Metformin is one of the most commonly prescribed medications for type 2 diabetes and prediabetes. That means it’s also one of the topics we frequently receive questions about.
Here we’ve gather up 20 questions about metformin for diabetes and provided the answers.
For more information on how metformin works and it’s side effects, read this information.
My doctor wants me to take metformin but I’m concerned about side effects. What are the most common side effects?
The most common side effect of metformin is gastrointestinal: diarrhea, bloating, gas, and abdominal discomfort. This occurs in a small percentage of patients and it generally goes away within 2 weeks as the body adjusts to the medication.
Other side effects include: risk of vitamin B12 deficiency and lactic acidosis (rare).
Why does metformin cause diarrhea?
Metformin does not cause diarrhea in everyone, and in fact most people do not experience any problems with it. As with all medications, different bodies react differently – some experience side effects while others do not.
While the exact mechanism is not clear, in most cases it is simply the gastrointestinal tract getting used to a new substance. The diarrhea usually goes away in time and doesn’t have lasting, long-term impact in most people. However, if you find it too discomforting or if diarrhea persists, you should consider other options.
For instance,berberine is a natural agent that’s been proven to be as effective as metformin. And remember, diet and lifestyle changes can often reduce or eliminate the need for metformin.
Can metformin stop your period?
No. Metformin does not have an action that affects female hormone production or utilization.
How do I stop taking metformin? Do I have to reduce slowly or can I just stop?
If your doctor recommends you stop taking it you can simply stop taking it – unless he/she very specifically instructs you to wean from it. Metformin doesn’t have any sort of addictive physiological effect that would cause withdrawal symptoms.
However, if you are simply trying to gradually go off medication and are at the maximum dose, it may be wise to discuss with your doctor a method of decreasing slowly, to see if a smaller dose is able to better control your sugars.
Why is metformin used for weight loss?
Metformin has a weight loss effect, but it is not currently approved for use as a weight loss medication. It’s prescribed use is for blood sugar control, but one possible side effect of taking metformin is weight loss.
Metformin does not increase metabolism but tends to affect appetite slightly causing a decrease in food intake.
Are there foods I need to avoid while taking metformin?
Nope!
Although, if you are taking metformin it is probably for blood sugar control, so you will want to limit your total carbohydrates, especially white refined carbs and sugars, which is recommended regardless of whether you’re taking meds or not.
Should I expect immediate results from metformin?
Results vary from person to person, but will probably take a minimum of a few days to a week to see changes. Most often people will need to gradually increase the dosage over time before they start seeing numbers come down. If you don’t see any difference in a month it probably isn’t having much of an effect.
Can metformin cause yeast infections?
No, this is a side effect of some other diabetes medications (such as the SLGT-2s like Invokana, Jardiance etc), but not metformin.
How much does metformin lower A1c?
Again, this will vary from person to person, but averages from clinical trials conducted show an A1c lowering potential of 1%. That is pretty impressive considering it has minimal side effects and weight loss benefits.
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Is it safe to take herbal supplements while taking metformin?
It depends on what the supplement is. Dietary supplements are not regulated, at least in the United States, and so they are not certified and approved by any agency for safety or efficacy.
In saying that, there are clinical trials that indicate some herbal supplements can provide better outcomes when combined with metformin, such as berberine.
In any case, please do your research, make sure you buy from a reputable source and check with your doctor or pharmacist before taking an herbal supplement.
Can metformin cause foot pain?
No, this is not a side effect of metformin. Your foot pain could be due to neuropathy, a diabetes complication not caused by the medication.
Is metformin safe to take with other medications?
Generally yes, but because there are so many, it is always wise to check with your doctor or pharmacist before taking any new medications, just to be sure.
One thing to note is that if you are having a procedure that requires contrast dye (such as an MRI or CT scan), metformin should be stopped several days prior to the test.
I heard metformin can lead to vitamin B12 deficiency, is this true?
Yes. Metformin can cause vitamin B12 deficiency over time.
If you’ve been taking Metformin for several years, it is advisable to get a B12 blood test. This deficiency can easily be corrected through supplementation or periodic B12 injections.
Metformin says: “Take with a meal.” Should I take the tablet at the beginning of the meal, half-way through the meal, or after the meal?
It doesn’t make a difference, as long as there is food in your belly at the same time as the medication, you’re good to go.
