve been taking it for 2 months i’ve had lower back pain always before because of all the other meds i was on that i refuse to take now. one day the sevier lower back pain stopped it scared me to death because i thought it would come back. now i have some pain in both of me upper hips and i’m wondering if the metform isn’t causing it so i’m not going to take any for a while. I just want my life back and when drs and people say live with it i don’t want to the pain in my legs and lower back has stolen my life drs are so uneducated about these things and i dread to go to the dr. its like here we go again.

    Posted by shirlee |
  54. I have been taking metaformin hcl 1500 mg a day for almost 4 months now. The reason I take it is because i have PCOS, I have had back pain in the past but NOTHING like what I have now and it keeps coming back. I had an MRI done and it showed L4, L5, and S1 degenerative disc changes, I think the metaformin is making it WORSE, BUT, my moods have improved so much!!! Before the metaformin my sugar would fluctuate, causing me to have super highs and lows, I felt Bipolar!!! Since on the metaformin, I no longer have serious mood swings, but instead very bad lower back pain. I feel like I have two choices, Back pain, that is so bad I cant work more then a 4 hour shift without popping meds, or, mood swings that are so bad I am miserable 90% of the time. WTH!!!! Does anybody have any ideas? I have been to SO many Gynos, Edocrinologist, MD, you name it!!! What NOW!!!!

    Posted by Nicole |
  55. I am posting this because I have not seen any other similar posts.

    I have been taking Metformin 500 mg 3x per day for almost 4 years, with varying results.

    I take no other medication, prescription or over-the-counter.

    The Metformin I get from my pharmacy varies in size, shape, color, and PRICE from month to month. Is this normal?

    The reason I ask: on November 14th, 2011 I had a vitreous hemorage. Every time I moved, at all, my eyes would start bleeding again. If I sat still for a little while it would clear, but if I moved (to get up to go to the kitchen, for example) the eye would start bleeding again. The bleeding went on for 4 weeks before finally lessening and finally stopping. Needless to say, I couldn’t work, or do anything, for that matter.

    The bleeding began 3-4 days after starting a new bottle of Metformin. It stopped 4 days after finishing that bottle and starting the another bottle.

    Is there a possibility there was a bad batch of Metormin? That one of the inert ingredients caused this problem?

    There were no changes in my diet, exercise levels, or daily blood sugar levels.

    If anyone has experienced similar issues, or offer any suggestions. I would really appreciate it.

    Posted by Bob |
  56. Let me offer something here just to help:

    If the dose of metformin is high enough when it gets into blood system, it will shut down the liver excess glucose release during the time metformin up to strength in blood.

    I had hemorages shown up prior to 2 years back and prior to getting average BG down and A1C under 7. AFter getting there, hemorages in eye cleared up.

    The part of the story is this:

    watching on cgms I could watch whne liver leaking glucose bad and when shut down. In addition certain generic metformins 500mg seemed capable of stopping the liver and others did not come close.

    Later chasing data on web came across research work done by John Hopkins that they suggested that metformin could shut down liver and that they had way to find dose size needed on each person to be afective. This is only research data - not approved cures.

    I had found that 250 mg never worked of the “good” working brand while 500 mg generally did but later identified some missfires. I later realized that the brands were not defective or defective pills but possibly doses sitting on edge and occasionly not strong enough to stop liver issue.

    On another front, I am not Doctor nor qualified to give advice but I would get good retinologist on tapp and check your a1c and average Blood glucose readings. An issue with finger stick machines being manual, one is not testing thru the dark hours as one is sleeping. I would be closely checking A1c and what it thinks as your average BG and A1C is.

    Since getting my actual a1c sub 7.0 and its average Blood glucose of 155, my eyes healed up and have been clear of hemorgages.

    I am told that sometimes their may be blood vessels in eye that may need dealing with by retinologist as they may be bleeders.

    Also blood pressure - how is that doing. Your post makes no mention of private actual numbers that may need to be analyzed by an expert/experts to assist you.

    Best wishes.

