The good, the bad and the ugly of metformin

By Dan360 Latest Reply 2018-09-19 07:37:12 -0500
Started 2015-09-17 15:35:33 -0500

I have been taking metformin sense the day I was first diagnosed with type 2 diabetes. As you probably know, it is the first-line drug of choice for the treatment of type 2 diabetes and I doubt that there are many of you that do not take metformin. Metformin works by suppressing glucose production by the liver. Evidence suggests metformin may prevent the cardiovascular and possibly the cancer complications of diabetes. It helps reduce LDL cholesterol and triglyceride levels and is not associated with weight gain; in some people, it promotes weight loss. Metformin is one of only two oral antidiabetics in the World Health Organization Model List of Essential Medicines.
One of my first experiences with diabetes was finding that when I worked out my glucose level would actually increase. That was very frustrating sense I was working out to lower levels of glucose. When I told my doctor she put me on a heavier dose of metformin, 1000 mg twice a day. As with most drugs the treatment of one problem often causes another. There is a whole list of side effects associated with metformin: abdominal or stomach discomfort, cough or hoarseness, decreased appetite, diarrhea, fast or shallow breathing, fever or chills, general feeling of discomfort, lower back or side pain, muscle pain or cramping and painful or difficult urination. Other problems metformin may cause which will usually diminish over time is: Acid or sour stomach, belching, bloated, excess air or gas in the stomach or intestines, full feeling, heartburn, indigestion, loss of appetite, metallic taste in the mouth, passing of gas, stomachache, stomach upset or pain and vomiting. I hope this isn’t too much information!
My latest experience with metformin was excess air or gas in the stomach. I experienced what seem to be a swelling in my throat followed by belching or burping. I cut my dose of metformin in half and the problem went away. Have any of you experienced discomforts with metformin?

54 replies

sbritner 2018-09-19 07:37:12 -0500 Report

I was on insulin and then Metformin. I developed an allergy to the Metformin. It shut my kidneys down. As a result I went into cardiac arrest. LuckilyI was already in the ER. They revived me and put me on dialysis for 24 hours. Also a medically induced coma for a few days. Every medical record I have now says …Allergic to Metformin. I would advise anyone to be careful of this drug.

Jack Chase
Jack Chase 2018-07-30 13:41:07 -0500 Report

I experienced some side effects, at the beginning, that calmed down. My sugars were still crazy. We increased my Metformin: 250 twice a day to 500 twice a day. Now I sweat with the exertion of walking in the house. The whole back of my head and that hair and running down my body and face. Eorse than the sweat is the horrible odor of all my bodily fluids and products. I just started seeing a hand therapist. The tape absorbed the smell. The splint stinks. I STINK! Soap and shsmpoo and deodorant are not the answer. The deodorant/antiperspirant works. I need to call my doctor ASAP and ask for something else. I called the pharmacist and asked about the immediate release and side effects and had he seen patients change to ER and find relief. He said that was not his experience. I cannot handle the smell. Does anyone here have any ideas? I would rather take injections of insulin that stink to high heaven. My grand dogs smelled me all over. That's a little embarrassing. I have almost no sense of smell, so when I notice it, it must be bad.

Jaszzmme 2018-07-21 18:36:27 -0500 Report

After reading some of your posts and being a type 2 diabetic myself and taking Metformin, I am starting to believe that Metformin actually makes you worse. A1C's rising. I exercise 4 to 5 times a week now. I've dropped in weight from 315 lbs down to 280lbs since last November and I've cut back on sugars and carbs while taking at first 500MG's once a day to 1000MG's twice a day with my A1C increasing. That shouldn't be right. My symptoms were diarrhea, constipation, hips, and joints hurting, night sweats. I know this is a no-no, but I quit taking my Metformin and my joints don't hurt anymore, I sleep better, My workouts are better. Plus my doctor wanted me to take an extra pill on top of the Metformin with all sorts of side effects. I refused. That's how it starts! That's how the pharmaceutical companies get you. Starts with one pill, and then they add another, then put you on pills to combat the side effects. I figure, if I'm going to die, it won't be from meds.