In fact, the metformin does not need food to work; it’s just that food helps reduce any stomach upset that may occur from taking it.
My weight has gone up by 10 lbs (4.5kg) since starting the Metformin medication, is this normal?
That is not normal. Have you eaten more during this time period due to increased hunger or appetite?
Has anything else changed during this time – your activity level, other medications, illnesses etc?
Or is the metformin the only variable you think is different? What is the time period?
It’s unlikely that metformin would be the cause, but it’s recommended you eliminate all other possibilities and discuss these details with your healthcare team.
If my A1C drops from 7.4 by a couple points, do you think I should have to continue taking metformin?
Changing medications is always a joint decision between you and the doctor who prescribed it. You should consider your goals, your risks and the benefits/drawbacks of the medication.
In saying that, if your A1c levels dropped to 5.4, you wouldn’t even be within pre-diabetes range, in which case medication probably won’t be needed. Many of our members are reducing, then eliminating medications – it is possible.
However, if you do reduce A1c by a couple of points, it may be the case that your A1c lowers because of or with the help of metformin, in which case going off it may lift you back above your goal. Again, you will need to discuss this with your doctor, and monitor your individual changes. In any case, improving your A1c is a good sign of progress and indicates you are doing many things right!
And you can of course eliminate medications if you continue to implement diet and lifestyle changes and gain/maintain good blood sugar control.
I am on metformin 2 x day, if I’m careful can I prevent going on insulin?
Yes, possibly. But overall, it depends on how much is still within your control. Many people who are diligent with their diet, activity, weight and medication are able to reverse their numbers and don’t currently need insulin, and they likely never will.
However, if your numbers are out of control and you’re doing nothing but take medications, your condition will likely progress. Relying on medications alone, is not enough, you have to be proactive with your diet and lifestyle.
There are also some cases where people put forth due diligence, yet even so, over time they still end up needing to take medications or insulin due to a decline in pancreatic function. Some of this may be a result of things you can’t control like genetics and age. Hopefully, you end up in the former category, but remember if not, don’t feel bad about it, insulin is what the body needs if it cannot make it!
I am a newly diagnosed diabetic and on metformin and would like to know, if I am able to get my blood sugars down in the near future, can I stop taking medications?
Yes. Many people within the DMP community have managed to reduce or eliminate their medications. But again, that is a discussion between you and your doctor and will depend on you gaining and maintaining good blood sugar and A1c control.
Reducing or eliminating medications is a great goal to aim for. And remember, making lifestyle changes will always reduce the medicine load you would otherwise need, which means, even if you don’t end up being able to go off medication completely, you will be able to reduce the amount you need to take.
How do I time my 2 x 1,000 mg daily doses of Metformin?
Take one pill in the morning with breakfast and one in the evening with dinner.
How does Metformin work with food? Should I be consistent with carbs throughout the day? Will my numbers drop low if I don’t eat enough carbs?
No, your numbers will not drop low as a result of carbs and metformin. Metformin does not work better or worse with or without food. It’s simply the case that food in the stomach helps reduce side effects of the medication, such as bloating, stomach ache or diarrhea.
With that said, it is important to aim for a relative consistency with carbohydrates. Here at DMP, we encourage people to consume a low carb diet because research shows it’s one of the most beneficial diets for producing outcomes – lower blood sugar, A1c, cholesterol etc. So be aware that if you’re cutting back on carbs, your numbers are obviously going to be lower, that’s a great consequence of eating lower carb – people gain much better control of their numbers! But in most cases, those numbers shouldn’t go so low as to cause hypoglycemia.
However, if you’re taking insulin, you do need to be more cautious and aware when reducing carbs because you may need to adjust your dosage to prevent hypoglycemia.
For more information on how metformin works, read this information.
Over 40 years ago I had a mastectomy and was told I was never to take hormones for the rest of my life. Is it safe to take Metfermin XR 500mg?
Metformin is not a hormone, however, for any concerns regarding medications, please speak to your physician.
Is there a link among producers of Metformin, Pharmacists and the doctors. Even on demand by patients doctors don’t prescribe alternative medicine for Metformin ? Is there no alternative medicines available.
Medications are definitely overprescribed! There are alternate medicines available, the natural therapeutic Berberine being one good example.