    Posted by jim snell |
  57. I am type 2 and initially started on metformin but quit after about 2 weeks. I felt so sick to my stomach I didn’t even want to eat. I am only 150 lbs (6′2″) so cannot afford to lose weight. So my dr. put me on glipizide which has worked well for a couple of years. Recently I read that if you can make it past the first couple of weeks of metformin, the nausea goes away. So I tried it again and this time went very slow on raising the dosage. After a month I was finally up to 1000 mg. Couldn’t go any further because it made me too sick - worse than when I first took it. So for a three months my blood sugar is not staying down like it did with glipizide. Nothing has changed.

    I have noticed that now in my fourth year of diabetes neither metformin nor glipizide alone help me. My blood sugars go up even with a very strict diet (no junk food, no processed or refined foods, limited carbs). 3 hours after eating I have 180 which is not what I typically would have had just a year ago. I exercise daily so am clueless as to what is going on.

    Another question I have is whether or not stress can cause blood sugars to go up in a person.

    Posted by Clif |
  58. The most likely explanation of worsening blood glucose control over several years in a person with Type 2 diabetes is worsening insulin sensitivity, otherwise known as insulin resistance. This occurs with the progression of the disease for many reasons but may be partially offset by exercise to include resistance exercise. I am attaching an article in regards to exercise and insulin sensitivity. If you need information on insulin resistance I can forward articles on those as well.

    http://diabetes.diabetesjournals.org/content/59/3/627.full.pdf+html

    Posted by Mark T. Marino |
  59. I am taking metformin 500mg two times a day along with diamicron 30mg. My question is regardless of my diet being watched very closely I am still getting levels of anywhere from 12-15 instead of 5 or 6. I can have 4 cups of coffee with 1 tsp of sugar because i am on the go and get a mid day reading of 8-10 and on other days when I have a toasted bagel or a bowl of Cheerios in the morning plus 1 coffee get a reading of 14. before I started taking meds my mid afternoon reading was 16-18. It has gone down with meds but i am confused about what seems to bring it up? I would have thought having 4 spoons of sugar in the morning would be worse than a bowl of cereal or a toasted bagel….some days we eat supper around 5 and when I eat lets say rice with a sauce and chicken my reading 2 hours later is 9 to maybe 12 depending on how high it was 1 hour before I eat. Lunch is usually a bust….I am not hungry in the morning when I wake and usually eat something around 10 or 10:30.Any suggestions would be appreciated

    Posted by sandra |
  60. This drug does have side effects,iam also one of those people who had pain in back both sides and leg after taking this metformin drug.i did lose 45 lbs but couldnt fiquore out what was causing me back pain,so i went to a back doctors took xrays and did a scan no damage was found.got off the metformin for a week ,i had no back pains,but that was because i ran out.the doctors dont no about this side effect and so many people are hurting from it.why dont they no.they need to include this in the side effects area on the bottle.this could cause leg and back pain,the higher the dose the more pain,plain and simple,come on doctors out there are we all lieing,listen and learn.

    Posted by charles wilson |
  61. I have been on metformin 2 and half years. I have notice in the last 6 months I have passed in my bowls what looked likes a large capsule in a yellow casing. I thought it was a pal-up and finally took one out of the bowl. When I took a plastic knife and cut it open it was pure white in side, I swear it was the metformin (at least one pill) taking 2000mg a day is not being digested.

    I am sorry to be so graphic, but I do not know if this happen to anyone else. Please share with me if you know of this happening to them.

    Posted by Donna Jones |
  62. that can be common with eating fatty food it is not the pill that didnt dislove it has happened to me dr said watch what you eat, havent seen another one I was shocked it was so well formed

    Posted by mary |
  63. I hear all of the comments about metformin, but everyone I have spoke with has nothing good to say about the drug. My mother complained about many of these symptoms mentioned, her liver was damaged badly, and she passed this July. I listen to her complain for years about kidney stones, kidney failure, and eventually heart problems. I have spoke with friends of the family who have stated they were taken off of metformin because of kidney problems. Many of the reports I have read states that the damage is caused to more people who takes metformin alone, instead of with other meds, such as insulin. I now have a brother who began to have problems with his kidneys, and takes metformin. I recently asked him to go back to his doctor and suggest something else. I think the doctors are really down playing the negative affects this medicine is causing. I have talk to several people about this, and ALL the comments were negative.