Anonymous 2018-07-03 16:06:22 -0500 Report

I've been on Metformin15 years. I've suffered from hips hurting, right and left flank pain, lower back, diharrea, belly bloat, joints achy all the time. I can't take the metformin in the morning because I'm a teacher and can't go to bathroom ever 5 minutes. I hate metformin. It has been a thorn in my side. I've asked for Endo to change but she keeps saying it works. I was originally on Glucophase and not as many side effects but insurance won't pay for it and they think they are the same. Not sure. I also feel after 13 years maybe it's just not working. I say metformin is the worst of many other ones. JS

Anonymous 2018-06-02 11:39:32 -0500 Report

Hi I’m new here. Have had diabetes type 2 for many years. Was taking 500 mg Er twice a day. Am and Pm. Numbers were always good.
All of a sudden they are going up into the 200’s. Can’t understand why.
Dr put me on 1000ER twice a day. I have experienced nausea, diarrhea, lite headedness, extremely tired. Just an all over sick feeling

Drwho123 2018-04-20 06:12:07 -0500 Report

Hi, I'm new here.
I just got out of the hospital, where they put me back on Metformin after being off of it for at least 2 years. First let me say I'm not real sure of the definitions. I call type 1 if you need to inject insulin every day. Type 2 is if you can get away with pills only, and PRE-diabetic would be if you just need to watch what you eat, better than I do.
I went into the hospital for Pneumonia, aggravated COPD, and Afib, They said my A1c was up to 8.5, I think. So right now I'm also on Prednisone which raises the BS. I don't remember any side affects from being on Metformin before, but had stopped taking any prescriptions after my mother got sick with cancer. All thoughts of MY health went out the window.
I have not been having the side affects you people are talking about, except maybe some gas maybe it's just too soon for me. Or maybe they got the dosage right. I'm hoping that I can lose some weight and get off everything. I keep seeing, eating this or that will kill diabetes. Is there any truth to any of it? I am a fan of alternative medicine, or holistic medicines if you prefer. and feel we need healthcare reform in this country SOOO BAD. I got out of the hospital, and went to pick up the RX meds they want me to take, and it was OVER $800.00. Where do these damned drug companies get the nerve. Only two of the scripts were really bad, and OVER $800.00 gimme a break. And don't give me "research and development" for an excuse, if they can look into brainless jellyfish for something that is good for the human brain, for supplements mind you.
Pardon my rant.

Herickson24 2018-01-06 09:25:03 -0600 Report

I was put on Metformin after one blood test showed 5.6 as my A1C. My blood sugar is 115-130. I have a lot of side-effects that decrease quality of life and make getting physically active hard. Aren't you supposed to have more than one bad test to be treated? How bad would it be to quit? I tested 104 this morning, for goodness sake!

malyons76 2018-03-18 23:33:04 -0500 Report

I was also started on Metformin after my first A1C that was 5.7. All other bloodwork, including fasting glucose (84) and everything else all normal. I am about 100 lbs. overweight, and i can honestly say, I've eaten poorly, especially over the past year, and did very little in the way of exercise, other than walking to and from here and there and at work. I was told i didn't need to check my glucose levels, just start the meds, exercise, and start a low carb diet. This was almost 2 weeks ago. So far, I've been walking every day, except yesterday, because my stomach cramps were so bad, after adding the second dose of Met. (started on 500 and instructed to gradually increase to 2000 mg.) i will not be taking more than 500 mg, cause i can't do much to help myself if i can't even eat, much less exercise, because if the cramping!!! i did check my glucose twice last week, in the afternoon, readings were 103 & 106. And I've lost 4 lbs. as of last Tuesday

govna 2017-10-13 13:00:44 -0500 Report

Let me tell you about my awful 3 year journey with metformin! I dealt with all the horrible side affects for a few years Mostly massive pain and intestinal bloating all that goes with it to the point of doctors taking out my gall bladder then on to a colonoscopy and endoscopy and then on to a stress test! All was "just fine" Finally doc said take me off the metformin since a small percentage of people cannot tolerate metformin. Well low and behold I was one of them! After about two weeks most all of the hellish discomfort disappeared! I now take 50 units of toujeo every morning feel great and found a new lease on life energy wise! I am back baby!!!! It is just a shame looking back on how long I suffered needlessly. Not to mention the metformin wasn't even bringing my sugar down anyhow. All it did was make me extremely sick!!!

