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 can assist folks with diabetes drop some pounds.
However can metformin trigger diarrhea? And if that’s the case, what’s the answer? This text will examine this frequent facet impact of metformin, the dangers related to power diarrhea after metformin use, and what to do about it.
Key Factors:
- Diarrhea is the commonest facet impact of metformin. It sometimes goes away inside a number of weeks of beginning remedy.
- Taking the medication with a meal and switching to the extended-release (ER or XR) model of the drug can assist scale back the probabilities of experiencing diarrhea from metformin.
Metformin for diabetes
Metformin is an oral drug that was accredited by the U.S. Meals and Drug Administration (FDA) for treating kind 2 diabetes in 1994. It is likely one of the hottest diabetes medicine on the planet, with physicians writing over 120 million metformin prescriptions yearly worldwide.
Metformin is inexpensive in the USA, and nearly all medical health insurance plans cowl the drug. It’s often taken a couple of times per day with meals and is advisable for use together with a healthful eating regimen and bodily exercise.
Metformin is believed to work by lowering 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 unintended effects.
Frequent metformin unintended effects
Frequent, and often 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 number of weeks of beginning the medication.
Extra data on unintended effects could be present in our article: Metformin Facet Results: What You Must Know.
Does metformin trigger diarrhea?
A examine out of the American Faculty of Scientific Pharmacy discovered that, sure, metformin could cause diarrhea, and it’s truly extra frequent than one would suppose. In truth, diarrhea is the commonest facet impact of metformin, with roughly 53% of people that take the medication experiencing this problem.
Those that are taking a number of medicines may be at elevated danger for power diarrhea from metformin use, attributable to interactions between their several types of medicine.
What’s extra, though unintended effects akin to nausea, vomiting, and diarrhea sometimes fade away after an preliminary adjustment interval, generally, after years of secure metformin remedy, 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, stomach cramping, and explosive, watery diarrhea that often induced 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 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 unintended effects. The diarrhea was painless, however extreme, with no different underlying trigger. On this case as nicely, 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 offer you 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 number of weeks.
Nonetheless, not all unintended effects could go away, which contributes to the big share of people that don’t take the medication as prescribed.
Power diarrhea could be a type of unintended 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 specific meals whereas taking metformin to stop diarrhea. That mentioned, there are particular meals and drinks that may enhance the chance of diarrhea generally, so you could wish to scale 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 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
These adjustments may assist handle diarrhea signs whereas taking metformin.
Different diabetes-related causes of diarrhea
Metformin isn’t the one diabetes-related reason behind diarrhea. It’s vital 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 known as diabetic enteropathy. This type of nerve harm to the digestive tract can impression not solely the frequency of bowel actions, however the consistency as nicely, typically inflicting diarrhea.
Bacterial overgrowth
Diabetes issues akin to gastroparesis can gradual the motion of meals and drinks by means of the digestive system, which creates the best atmosphere for micro organism to develop.
This slowing of the digestive system could cause all the things from constipation to diarrhea. (Communicate along with your physician when you 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 probably wreak havoc on the digestive system, typically inflicting diarrhea.
It’s because synthetic sweeteners are poorly digested by the gastrointestinal tract. When you embody synthetic sweeteners as a part of your meal plan, make certain to make use of them sparingly.
The risks of power diarrhea
Persistent diarrhea can merely trigger a light inconvenience, or it will probably depart an individual utterly housebound, unable to train, work, or perform in society.
And past the life-style impression, power diarrhea could be extraordinarily detrimental to well being, too. Some issues of power diarrhea embody:
- Malnutrition/malabsorption of vitamins
- Dehydration
- Extreme thirst
- 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 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 might be able to hold 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 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 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 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. When you begin to really feel nauseous or expertise diarrhea, contact your physician about reducing your dose till you construct tolerance once more.
You’ll be able to learn extra about how a lot metformin to absorb our metformin dosage information.
Cease taking metformin for a number of weeks
Giving your intestine time to heal with a number of weeks’ break free from the medication can assist cease diarrhea and stop it from coming again. (Make sure to speak 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, speak to your physician about stopping metformin and making an attempt alternate remedies to handle your diabetes as an alternative.
Learn extra: The Greatest Options to Metformin for Kind 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 attempt treating it at dwelling first, a few of the following remedies could provide non permanent reduction:
- Ingesting loads of water and getting electrolytes (current in drinks akin to Gatorade or coconut water) to stop dehydration and replenish misplaced salts.
- Taking an over-the-counter bismuth-based product to cease the diarrhea, akin to 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 day by day fiber complement.
- Taking antidiarrheal drugs, akin to loperamide (Imodium). (Be certain by no means to take greater than the advisable dose, as exceeding that has been linked to critical coronary heart issues in some folks.)
Ultimate ideas
All the time work along with your diabetes crew to evaluate the correct remedy choices in your life-style. With cautious coordination and suggestions out of your care crew, you could find the correct strategy for you, lowering your danger of diarrhea from metformin whereas maintaining your diabetes well-managed.