    Posted by Karen |
  64. Before one throws stones at metformin, with me an extensive user of metformin and dam glad I do, my kidneys started going down hill and the culprit was actos.

    Actos removed, kidneys recovered and stabalized and metformin made no difference here throughout the 4 year cycle hiatus.

    There are too many mis information factoids out there.

    Posted by jim snell |
  65. Metformin is just plain a bad choice for me. A1c in April was 8.7; after sporadic use since then and some diet watching was 8.3 in January. I can’t tolerate most drugs without severe side effects and allergies, and metformin is one of the worst. Terrible stomach pain, explosive diarrhea with little warning, gas, bloating. Bad stomach pain that rarely responds to pepto-bismal or any stomach acid control, doesn’t respond to immodium. I just feel absolutely like the worst flu. Dr. wanted me to increase from 500 mg which I can barely tolerate every other day to 1000 mg every day. What a joke! All food taste was oblitated. I couldn’t even stand trying to eat Cobb salad yesterday - Glucerna is about the only thing that doesn’t cause problems. I’m still waiting for the perfect food that is metabolically correct, inexpensive and enables me to ditch all meds for diabetes. Doctors are such idiots — there is no way I am going on multi-drug regimens that make me feel like I have a chronic case of flu and diarrhea and insomnia just to achieve quasi control of blood sugar while I starve myself. I’d just rather die and go home and be with the Lord Jesus.

    Posted by Susannah |
  66. I recently had a hip replacement 6 weeks ago. I was put on blood thinners and started metformin at the same time…. 500mg’s 2x a day….I started to see blood in my stool’s and also notice that I was not having regular bowel moments…a lot of gas, clotted blood pieces, etc…no real proper stool’s however…I stopped the blood thinners last friday…so it has been a week now but am still seeing the blood…can the metformin cause bleeding in the colon and would it produce the type of blood that I am seeing…Ie the clotted pieces…I am going for a stool test next week to check for cancer but don’t see how they can check if I am not having proper bowel/ stool movements.

    Posted by Micheal |
  67. I too am having lower back pain around the kidney area. Thought i pulled something on elliptical machine. Just diagnosed type 2, 2 weeks ago and started metformin. Going to doctor with these post too ask about this back pain. seems like this drug has issues.

    Posted by Drew |
  68. My wife is 4 month pregnant, after checking her blood report the sugar in blood is slightly increased so doctors prescribed to her a tab “Metformin250mg” is it safe in 4th month of plangency.

    Posted by Abhijeet |
  69. @Abhijeet,

    It should be, and it’s certainly safer for both mother and child than uncontrolled blood sugar.

    In general, metformin is one of the safest medications around. The main problems are diarrhea or stomach upset, both of which usually lesson over time. In fact, metformin seems to reduce the risk of certain cancers and be healthful generally.

    Posted by Christoph Dollis |
  70. I have been on metformin on and off for the past 10yrs for PCOS. At first it was tollerated well even though my condition did not improve (but it did not get any worse either). After being off of it for a year I was put back on it and had a horrible reaction. Two days in to the 1 a day dose, it started with extreme bone/joint pain in my right wrist. The urgent care Dr told me I must have sprained my wrist folding laundry because nobody has a reaction to metformin like this. Two days later is was in both wrists, both knees & ankles and I started to swell. Day 6 I broke out in a rash from head to toe. A different urgent care Dr took one look at me and said what ever medication I was taking to immediately stop. My rash was a classic drug reaction rash. I stayed off of it for a year and at the advise of my OBGYN who believes that nobody is allergic to this medication was put back on it. At first I was ok. A few months and a hysterectomy later, not so much. The joint pain was back and more sever than ever! This time in my ankle, then both of my knees to the point I could barely walk. After unsuccessfully trying anti-inflamitories for the past month I decided to stop my metformin. Two days later I am pain free. Yet there is no information out there on these possible side effects.