Marine1970 2017-09-17 05:08:52 -0500 Report

I have not had a real problem with metformin. When the doctor first prescribed it for me, we started off with a low dosage of 500 mg, then gradually increased it to 2000 mg per day. As I took more of the medicine, I did have the upset stomach problem. I am not a serious case of diabetes, so I started adjusting my medication until I reached a level that I could tolerate with out getting diarrhea. Turns out I can tolerate 500 mg per day and that is sufficient to keep my glucose blood count in check. I even reached the point where the doctor told me I could stop taking the medicine, but after doing so my glucose count started to rise again so I went back to 500 mg per day. I have not experience any of the other symptoms that have been discussed. Maybe my body is different or I am just lucky, either way metformin is working for me with no problems. Good luck to the rest of you.

Anonymous 2017-07-26 14:52:31 -0500 Report

My husband started taking 500 mg of Metformin once a day for two weeks. After his doctor's appointment, for some reason the doctor told him to take two a day. When he started taking two 500 mg of Metformin, he started feeling light headed, nausea, and needed to puke. He also became very irritant easily and even got mad over the smallest thing, breaking some dishes. He decided to go back to taking one a day and now he feels better. He's planning to get off of it completely since his sugar level is basically back to normal. He notices that it decreases when he exercises and eats healthier. Hopefully we get him off it completely soon.

TMac68 2017-04-13 04:24:06 -0500 Report

Maybe I have an answer as to why my husband, best friend and father of my 2 daughters is no longer of this earth and passed away very suddenly at age 50 at hone, in my arms. He was taken off of Metforman just months prior to his passing. The daily vomiting *which would come on so quickly that he couldn't even stand, let alone get to the bathroom to vomit, the incredible stomach pain and nausea etc…left him dehydrated and very week. In tge 1 &1/2 yrs he was on Metforman, he went from a healthy, middle aged man to what felt to him and appeared to everyone literally a 70 to 80 yr old man. He complained about the side effects constantly but his complaints were dismissed He was (3-4mths before his passing away), switched to a different medication. This new information about Metforman is extremely disturbing.

Wringer 2015-11-18 22:56:21 -0600 Report

Yes thanks for info. i feel like a dull stomach ache all the time. dont know about the guys, but my breast hurt.

JoleneAL 2015-10-12 13:15:07 -0500 Report

Thank you for this. I am considering asking to be taken off metformin, as I believe it is the cause of my high blood pressure. Because of a pharmacy screw up, I'm out of metformin for a few days, so am relying on my insulin and watching what I eat. I did take my HBP meds and now my BP is low. The only difference is no metformin today. I'm my 11th year as a diabetic and am wondering if maybe I don't need it anymore. My BS levels are in the 90s today, so clearly, the metformin wasn't doing any thing for me. (sigh) And of course I have an over-worked doctor that doesn't want to spend any time with me.

urquidi2015 2015-09-23 15:20:32 -0500 Report

The only side effects has been … gas. Usually in the morning.
When I workout at times, my numbers do go up. These are the only two things I've noticed.
I would like to stay on one metformin of 500mg, but my thyroid doctor decided two per day was better.
I have not noticed any changes since the increase of metformin.

KarmannGhiaChristy 2015-09-22 01:13:48 -0500 Report

I'm on Metformin 500mg 2x a day for the last 6 weeks - the only side effect I have noticed is a sort of charlie horse feeling in my lower legs (front and back of calf), usually just in the morning. I've had a few charlie horses in the middle of the night, not bad ones, but hardly ever had them before this medication.

Dan360 2015-09-23 11:16:16 -0500 Report

Since I wrote my article I decided to go completely off metformin just to see what effects it would have. I have been taking metformin for about 10 years and during a 10 year period I suppose just about everyone will see changes in there body that they do not know where they came from. I developed a case of dry mouth and have to use biotene every night before going to bed. In addition to digestive track irritation I also developed difficult urination. I never expected these condition to be caused by metformin but apparently they were because sense going off it these effects have disappeared. I haven't had any difficulty with charlie horses but it just goes to show that every-bodies body is different.

