Metformin is a well known, inexpensive, 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 may help individuals with diabetes drop some weight.
However can metformin trigger diarrhea? And if that’s the case, what’s the answer? This text will research this frequent facet impact of metformin, the dangers related to persistent diarrhea after metformin use, and what to do about it.
Key Factors:
- Diarrhea is the most typical facet impact of metformin. It usually goes away inside a couple of weeks of beginning remedy.
- Taking the medication with a meal and switching to the extended-release (ER or XR) model of the drug may help cut back the probabilities of experiencing diarrhea from metformin.
Metformin for diabetes
Metformin is an oral drug that was permitted 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 inexpensive in the US, and just about all medical health insurance plans cowl the drug. It’s normally taken a few times per day with meals and is beneficial for use together with a healthful weight loss plan 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 life to enhance well being outcomes, however some do expertise unintended effects.
Widespread metformin unintended effects
Widespread, and normally gentle, unintended effects of metformin could embody:
- Abdomen cramps
- Nausea
- Vomiting
- Diarrhea
- Stomachache
- Suppressed urge for food
- Weight reduction
- Low blood sugar (in people who find themselves additionally being handled with insulin)
Most unintended effects go away inside a couple of weeks of beginning the medication.
Extra data on unintended effects might be present in our article: Metformin Aspect Results: What You Must Know.
Does metformin trigger diarrhea?
A research out of the American School of Medical Pharmacy discovered that, sure, metformin could cause diarrhea, and it’s really extra frequent than one would suppose. In actual fact, diarrhea is the most typical facet impact of metformin, with roughly 53% of people that take the medication experiencing this subject.
Those that are taking a number of medicines may additionally be at elevated threat for persistent diarrhea from metformin use, because of interactions between their various kinds of medicine.
What’s extra, though unintended effects equivalent to nausea, vomiting, and diarrhea usually 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 sometimes triggered incontinence,” after a number of years of constant metformin remedy. The affected 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, persistent 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 individuals till it’s not.
How lengthy does metformin provide you with diarrhea?
Based on the journal Diabetes, Weight problems, and Metabolism, most of the preliminary gastrointestinal unintended effects that folks 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 unintended effects could go away, which contributes to the big proportion of people that don’t take the medication as prescribed.
Continual diarrhea might be a type 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
Consultants don’t particularly advocate avoiding any explicit meals whereas taking metformin to forestall diarrhea. That stated, there are particular meals and drinks that may enhance the chance of diarrhea typically, so it’s possible you’ll need to cut back your consumption of them if you’re experiencing diarrhea with metformin. These embody:
- Sugar
- Synthetic sweeteners
- Dairy merchandise
- Garlic, onions, and different meals excessive in FODMAPs (sure sugars which are poorly absorbed and will 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
These modifications may assist handle diarrhea signs whereas taking metformin.
Different diabetes-related causes of diarrhea
Metformin isn’t the one diabetes-related reason for diarrhea. It’s necessary 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 injury to the digestive tract can impression not solely the frequency of bowel actions, however the consistency as properly, typically inflicting diarrhea.
Bacterial overgrowth
Diabetes issues equivalent to gastroparesis can gradual the motion of meals and drinks by way of the digestive system, which creates the perfect atmosphere for micro organism to develop.
This slowing of the digestive system could cause every thing from constipation to diarrhea. (Converse together 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 will doubtlessly wreak havoc on the digestive system, typically inflicting diarrhea.
It is because synthetic sweeteners are poorly digested by the gastrointestinal tract. In case you embody synthetic sweeteners as a part of your meal plan, make sure that to make use of them sparingly.
The risks of persistent diarrhea
Persistent diarrhea can merely trigger a gentle inconvenience, or it might probably depart an individual utterly housebound, unable to train, work, or operate in society.
And past the approach to life impression, persistent diarrhea might be extraordinarily detrimental to well being, too. Some issues of persistent diarrhea embody:
- Malnutrition/malabsorption of vitamins
- Dehydration
- Extreme thirst
- Extreme weight reduction
- Fatigue
- Dizziness
- Lethargy
- Darkish urine
- Low blood sugar
- Lack of ability to train
- Social isolation
- Embarrassment
- Pores and skin irritation
In case you’re experiencing persistent diarrhea and have any of those well being issues, contact your physician immediately to get assist.
The best way 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 implies 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 cut 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 medication 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 enhance your dose with out the steerage of your physician. In case you begin to really feel nauseous or expertise diarrhea, contact your physician about reducing your dose till you construct tolerance once more.
You possibly can learn extra about how a lot metformin to soak up 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 may help cease diarrhea and stop it from coming again. (Remember to discuss to your physician earlier than you cease taking metformin.)
Research have proven that stopping metformin remedy virtually instantly alleviates late-onset, persistent 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 making an attempt alternate therapies to handle your diabetes as an alternative.
Learn extra: The Greatest Alternate options to Metformin for Type 2 Diabetes Administration
Treating persistent diarrhea
Individuals 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 attempt treating it at house first, a few of the following therapies could supply momentary aid:
- Ingesting loads of water and getting electrolytes (current in drinks equivalent to Gatorade or coconut water) to forestall dehydration and replenish misplaced salts.
- Taking an over-the-counter bismuth-based product to cease the diarrhea, equivalent to Pepto Bismol.
- Consuming a higher-fiber weight loss plan to agency up stools (slowly enhance your fiber consumption to keep away from gasoline, bloating, and cramps).
- Taking a each day fiber complement.
- Taking antidiarrheal drugs, equivalent to loperamide (Imodium). (Make sure by no means to take greater than the beneficial dose, as exceeding that has been linked to severe coronary heart issues in some individuals.)
Remaining ideas
At all times work together with your diabetes group to evaluate the correct remedy choices to your life-style. With cautious coordination and suggestions out of your care group, you will discover the correct method for you, decreasing your threat of diarrhea from metformin whereas preserving your diabetes well-managed.
