Metformin is a widely known, reasonably priced, and extensively 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 will help folks with diabetes reduce weight.
However can metformin trigger diarrhea? And in that case, what’s the answer? This text will examine this frequent 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 authorised by the U.S. Meals and Drug Administration (FDA) for treating kind 2 diabetes in 1994. It is among the hottest diabetes medicine on the planet, with physicians writing over 120 million metformin prescriptions yearly worldwide.
Metformin is reasonably priced in the USA, and nearly all medical health insurance plans cowl the drug. It’s often taken one to 3 instances per day with meals and is advisable for use together with a healthful weight loss program and bodily exercise.
Metformin is believed to work by reducing the discharge of glucose from the liver and rising insulin sensitivity within the muscular tissues. Most individuals discover the drug tolerable and simple to suit into their life to enhance well being outcomes, however some do expertise unwanted side effects.
Frequent metformin unwanted side effects
Frequent, and often gentle, unwanted side effects of metformin could embody:
- Abdomen cramps
- Nausea
- Vomiting
- Diarrhea
- Stomachache
- Suppressed urge for food
- Weight reduction (often comparatively minor — typically 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 might be present in our article: Metformin Facet Results: What You Must Know.
Does metformin trigger diarrhea?
A examine out of the American School of Medical Pharmacy discovered that, sure, metformin may cause diarrhea, and it’s truly extra frequent than one would suppose. In actual fact, diarrhea is the most typical aspect impact of metformin, with roughly 53 p.c of people that take the medication experiencing this challenge.
Those that are taking a number of medicines might also be at elevated threat for power diarrhea from metformin use, resulting from interactions between their several types of medicine.
What’s extra, though unwanted side effects similar to nausea, vomiting, and diarrhea sometimes fade away after an preliminary adjustment interval, generally, after years of steady metformin therapy, the physique could begin to reply negatively to the medication as soon as once more.
In a single case, a examine topic began producing what the researchers describe as, “nausea, belly cramping, and explosive, watery diarrhea that often brought on incontinence,” after a number of years of constant metformin therapy. The person’s gastrointestinal signs went away as soon as therapy was stopped.
One other examine, 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 unwanted side 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 therapy 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 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.
Nonetheless, not all unwanted side effects could go away, which contributes to the big proportion of individuals who don’t take the medication as prescribed.
Continual diarrhea might be a kind of unwanted side effects — at greatest pesky, and, at worst harmful — that will not go away whereas somebody is on a metformin routine.
Meals that trigger diarrhea with metformin
Specialists don’t particularly suggest avoiding any explicit meals whereas taking metformin to forestall diarrhea. That mentioned, there are specific meals and drinks that may enhance the danger of diarrhea generally, so you might wish to cut back your consumption of them in case you are experiencing diarrhea with metformin. These embody:
- 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 loss program by decreasing these potential triggers may 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 totally different meals and talk about gastrointestinal signs along with your healthcare supplier.
Metformin isn’t the one diabetes-related reason 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 is named diabetic enteropathy. This type of nerve injury to the digestive tract can affect not solely the frequency of bowel actions, however the consistency as properly, typically inflicting diarrhea.
Bacterial overgrowth
Diabetes issues similar to gastroparesis can gradual the motion of meals and drinks by the digestive system, which creates the best atmosphere for micro organism to develop.
This slowing of the digestive system may cause all the things from constipation to diarrhea. (Converse along with your physician in the event you suppose you will 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 doubtlessly wreak havoc on the digestive system, typically inflicting diarrhea.
It is because synthetic sweeteners are poorly digested by the gastrointestinal tract. If you happen to embody 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 light inconvenience, or it could possibly depart an individual utterly housebound, unable to train, work, or perform in society.
And past the approach to life affect, power diarrhea might be extraordinarily detrimental to well being, too. Some issues of power diarrhea embody:
- 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
If you happen to’re experiencing power diarrhea and have any of those well being issues, contact your physician straight away to get assist.
Methods 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 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 anybody 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 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 medication is often higher tolerated within the night, so taking it with dinner is greatest.
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. If you happen to 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 will help cease diarrhea and forestall it from coming again. (You should definitely discuss to your physician earlier than you cease taking metformin.)
Research have proven that stopping metformin therapy virtually instantly alleviates late-onset, power diarrhea.
Look into alternate therapy 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 making an attempt alternate therapies to handle your diabetes as an alternative.
Learn extra: The Finest Options to Metformin for Sort 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 are usually not extreme and also you want to attempt treating it at dwelling first, a few of the following therapies could supply non permanent aid:
- Consuming loads of water and getting electrolytes (current in drinks similar to Gatorade or coconut water) to forestall dehydration and replenish misplaced salts.
- Taking an over-the-counter bismuth-based product to cease the diarrhea, similar to Pepto Bismol.
- Consuming a higher-fiber weight loss program to agency up stools (slowly enhance your fiber consumption to keep away from gasoline, bloating, and cramps).
- Taking a every day fiber complement.
- Taking antidiarrheal drugs, similar to loperamide (Imodium). (Make sure by no means to take greater than the advisable dose, as exceeding that has been linked to severe coronary heart issues in some folks. Additionally notice that loperamide, like many antidiarrheals, is just not supposed for long-term use except cleared by your healthcare supplier.)
Ultimate ideas
At all times work along with your diabetes crew to evaluate the correct therapy choices on your way of life. With cautious coordination and suggestions out of your care crew, you’ll find the correct method for you, decreasing your threat of diarrhea from metformin whereas preserving your diabetes well-managed.