    Posted by Stacia |
  71. I am 59 and type II for 14 years. Like many others Metformin made me nauseous when I first started it back in the beginning. I went to Glyburide. Several years down the road my doc added the Metformin back in slowly. Things seemed OK sugar wise if not ideal. However, for all these years I have experienced extreme debilitation energy wise. I have sleep apnea, very low iron, low vitamin b12 and vitamin d, consistently bad diarrhea. I have had every kind of “oscopy” known to man with no definitive results. I am also on Lantus. I have been reading that Metformin actually could be responsible for all my issues. I am disturbed that I had to do all this digging to learn about them. Seems like it is a wonderful drug for many people but it is clearly not safe for everyone and we should be warned. I have stopped taking it but my blood sugars have skyrocketed even though I increased the Glyburide and the insulin. My doctor is out of the office until July with her own medical problems (cancer I think)and I heartily dislike and distrust her coworkers in her clinics. I need to find a better drug or drug combination. I need suggestions.

    Posted by Marla |
  72. I have been on metformin for a couple of years, just 1 pill 1x/day. I take it at night with my dinner along with an acid reducer. Every morning when I wake up I have pretty bad gas with a terrible odor. Can this be from metformin? If so what can I do to prevent the gas?

    Posted by Helen |
  73. Highly informative and very reassuring.

    Posted by Dr. Lalhmachhuana (Ph.D.) |
  74. I believe the information about the ampk chain as being involvedis old guesses. The latest research findings released in Jan 2013 documented how metformin actually bypasses the ampk chain and works directly to stop the liver releasing excess glucose by antagonizing the glucocon. Test were done in lab work to identify this data.

    Posted by jim snell |
  75. I too am a metformin extended release user for a few years now. I take all 3 (500 mg tabs) at once right after dinner. My prescription allows me to get a bottle of 100 at a time.
    I noticed a few bottles ago that the manufacturer had changed to Sandoz.Problem, my sugar levels are still going up. I have noticed since the change in manufacturer, the pills are bigger and my body is not processing them. I notice that my body expels them the next morning fully in tact.
    I am wondering if this pill by this manufacturer if there is something wrong with them as i would think they would have dissolved between dinner and the next morning. I have a Dr appt in a couple of weeks an i think i am going to ask him to take me off this drug. I also take onglysa, so maybe there is something else i can take in place of the metformin. I sure hope so.

    Posted by Karen |
  76. I saw my doctor today and he stated the meds in the pills may still be releasing. Good news was my sugar came down from a 7.2 to 6.7. Not great but better so he was happy.

    Posted by Karen |
  77. One thing I think I may have discovered with metformin is to NOT take it after you have just eaten. Take it either just before you start eating or in the middle of the meal to be certain the food takes it all the way into your stomach. On a couple occasions I took it ~20 minutes after eating (with plenty of water too) and think maybe it became lodged in my esophagus just above my stomach and I got burned by it causing significant pain close to my heart.

    Posted by Mike M |
  78. Hello,I realize this is old but wanted to thank all of the people who have posted on here. I started taking Metformin ER about 5 weeks ago. I am having terrible side effects. I was told it would get better.
    It is not improving and I seem to be getting more side effects as it builds up in my system. Evidently that is when it starts to work, once it builds up. I have been having nausea ever day
    I looked up adverse effects and found on WebMD that it can cause back pain and other types of pain have been reported.
    I decided to stop it when it made my heart race.
    I will closely monitor my diet and do it without medication.
    Metformin may be good for many people, it is not good for me.

    Posted by Dee1956 |
  79. If the manufacturer does not form the hydrochloride completely, there will be some of the biguanide free in the pill and it will stink. If the amine is completely neutralised with HCL then there is no smell.

    Posted by bill alexander |
  80. Neuropathy and metformin.
    If you have diabetes you are susceptible to neuropathy metformin or any other chemical bite or sting can set it off.
    I had a heart scan recently the iodine dye effected me.
    I had various things happen everyday.
    Two docs thought it an allergic reaction.
    They prescribed antihistamine I said that it and steroids are no good for Lyme Disease….
    Another doc thought it may of effected my kidneys as the pain went for my legs.. The heart doctors ignore the situation.
    It may of help push the infection out of my heart as a therapist for lymphademia and cellulitis thought if you touch someone
    The infection can be moved.
    At any rate I am stuck with this problem for now.
    As for docs who tell their patients they are mad just because
    they don’t know.
    We have the internet now.
    It’s just persuading doctors to stop and think.
    It takes 18 years for a consultant to take things on board.
    If the drug companies tell them it comes along sooner.
    I have Lyme Disease since 2005 now 2014 doctors keep saying but that’s a rare disease you can’t have that you must be mad. So in another 8 years doctors might say there is a problem. But what can we do about it?