I haven't seen any problems since going off it and so the question I have is do I really want to go back on it. I have a doctor's appointment in a week and I will see what she thinks. Thanks for sharing. Dan

KarmannGhiaChristy 2015-09-24 01:33:39 -0500 Report

Hi Dan. Since going off Metformin, have you noticed any difference in your daily testing, as in numbers going up? My experience so far is, the food has much more to do with my numbers than the meds, but I've only been on it for 6 1/2 weeks. I really hate taking meds, but I figured I would go along with the doctor's plan until I had more knowledge. I'm only planning to take it short term, maybe 6 months - but maybe I'm delusional?

Dan360 2015-09-24 14:04:05 -0500 Report

My experience is much the same as yours in that food intake and exercise has much more to do with glucose readings than the meds. I take insulin and have not had to increase my dosage since going off metformin. My glucose readings have also remained pretty much the same as they were before going of metformin. I think metformin has been the accepted drug of choice for type 2 for so long that people (doctors) have learned to not question its effectiveness.

The primary function of metformin is to block the livers release of glucose. Glucagon from the pancreas usual controls that. This is one half the control mechanism for maintaining a constant glucose level. The other half is the release of insulin by the pancreas. I see the function of metformin as a way of blocking one half of the body's normal function in the effort to control glucose. For type 2, the body has lost the ability to control the positive swings of glucose but not the negative swings. Why interfere with the part that is working.Find another way which for me is to take insulin.

Sounds like you have gestational diabetes. I wish you the best and hope it is not type 2.

KarmannGhiaChristy 2015-09-25 00:32:30 -0500 Report

I am sure of one thing - I do NOT have gestational diabetes, not at my age LOL!

That was a very good explanation of how the body works, and how the Metformin works. That is very helpful, thank you.

I am hoping to get my numbers into normal range, and be able to maintain it through diet. If I can get a couple of good A1c scores, my goal is to quit taking the Metformin (crossing fingers!)

Dan360 2015-09-25 07:23:15 -0500 Report

I should have not assumed. The reason I made such a judgement was because you said you started treatment 6-1/2 weeks ago and hoped it would not last very long.

What I know about diabetes has been obtained from on-line info and my own personal experience. My info is subject to error because my experience and knowledge is limited. I am very interested in what my doctor has to say about me going off metformin. If she is against it and has a good explanation I will go back on it. Dan

Velociwrecker 2015-09-20 15:27:34 -0500 Report

I take 1000mg twice a day along with glipizide and I have issues with my stomach and I've been taking metformin for a year now. They told me the side effects are temporary but I have yet to find relief. It is completely frustration especially since my glucose levels still suck

Dan360 2015-09-20 16:59:05 -0500 Report

When I first started out on my treatment plan I was put on metformin and januvia. It wasn't working for me either. I was still getting high glucose readings. I worked with a couple of different doctors and finally I requested that I go on insulin. A lot of people don't like to do that because it requires sticking themselves. Some doctors don't like to put patients on insulin because there is the threat of hypoglycemia which can cause death. If you are careful I think the danger is miniscule. It works, I can tell you that and more and more doctors are putting type 2 diabetics on insulin.

Velociwrecker 2015-09-20 18:01:07 -0500 Report

I have a doctors appointment Friday and I was actually thinking about insulin instead I'm not a fan of being poked but since phlebotomy school I'm less nervous

AL-Fla 2015-09-20 11:47:38 -0500 Report

This is all interesting. I take Metformin twice a day 500mg each. I sometimes experience lower back pain. I'm not sure if it's the Metformin or stress. I experience lots of stress at work.

Dan360 2015-09-20 12:37:49 -0500 Report

I hope you will read my other post, "The meaning of hunger". In there I call attention to the relationship between diabetes and stress. Back pain is a product of stress. I am not trying to play doctor here. The information in my posts is on the web.

