Metformin is a widely known, reasonably priced, and broadly used drug to assist handle kind 2 diabetes.
It helps decrease blood sugar ranges, improves HbA1c readings (a measure of glucose management over the earlier 2 to three months), and might help folks with diabetes reduce weight.
However can metformin trigger diarrhea? And if that’s the case, what’s the answer? This text will research this widespread aspect impact of metformin, the dangers related to power diarrhea after metformin use, and what to do about it.
Metformin for diabetes
Metformin is an oral drug that was authorized by the U.S. Meals and Drug Administration (FDA) for treating kind 2 diabetes in 1994. It is without doubt one of the hottest diabetes medication on the planet, with physicians writing over 120 million metformin prescriptions yearly worldwide.
Metformin is reasonably priced in the US, and nearly all medical health insurance plans cowl the drug. It’s often taken one to a few instances per day with meals and is really useful for use together with a healthful eating regimen and bodily exercise.
Metformin is believed to work by reducing the discharge of glucose from the liver and rising insulin sensitivity within the muscle tissue. Most individuals discover the drug tolerable and simple to suit into their existence to enhance well being outcomes, however some do expertise unintended effects.
Frequent metformin unintended effects
Frequent, and often gentle, unintended effects of metformin might embrace:
- Abdomen cramps
- Nausea
- Vomiting
- Diarrhea
- Stomachache
- Suppressed urge for food
- Weight reduction (often comparatively minor — usually 5 to fifteen kilos most)
- Low blood sugar (in people who find themselves additionally being handled with insulin)
Most unintended effects go away inside just a few weeks of beginning the medication.
Extra data on unintended effects may be present in our article: Metformin Facet Results: What You Have to Know.
Does metformin trigger diarrhea?
A research out of the American School of Scientific Pharmacy discovered that, sure, metformin could cause diarrhea, and it’s truly extra widespread than one would suppose. Actually, diarrhea is the commonest aspect impact of metformin, with roughly 53 % of people that take the medication experiencing this problem.
Those that are taking a number of medicines can also be at elevated danger for power diarrhea from metformin use, as a result of interactions between their several types of medication.
What’s extra, though unintended effects resembling nausea, vomiting, and diarrhea usually fade away after an preliminary adjustment interval, generally, after years of steady metformin remedy, the physique might begin to reply negatively to the medication as soon as once more.
In a single case, a research topic began producing what the researchers describe as, “nausea, stomach cramping, and explosive, watery diarrhea that sometimes triggered incontinence,” after a number of years of constant metformin remedy. The person’s gastrointestinal signs went away as soon as remedy was stopped.
One other research, within the Journal of Endocrinology and Metabolism, discovered that late-onset, power diarrhea occurred in somebody who had been taking metformin for over 5 years, with no earlier issues or unintended effects. The diarrhea was painless, however extreme, with no different underlying trigger. On this case as properly, the diarrhea utterly went away after the metformin remedy was stopped.
In each of those instances, the precise set off of the sudden diarrhea was unknown; metformin appears to be well-tolerated in some folks till it’s not.
How lengthy does metformin provide you with diarrhea?
In response to the journal Diabetes, Weight problems, and Metabolism, most of the preliminary gastrointestinal unintended effects that individuals taking metformin expertise can seem instantly after the primary dose, with most going away after the physique adjusts to the medication inside just a few weeks.
Nevertheless, not all unintended effects might go away, which contributes to the big share of people that don’t take the medication as prescribed.
Persistent diarrhea may be a kind of unintended effects — at finest pesky, and, at worst harmful — that won’t go away whereas somebody is on a metformin routine.
Meals that trigger diarrhea with metformin
Specialists don’t particularly advocate avoiding any explicit meals whereas taking metformin to forestall diarrhea. That mentioned, there are specific meals and drinks that may enhance the chance of diarrhea generally, so chances are you’ll wish to scale back your consumption of them in case you are experiencing diarrhea with metformin. These embrace:
- Sugar and refined carbohydrates
- Synthetic sweeteners
- Dairy merchandise
- Garlic, onions, and different meals excessive in FODMAPs (sure sugars which are poorly absorbed and should trigger intestinal misery)
- Fructose (a pure sugar present in fruit)
- Gluten (a protein present in wheat, rye, barley, and their hybrids)
- Fried or fatty meals
- Spicy meals
- Alcohol
- Caffeine
Adjusting your eating regimen by decreasing these potential triggers would possibly assist handle diarrhea signs related to metformin. It’s necessary to notice that particular person responses can range, so you need to monitor how your physique reacts to completely different meals and talk about gastrointestinal signs along with your healthcare supplier.
