What is Metformin and how does it work? Is Metformin safe to take? Is Metformin effective in the treatment of diabetes? What about polycystic ovarian disease? Does Metformin cause weight loss? If you have type 2 diabetes, chances are you have heard of metformin. In fact, it is often the first medication recommended as a treatment for diabetes. Metformin is all about improving blood sugar control. It has been around for a long time (basically forever)… Metformin contains a substance called guanidine, which can lower blood sugars. Guanidine is found in an herb called goat’s rue (also known as French lilac), and this herb has been used to treat diabetes since the early 1900s. It works in several different ways… it decreases production of glucose by the liver, it decreases the amount of glucose absorbed in your intestines, and it improves insulin sensitivity so more blood sugar can be used by cells in the body. Each of these mechanism effectively lowers the blood sugar. Dontt worry if your blood sugar doesn’t drop immediately, because it takes 4-5 days to start working. Metformin does have some other positive effects, which ill mention later, but an exciting one for some people is weight loss! Another great fact about metformin is that it does not carry as much of a risk of hypoglycemia, or low blood sugar, which is a side effect of many other diabetic medications. Metformin is also used in the treatment of PCOS, a disease which can include insulin resistance and abnormal menstrual cycles. In addition to helping with blood sugar control, metformin can help stabilize hormones and restore more regular periods The medication is taken twice a day and comes in tablets of 500, 850, or 1000 mg. First warning, the medication itself can have a fishy smell to it. The most common side effect includes abdominal discomfort and diarrhea (this actually happens in up to 50% of people taking it). To avoid these side effects, you should take metformin with meals. Try to hang in there if possible, because for most people these stomach issues will resolved after two weeks! If you continue to have stomach upset or diarrhea, you may benefit from taking a lower dose of the medication or switching to an extended release (once a day) pill. You may also benefit from a metformin holiday, meaning you take a break from the medicine until symptoms improve, then restart it. This is usually successful! How effective is this medication? On average, it reduces your hemoglobin A1c by 1.5 (in other words, decreasing your blood sugars by about 50). You may also love one of the other side affects of metformin, which is weight loss! Other small benefits of the drug include a very small reduction in cholesterol and possibly even a reduction in cancer! Here are the important side effects to know about if you choose to take this medication. Like we said before, the most common side effects are abdominal symptoms including stomach discomfort, diarrhea, even a metallic taste in the mouth. Another side effect is vitamin b12 deficiency. Metformin will decrease the ability of your intestines to absorb vitamin b12, which is important for making hemoglobin. Vitamin b12 deficiency can lead to anemia (low hemoglobin) and peripheral neuropathy. If you start experiencing numbness or tingling of your legs while taking metformin, ask your doctor to check your vitamin b12 level. The most serious side affect of metformin is a condition called lactic acidosis. In normal conditions, cells use oxygen in their energy producing process. Whenever a cell runs out of oxygen, it switches energy production to a differnt mechanism which makes lactate. High levels of lactate cause the blood to become more acidic, which is the indication of a severe condition, in some cases leading to death. 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Aired: May 12, 2025
