Metformin is a well known, reasonably priced, and extensively used drug to assist handle sort 2 diabetes.
It helps decrease blood sugar ranges, improves HbA1c readings (a measure of glucose management over the earlier 2 to three months), and can assist individuals with diabetes shed extra pounds.
However can metformin trigger diarrhea? And in that 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.
Desk of Contents
Metformin for diabetes
Metformin is an oral drug that was permitted by the U.S. Meals and Drug Administration (FDA) for treating sort 2 diabetes in 1994. It is likely 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 USA, and just about all medical insurance plans cowl the drug. It’s normally taken one to 3 instances per day with meals and is really helpful for use together with a healthful weight-reduction plan and bodily exercise.
Metformin is assumed to work by lowering the discharge of glucose from the liver and growing insulin sensitivity within the muscular tissues. Most individuals discover the drug tolerable and straightforward to suit into their life to enhance well being outcomes, however some do expertise unwanted side effects.
Frequent metformin unwanted side effects
Frequent, and normally delicate, unwanted side effects of metformin could embrace:
- Abdomen cramps
- Nausea
- Vomiting
- Diarrhea
- Stomachache
- Suppressed urge for food
- Weight reduction (normally comparatively minor — usually 5 to fifteen kilos most)
- Low blood sugar (in people who find themselves additionally being handled with insulin)
Most unwanted side effects go away inside a couple of weeks of beginning the medication.
Extra info on unwanted side effects could be present in our article: Metformin Facet Results: What You Must Know.
Does metformin trigger diarrhea?
A research out of the American School of Medical Pharmacy discovered that, sure, metformin may cause diarrhea, and it’s really extra widespread than one would suppose. In reality, 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 may additionally be at elevated threat for power diarrhea from metformin use, because of interactions between their several types of medication.
What’s extra, though unwanted side effects corresponding to nausea, vomiting, and diarrhea sometimes fade away after an preliminary adjustment interval, typically, after years of steady metformin remedy, the physique could 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 often brought on 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 problems or unwanted side effects. The diarrhea was painless, however extreme, with no different underlying trigger. On this case as effectively, the diarrhea fully 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 individuals till it’s not.
How lengthy does metformin offer you diarrhea?
In keeping with the journal Diabetes, Weight problems, and Metabolism, lots of the preliminary gastrointestinal unwanted side 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 a couple of weeks.
Nevertheless, not all unwanted side effects could go away, which contributes to the massive proportion of individuals who don’t take the medication as prescribed.
Continual diarrhea could be a kind of unwanted side 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
Consultants don’t particularly advocate avoiding any specific meals whereas taking metformin to forestall diarrhea. That stated, there are specific meals and drinks that may improve the danger of diarrhea usually, so it’s possible 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 can be 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 weight-reduction plan by lowering these potential triggers may assist handle diarrhea signs related to metformin. It’s vital to notice that particular person responses can fluctuate, so you must monitor how your physique reacts to completely different meals and focus on gastrointestinal signs together with your healthcare supplier.
Metformin isn’t the one diabetes-related explanation for diarrhea. It’s vital to work together with your healthcare supplier to rule out different causes of diarrhea earlier than altering your diabetes medicine
Diabetic neuropathy from persistent excessive blood glucose ranges
Diabetic neuropathy that impacts the digestive system is named diabetic enteropathy. This type of nerve harm to the digestive tract can impression not solely the frequency of bowel actions, however the consistency as effectively, typically inflicting diarrhea.
Bacterial overgrowth
Diabetes problems corresponding to gastroparesis can sluggish the motion of meals and drinks via the digestive system, which creates the best atmosphere for micro organism to develop.
This slowing of the digestive system may cause every little thing from constipation to diarrhea. (Converse together with your physician if you happen to suppose you might 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’s because synthetic sweeteners are poorly digested by the gastrointestinal tract. When you embrace synthetic sweeteners as a part of your meal plan, ensure that to make use of them sparingly.
The risks of power diarrhea
Persistent diarrhea can merely trigger a gentle inconvenience, or it might go away an individual fully housebound, unable to train, work, or operate in society.
And past the life-style impression, power diarrhea could be extraordinarily detrimental to well being, too. Some problems 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
- Incapacity to train
- Social isolation
- Embarrassment
- Pores and skin irritation
When you’re experiencing power diarrhea and have any of those well being problems, contact your physician straight away to get assist.
How one can cease metformin diarrhea
Prolonged-release tablets
Research have proven that individuals who develop diarrhea utilizing immediate-release metformin might be able to maintain experiencing the advantages of the medication and discover aid by switching to extended-release metformin tablets.
These variations of the medication are designed to be absorbed slowly all through the digestive system, which suggests 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 cut back the danger 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 normally 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 improve your dose with out the steering of your physician. When you begin to really feel nauseous or expertise diarrhea, contact your physician about reducing your dose till you construct tolerance once more.
You may learn extra about how a lot metformin to absorb our metformin dosage information.
Cease taking metformin for a couple of weeks
Giving your intestine time to heal with a couple of weeks’ break free from the medication can assist cease diarrhea and stop it from coming again. (Make sure to discuss to your physician earlier than you cease taking metformin.)
Research have proven that stopping metformin remedy nearly 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 remedies to handle your diabetes as an alternative.
Learn extra: The Finest Alternate options to Metformin for Kind 2 Diabetes Administration
Treating power diarrhea
Folks experiencing long-term diarrhea ought to search skilled medical consideration, particularly if they’ve diabetes.
In case your signs will not be extreme and also you want to strive treating it at dwelling first, a number of the following remedies could supply momentary aid:
- Ingesting loads of water and getting electrolytes (current in drinks corresponding to Gatorade or coconut water) to forestall dehydration and replenish misplaced salts.
- Taking an over-the-counter bismuth-based product to cease the diarrhea, corresponding to Pepto Bismol.
- Consuming a higher-fiber weight-reduction plan to agency up stools (slowly improve your fiber consumption to keep away from gasoline, bloating, and cramps).
- Taking a each day fiber complement.
- Taking antidiarrheal medicines, corresponding to loperamide (Imodium). (Be certain by no means to take greater than the really helpful dose, as exceeding that has been linked to critical coronary heart problems in some individuals. Additionally observe that loperamide, like many antidiarrheals, isn’t meant for long-term use except cleared by your healthcare supplier.)
Remaining ideas
All the time work together with your diabetes workforce to evaluate the fitting remedy choices in your life-style. With cautious coordination and suggestions out of your care workforce, you could find the fitting strategy for you, lowering your threat of diarrhea from metformin whereas holding your diabetes well-managed.