AL-Fla 2015-09-21 22:14:02 -0500 Report

I always figured my back pain is due to stress. I keep telling that to my wife. She believes me-we are in agreement. Sometimes it's others who don't believe me. I'm glad to hear that others unfortunately have similar symptoms and it's not only me when I try to explain to non-diabetics that stress causes pain.

KassiaP 2015-09-19 18:42:41 -0500 Report

I have been taking Metformim for 13 years . I absolutely loved Glucophage - it worked great for me. Metformin is totally another "animal" and I have problems if I take the regular Metformim - since I started taking Metformim 1000 mg Extended Release I don't have the diarrhea or the metallic taste - I take before breakfast and eat right after - and I am taking at night around 8pm and it helps for the morning.
My best information on insulin resistance and the use of Metformim and how to use it to fit my needs I found on the book Diabetes Solution - even after nursing school I have never understood insulin resistance like I do now and what I read in that book and here in DC.
Metformim is also used to treat Polycistic Ovarium Syndrome - which I have so I would be taking Metformim anyway!
One thing I have learned is that because everyone is different sometimes a medication can give some unusual symptoms. I have never heard anyone say that they feel hungry after taking Metformim. But it happens to me. If I take after I eat (specially when I forget to take before eating :) blame it on my age!) I really have to tell myself I am really not hungry its just the metformim - but its a struggle for me.

Dan360 2015-09-20 05:51:33 -0500 Report

Your dosage of matformin is the same as mine. Not sure why the doctor prescribed that dosage for me but I am questioning it. Sounds like yours is justified.
From my limited knowledge I cannot figure why metformin would cause you to feel hungry afterwards. I know that for diabetes it shuts off (or reduces) your release of glucose from the liver and decreases your insulin resistance. Therefore, it could be that your blood glucose drop enough to trigger hunger. Just a guess.

KassiaP 2015-09-20 12:40:33 -0500 Report

Dan, I think that is exactly what happens. I never really gave much importance because I just figured that it was a signal that it was working. I am really going to talk with my MD on my next visit - but since so far I have never heard of anyone saying this I just took as an anomaly.
I am going to try to stay with the metformim ER at night 8pm and see if she lets me take the regular metformim 500 mg at breakfast 7am and 500 mg at 4pm for dinner - the ER the max daily dose is 2000mg but the regular metformim the max dose in the US is 2500mg daily - but in Europe the max dose is 3000mg. I check on a PCOS site from time to time - (women that are taking Metformim due to fertility problems and it was were I saw doses really higher than that).
I think the one good thing about metformim is that its been widely used and there are tons of us that take and we can report on it - so we don't just depend on what the pharmaceutic research and their own reports say. I really resent the fact that I can't get Glucophage - even at a higher price from my insurance. To be honest I don't even know if I can order it from my Walgreens pharmacy with a prescription.
Like its happening with Lantus this year. Sanofi has released Tujeo since Lantus now has a generic available and it costs thousands of dollars. They even offer the assistance to pay for it. Its such a shame that there is no way to regulate price of medications.

Dan360 2015-09-19 06:02:45 -0500 Report

Thanks for the info. I have just recently started researching all the aspects of diabetes on line. I am going to see my doctor about scheduling a C-peptide and an insulin level test.

Jean1953 2015-09-18 15:46:06 -0500 Report

I tried taking Metformin with one tablet (500 mg) a day - it was hard to stay away from going to the bathroom in the morning. Also it made be feel incoherent the rest of the day - couldn't function at work. I started walking more and watch what I eat after dinner, if anything. Numbers are down without medication.

Dan360 2015-09-18 16:02:37 -0500 Report

That is very interesting. I am wandering if I should do the same and give it up altogether. I have found that metformin works by preventing your liver from releasing glucose and to some degree, reduces insulin resistance. I am thinking that if the liver is never allowed to release glucose that could lead to fat build-up in the liver. I would like someone to explain to me if that is not the case.

haoleboy 2015-09-18 17:31:50 -0500 Report

interesting theory but not how the body works …the build up of fat in the liver is caused by alcohol, obesity, insulin resistance and/or high triglyceride levels in the blood. the stored glycogen (how the body stores glucose) does not convert to fat.
glucose (in the form of glycogen) is also stored in the muscle tissues.

