Metformin is a widely known, inexpensive, 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 may also help folks with diabetes drop extra pounds.
However can metformin trigger diarrhea? And if that’s the case, what’s the answer? This text will examine this widespread aspect impact of metformin, the dangers related to persistent diarrhea after metformin use, and what to do about it.
Diarrhea is the most typical aspect impact of metformin. It usually goes away inside just a few weeks of beginning therapy.
Taking the medication with a meal and switching to the extended-release (ER or XR) model of the drug may also help cut back the probabilities of experiencing diarrhea from metformin.
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 likely one of the hottest diabetes medicine on the planet, with physicians writing over 120 million metformin prescriptions yearly worldwide.
Metformin is inexpensive in america, and just about all medical insurance plans cowl the drug. It’s often taken a couple of times per day with meals and is really useful for use together with a healthful weight loss plan and bodily exercise.
Metformin is assumed to work by lowering the discharge of glucose from the liver and growing 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 uncomfortable side effects.
Widespread metformin uncomfortable side effects
Widespread, and often delicate, uncomfortable side effects of metformin might embody:
Suppressed urge for food
Low blood sugar (in people who find themselves additionally being handled with insulin)
Most uncomfortable side effects go away inside just a few weeks of beginning the medication.
Extra info on uncomfortable side 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 Medical Pharmacy discovered that, sure, metformin could cause diarrhea, and it’s really extra widespread than one would assume. Actually, diarrhea is the most typical aspect impact of metformin, with roughly 53% of people that take the medication experiencing this problem.
Those that are taking a number of medicines might also be at elevated danger for persistent diarrhea from metformin use, as a consequence of interactions between their various kinds of medicine.
What’s extra, though uncomfortable side effects equivalent to nausea, vomiting, and diarrhea usually fade away after an preliminary adjustment interval, typically, after years of steady metformin therapy, the physique might 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 prompted incontinence,” after a number of years of constant metformin therapy. The affected 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, persistent diarrhea occurred in somebody who had been taking metformin for over 5 years, with no earlier issues or uncomfortable side effects. The diarrhea was painless, however extreme, with no different underlying trigger. On this case as properly, the diarrhea fully went away after the metformin therapy was stopped.
In each of those circumstances, 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 response to the journal Diabetes, Weight problems, and Metabolism, lots of the preliminary gastrointestinal uncomfortable side 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 just a few weeks.
Nonetheless, not all uncomfortable side effects might go away, which contributes to the massive share of people that don’t take the medication as prescribed.
Power diarrhea could be a kind of uncomfortable side effects — at finest 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 advocate avoiding any explicit meals whereas taking metformin to forestall diarrhea. That stated, there are particular meals and drinks that may improve the chance of diarrhea generally, so it’s possible you’ll wish to cut back your consumption of them in case you are experiencing diarrhea with metformin. These embody:
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
These modifications would possibly assist handle diarrhea signs whereas taking metformin.
Different diabetes-related causes of diarrhea
Metformin isn’t the one diabetes-related explanation for diarrhea. It’s essential to work together 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 influence not solely the frequency of bowel actions, however the consistency as properly, usually inflicting diarrhea.
Diabetes issues equivalent to gastroparesis can gradual 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 could cause all the things from constipation to diarrhea. (Converse together with your physician in case you assume 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 probably wreak havoc on the digestive system, usually inflicting diarrhea.
It is because synthetic sweeteners are poorly digested by the gastrointestinal tract. For those who embody synthetic sweeteners as a part of your meal plan, make certain to make use of them sparingly.
The risks of persistent diarrhea
Persistent diarrhea can merely trigger a gentle inconvenience, or it could go away an individual fully housebound, unable to train, work, or operate in society.
And past the approach to life influence, persistent diarrhea could be extraordinarily detrimental to well being, too. Some issues of persistent diarrhea embody:
Malnutrition/malabsorption of vitamins
Extreme weight reduction
Low blood sugar
Lack of ability to train
Pores and skin irritation
For those who’re experiencing persistent diarrhea and have any of those well being issues, contact your physician instantly to get assist.
Easy methods to cease metformin diarrhea
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 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 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 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. For those who 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 just a few weeks
Giving your intestine time to heal with just a few weeks’ break free from the medication may also help cease diarrhea and stop it from coming again. (Make sure you discuss to your physician earlier than you cease taking metformin.)
Research have proven that stopping metformin therapy nearly instantly alleviates late-onset, persistent 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 Kind 2 Diabetes Administration
Treating persistent diarrhea
Folks experiencing long-term diarrhea ought to search skilled medical consideration, particularly if they’ve diabetes.
In case your signs usually are not extreme and also you want to strive treating it at residence first, a few of the following therapies might supply short-term 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 improve your fiber consumption to keep away from fuel, 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 really useful dose, as exceeding that has been linked to severe coronary heart issues in some folks.)
At all times work together with your diabetes workforce to evaluate the fitting therapy choices to your way of life. With cautious coordination and suggestions out of your care workforce, you will discover the fitting method for you, lowering your danger of diarrhea from metformin whereas conserving your diabetes well-managed.