In 2009, I was put on Metformin. After a week of taking the medication, I called my doctor to report how it made me feel. My complaint was how immediately after taking just one tablet, my blood would literally boil inside my arteries and veins, and it was too painful. I am however, allergic to many medications, and perhaps this was why I was experiencing this boiling blood sensation. I have also read nothing good comes from taking Metformin, and whomever takes it needs to rethink doing so.
Several articles written on the topic of Metformin in 2009, were at least honest. Now, those same articles are impossible to locate and my question is why?
Hi Laura, it could be for many reasons, maybe they were published on sites that are no longer active, maybe people removed them to conform to the status quo, or took funding from pharmaceutical who didn’t allow it etc -so many possible reasons. We encourage people to deprescribe medication whenever possible, including Metformin if they can. Any medication can have side effects and they all affect people differently. Along with other side effects, Metformin can cause B12 deficiency, which can increase risk of nerve damage and neuropathy. It’s all about being well informed and proactive with your own health!
Hi, I am on the train of confused and alone.
Last summer I was sicker than a dog, I contracted Covid and my world has not been the same.
I finally drug myself into a urgent care and their I found myself bewilder as the Dr came into the room after running my tests and says “ what have you been doing ?” I look at her like what the heck are you talking about?!
Admittedly I was eating a lot more, drinking alcohol a lot more and had recently lost my place of living so yeah…I was stressing a lot more as I moved in with my X husband – as I had no where to go.
A couple of years before that I had a melanoma cancer on the bottom of my left foot and that was so traumatic, they took a chunk of my bottom arch area and skin graphed it with my hip tissue and wasn’t able to walk for several months.
So I’m just giving you a brief summary of what I have endured and now I am trying to figure this Diabetic label I have now??
The thing here from the urgent care Dr I received several referrals and wasn’t successful at getting to see anyone as this is free healthcare and I won’t say anymore.
I have only had 2 phone appts with the general Dr and I am 62 and so not use to that sort of medical assistance. She has never met me – wanted to put me on insulin yet I was never given a blood sugar reader to check my levels – I told her I did not want to go on insulin and that I could work on all the other factors and bring the numbers down.
I guess I am so confused that if I am in need of insulin yet I don’t have anything to indicate my levels and so I feel when I went to see urgent care I was at my worse – felt I could get back to my exercise and eat better lifestyle as I secured a place to live and no longer deal with that same stress level that I was using alcohol and food to comfort me .
I hope I am making some sense a lot of details have been skipped but to sum it up.
I’m scared I really don’t have a healthcare system or any Dr to see for this. To Dr on a phone is ludicrous – shouldn’t I have been seen in person at least for first time ?.
If you could give me some guidance I sure would appreciate someone to help me understand the food game and what I can drink besides water – summers here are brutal. Exercise is hard because of my foot. I see a foot Dr regularly for care – I can walk but have some issues with it. My foot gets tired so I can’t walk for exercise like I use to.
My life is the most difficult it’s ever been – I never dreamt I would be in this place – I just want someone to give me some guidance and put me on a path that I can afford and I’ll do the rest.
I’m a fighter / I just don’t want to go out with this illness. I’m scared and alone and although I have a small part time job and a small retirement life is so hard to just live.
I welcome any and all advice. Thank you for reading and I apologize for my rambling !! I guess I need someone to talk to….lol.
Hi Dea, sorry to hear you’ve had so many struggles. The healthcare system shouldn’t be like this, but unfortunately we do hear stories like this from many people. You should be given the details of your numbers and education about what to do. Insulin is a last resort, and there are ways to normalize your blood sugar, for example, through nutrition, which is what we teach people here at DMP. You can start with these free resources here. To receive further guidance and support, I would highly recommend you join us as a member.
I was diagnosed in 1996, in the 600 glucose range! Life style changes and Metformin sufficed for a few years, but doctors eventually changed me to a sliding scale insulin regime. More recently I had an Ischemic stroke. Doctor at Thai hospital made medication changes including stop insulin and take Metformin 500 mg. bid. This has resulted in 200+ readings almost everyday by lunch time. I have resorted to again injecting insulin at lunch time. Thus my mornings are now generally under 140. My next appointment isn’t for a month, and getting appointments here is not easy.
Does the constant use of metformin cause E.D?
Speak with your physician regarding specific side effects as he or she will know your full medical history.
been on metformin for many years and i wee a lot i believe it is the metformin also take 45mg pioglitazone also 5mg linagliptin
All medications come with certain side effects – discussing these side effects with your doctor in the best course of action as they can determine if there is a suitable alternate. Keep in mind that increased urination can also be a sign of high blood sugar levels, so if you’re levels aren’t controlled I would recommend starting there!