Dan360 2015-09-18 19:02:53 -0500 Report

Interesting. You seem to know a lot about the different metabolic aspects of diabetes. So, I have another question for you. Since type 2 is caused by insulin resistance and the inability of the pancreas to produce enough insulin, how can you know which is the more dominant cause in say your particular case. It seems to me that that knowledge would be helpful in determining the best meds and treatment.

haoleboy 2015-09-18 20:19:30 -0500 Report

one of the "advantages" of being disabled is that I have nothing to do all day so I can spend hours "researching" things online that interest or concern me …
perhaps the easiest way to figure out what your issue is would be to get a fasting insulin level test. seldom ordered by doctors but you can get one done. more commonly done are c-peptide tests that allow the calculation of insulin levels.
while I have not had this test done I am certain my pancreas is producing decent amounts of insulin as my A1c been progressively improving while not increasing or changing medication. also I have been able to add foods back into my diet that once spiked me terribly … indicating that my insulin sensitivity has been improving.


Dan360 2015-09-19 06:08:28 -0500 Report

Thanks for the info. I have just recently started researching all the aspects of diabetes on line. I am going to see my doctor about scheduling a C-peptide test.

Jibber Jabber
Jibber Jabber 2015-09-17 18:39:00 -0500 Report

I had issues when I first started it …for a couple mos I couldnt be more than a few feet from a bathroom…had to drop a lab…but thankfully the rest of my instructors where kind enough to bend the attendance rules…they knew me…and knew how seriously I took class…so they let me slide as long as I emailed in all my assignments on time..On the bright side…it was then..when I was trapped in the house..and constantly on my computer…that i discovered DC…

haoleboy 2015-09-18 10:57:17 -0500 Report

"couldnt be more than a few feet from a bathroom…had to drop a lab"
drop a lab. now there's a euphemism I've never heard ;)

haoleboy 2015-09-17 17:36:49 -0500 Report

500 mg 2x daily for the past 8 years never had an issue … works quite well.


Dan360 2015-09-18 10:48:39 -0500 Report

I was taking 1000 mg twice a day. Then I cut back to 500 mg a day. I haven't found anyone who didn't see 1000 mg a day a little excessive.

haoleboy 2015-09-18 10:55:14 -0500 Report

I know several type 2's that are taking 2550 mg daily (the max dose) with no issues and good success controlling BGL.

Dan360 2015-09-18 11:49:12 -0500 Report

That is good to know. I know that when I first started on the 1000 mg twice a day I did have a lot of gas. I want to take what I need but there is nothing to be gained by overdoing it. I am not sure the more recent problem with the restrictions in the throat is solved.

GabbyPA 2015-09-17 16:20:39 -0500 Report

I have had some, but nothing like what you are going through. I am so sorry to hear it is causing so many issues. I have trouble for about a week if the dose is changed, beyond that, I am fine. Maybe if you increase it just a little at a time instead of so fast??

Dan360 2015-09-18 11:43:20 -0500 Report

My list of side effects did not apply to me. I was just giving the information if anyone was interested. The main problem I have had from the beginning has been gas and bloating. The problem with the restrictions in my throat is fairly new. I am still not sure that problem is resolved.

GabbyPA 2015-09-18 11:53:39 -0500 Report

Do you take Lisinopril? That is known to cause throat issues and coughing.

Dan360 2015-09-18 12:11:16 -0500 Report

Yes I do and thanks for the tip. I went off of it about 9 months ago but have recently started taking it again because it seemed that my blood pressure was edging up.

Pegsy 2015-09-18 21:54:47 -0500 Report

I had similar issues with Lisinopril. I stopped it about 2 months ago. All issues resolved. My problems with Metformin recurred each time my prescription was refilled. It seems my pharmacy kept changing manufacturers and that makes a big difference. Now I use a different pharmacy and I get refills for 3 months at a time. When I renew a prescription I combine old with new for about a week or two. This has eliminated the digestive issues I was having.