    At the moment there is a vac in how safe it is? In northern Europe
    The FDA band the US version in 2002 it caused arthritis and was worse than the disease. They were vaccinating stage two of the disease not stage one. Those with a Hapla group were prone.
    New York has a epidemic in 2014 of Lyme Disease.
    How our immune system will hold up?

    Posted by Carol |
  81. I am using Metformin 500mg three times a day (1+1+1)for treatment of anovulation. Now I want to fast for 1 month (Ramadan) which is mandatory. Can I take one and half tablet in two meals? In fasting only two meals are allowed, one in the middle of night(2:45 am) and other in the evening (9:30pm)and nothing could be taken(not even water in between). Please answer me if I could take one and half tablet of Metformin in each meal.

    Posted by Erum Cirrus |
  82. Was taking Metformin alone. Doctor now has me taking Metformin and Glipizide. Has told me that my glucose is out of control. Readings are lower day and night than what is listed on my testing supplies. As I have told many others think that change of diet and regular exercise will take care of most issues.

    Posted by Jason L. Hargrove,Sr. |
  83. I am on Metformin 1000mg twice a day. About 30-40 minutes after taking it I get hit with symptoms. My heart always feels strange, I feel very warm - flu like almost, dizzy but not spinning, I have occasional throbbing pain in my kidneys (although I have NO kidney problems) and develop a headache. I do get the nausea but I read that’s normal. Its primarily the feeling I get in my heart that worries me. Like having drank too much caffeine is the closest I can describe it to. Is this normal???

    Posted by Pat |
  84. I too have excruciating spine pain with Metforin. I asked my dr. if I could reduce my intake to 1500mg a day aprox a yr. ago. My spine pain pretty much disappeared. I started taking 2000mg a day aprox two weeks ago and my spine pain has returned. I do believe some is due to my intestines being inflammed but my spine about midway up through my neck is sore to the touch. The pain is so unbearable that I get sick to my stomach and can’t sleep. At times I do notice the pain after eating. This pain was ongoing for over a yr. before I figured out the source of all my pain and achiness came from( my endo, regular dr., and an urgent care dr. did not suspect metformin they thought it was all in my head) I believe this drug causes fibromyalgia symptoms but the spine pain is the worst! I don’t want to make Metformin sound terrible or sound like Metformin hasn’t helped me at all because it has; without it I get extremly exhausted due to my IR. I just wanted to make people aware of how bad Metformin can make your spine/bones feel. I am not deficient in any vitamins, I do not eat terribly, & I am not over weight. I am 29.. currently this drug makes me feel 99. I’m going to reduce my dosage back down to 1500mg. I would like to get off of Metformin someday and use only ginger, cinnamon, and natural sugar blockers.

    Posted by Mc |
  85. I am convinced Metformin is causing my kidney pain. I had lithotripsy for a kidney stone in 2013. Have had horrible kidney pain on and off since. I assumed it was scar tissue from the surgery. I have had renal scans, a colonoscopy and blood tests and the doctors cannot find out what is causing my pain. Just recently I wondered if it could be caused by the Metformin I take for PCOS. Two days after I stop taking it, the pain goes away. If I start taking it again, the pain comes right back. I have tested it three times now. Always the same thing. I’m going to tell my doctor and stop taking Metformin.

    Posted by pkw1 |
  86. I was just diagnosed 2 days ago, and immediately put on Metformin. A1c of 9.4. I think it is interesting to read that metformin is only supposed to reduce A1c by about 1 to 2%. If that is true, I question why is it even prescribed? I am not super knowledegeable, but it seems to me that 1-2% does nothing for you unless you are barely over the limit anyway- as in around 6-7%. As someone who is 9.4, reducing me to 7.4 still makes me well over the limit. The more I read, the more I feel like diet and exercise work far better.. I welcome thoughts here, cause I am new to this…

    Posted by BJS |

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