Metformin isn’t the one diabetes-related explanation for diarrhea. It’s necessary to work along with your healthcare supplier to rule out different causes of diarrhea earlier than altering your diabetes remedy
Diabetic neuropathy from persistent excessive blood glucose ranges
Diabetic neuropathy that impacts the digestive system known as diabetic enteropathy. This type of nerve injury to the digestive tract can influence not solely the frequency of bowel actions, however the consistency as properly, typically inflicting diarrhea.
Bacterial overgrowth
Diabetes issues resembling gastroparesis can gradual the motion of meals and drinks by means of the digestive system, which creates the perfect setting for micro organism to develop.
This slowing of the digestive system could cause every part from constipation to diarrhea. (Communicate along with your physician if you happen to suppose you could have gastroparesis.)
Extreme use of synthetic sweeteners
Synthetic sweeteners could make having fun with sweeter treats simpler in your blood sugar ranges, however they’ll probably wreak havoc on the digestive system, typically inflicting diarrhea.
It is because synthetic sweeteners are poorly digested by the gastrointestinal tract. When you embrace synthetic sweeteners as a part of your meal plan, be sure to make use of them sparingly.
The hazards of power diarrhea
Persistent diarrhea can merely trigger a gentle inconvenience, or it might go away an individual utterly housebound, unable to train, work, or perform in society.
And past the life-style influence, power diarrhea may be extraordinarily detrimental to well being, too. Some issues of power diarrhea embrace:
- Malnutrition/malabsorption of vitamins (e.g., vitamin B12 deficiency)
- Dehydration
- Extreme thirst
- Electrolyte imbalance
- Extreme weight reduction
- Fatigue
- Dizziness
- Lethargy
- Darkish urine
- Low blood sugar
- Lack of ability to train
- Social isolation
- Embarrassment
- Pores and skin irritation
When you’re experiencing power diarrhea and have any of those well being issues, contact your physician immediately to get assist.
Find out how to cease metformin diarrhea
Prolonged-release tablets
Research have proven that individuals who develop diarrhea utilizing immediate-release metformin could possibly maintain experiencing the advantages of the medication and discover reduction by switching to extended-release metformin tablets.
These variations of the medication are designed to be absorbed slowly all through the digestive system, which implies there’s much less of the drug in anyone place at a time, making it gentler on the abdomen.
Take your metformin with meals
Taking metformin with meals has been proven to scale back the chance of diarrhea. Attempt to take it with a higher-protein meal or snack, and by no means take metformin on an empty abdomen. The drugs is often higher tolerated within the night, so taking it with dinner is finest.
By no means take extra metformin than is prescribed
Begin your metformin on a low dose, and don’t enhance your dose with out the steering of your physician. When you begin to really feel nauseous or expertise diarrhea, contact your physician about decreasing your dose till you construct tolerance once more.
You may learn extra about how a lot metformin to soak up our metformin dosage information.
Cease taking metformin for just a few weeks
Giving your intestine time to heal with just a few weeks’ break free from the medication might help cease diarrhea and stop it from coming again. (Make sure you discuss to your physician earlier than you cease taking metformin.)
Research have proven that stopping metformin remedy virtually instantly alleviates late-onset, power diarrhea.
Look into alternate remedy choices
If not one of the beforehand talked about methods assist alleviate your diarrhea, and it’s negatively affecting your high quality of life, discuss to your physician about stopping metformin and attempting alternate therapies to handle your diabetes as a substitute.
Learn extra: The Greatest Options to Metformin for Sort 2 Diabetes Administration
Treating power diarrhea
Individuals experiencing long-term diarrhea ought to search skilled medical consideration, particularly if they’ve diabetes.
In case your signs aren’t extreme and also you want to strive treating it at house first, a number of the following therapies might supply non permanent reduction:
- Consuming loads of water and getting electrolytes (current in drinks resembling Gatorade or coconut water) to forestall dehydration and replenish misplaced salts.
- Taking an over-the-counter bismuth-based product to cease the diarrhea, resembling Pepto Bismol.
- Consuming a higher-fiber eating regimen to agency up stools (slowly enhance your fiber consumption to keep away from fuel, bloating, and cramps).
- Taking a each day fiber complement.
- Taking antidiarrheal drugs, resembling loperamide (Imodium). (Make certain by no means to take greater than the really useful dose, as exceeding that has been linked to critical coronary heart issues in some folks. Additionally be aware that loperamide, like many antidiarrheals, just isn’t meant for long-term use except cleared by your healthcare supplier.)
Ultimate ideas
All the time work along with your diabetes workforce to evaluate the suitable remedy choices in your life-style. With cautious coordination and suggestions out of your care workforce, you will discover the suitable method for you, decreasing your danger of diarrhea from metformin whereas protecting your diabetes well-managed.