I take metform 2 tablets 1000×50 in one day and insulin 15 in morning and 15 before dinner every day remodel and still my pp is 175 please advise me
Riaz, it sounds like you really need to focus on your eating plan and eat to treat your diabetes. Grab a copy of our food list to get started and consider joining us as a member for the best help and support to lower your numbers and reduce meds.
HI Emily,
I have just been told by my doctor that I have Type 2 Diabetes. I have been prescribed Metformin ER. I am told to take (2) 500mg tablets 2X per day, so 1,000mg with breakfast and 1,000mg with dinner. Does that seem like too much? Or is that normal? I don’t like taking medicine in the first place, but I will do it religiously. It just seems like it’s too much. Idk. What are your thoughts on if that is normal or not?
Thanks
Always follow your doctors prescribed dosages, as they understand your current condition and health history. As you make changes to your diet and lifestyle you can work with your doctor to reduce dosages.
Hi I am so confused about my sugar readings. In the morning it’s 9 and that’s before I eat. The rest of the day it’s above 10. I have tried everything. I give up. I am afraid to eat.
Hi Marlene,
I am sorry you are feeling defeated. I would suggest really evaluating your diet and other lifestyle habits to make sure you are doing everything to keep your numbers under control. Are you still eating too many carbs? Are you under a lot of stress? Are you sleeping well? Do you move your body regularly? All of these things can contribute to higher blood sugars. Here is an article with some helpful tips. Stay positive, you can do this!
A comment here on breakfast foods other than eggs. I purchased an Instant Pot and started making my own Greek yogurt using the skim/fat free Fairlife milk weekly. You can add anything you like but I am partial to the fresh fruits I freeze. These are added with each serving not when you make it. One quart of the milk makes a quart of yogurt which last me a week.
Also I make egg bites in the instant pot and freeze them. I heat one in the microwave in the morning. They can be made very healthy by using turkey sausage and all sorts of veggies along with cottage cheese.
An instant pot can be a very healthy alternative way to cook. Oils and butter can be totally eliminated by the steaming of foods. I love mine and have lost 109 pounds in the last year while maintaining good blood sugar control.
Thanks for sharing that with is Lynn. And congrats on your great results so far – fantastic!! 🙂
Are you supposed to check your sugar 2 hrs from when you started eating or hrs from.when you stopped eating?
Great question– it’s measured 2 hours after you put the first bite of food in your mouth.
Alcohol and metformin??
Alcohol affects people differently, and only your doctor knows your medical history well enough to advise you about drinking while on metformin.
What can a diabetic patient do to stop medication?.
Hello Sefiya, lifestyle changes can make a big impact. Start here for some tips.
I have just been diagnosed with type 2 diabetes and am currently taking Metformin. Three weeks prior to my diagnosis I went to the eye doctor for an exam and new glasses. The glasses worked well until I started Metformin and a high cholestorol med. Now everything is out of focus and blurry! Is this common? Any suggestions on what i can do to help this situation. My doctor has sent me to see an eye specialist but my appointment is still 2 months out!
How is your control at this point? Diabetics are at increased risk for eye problems, so you need to make sure to keep your blood sugar under tight control so you aren’t making matters worse. Maybe inform your doctor about the 2 month wait time- he or she may be able to provide something for temporary relief.
Yes, that is normal. Blood sugar changes need monitoring. If no changes then u r good to go.
Will metformin affect my liver
Metformin works by decreasing the amount of sugar put out by your liver, so your liver is very closely related to this medication. That doesn’t necessarily mean its going to directly harm your liver, but this type of medication is contraindicated in liver disease so if you’re concerned about a weakened liver then we would definitely encourage you to speak more to your doctor about your concerns.
Can you suggest a dietitian who can help with diabetes.I live in Washington, DC.
Unfortunately we do not have a referral list at this time. You could try asking your doctor for a referral, however there is the uncertainty that you do not know what type of information that particular dietitian would be promoting.
If you’re looking for general meal advice for help managing your diabetes it may be worthwhile to consider subscribing to our meal plans which may be the type of guidance you are looking for. Find more info over on this page.
Can metformin cause hair loss
Hello,
There is no direct link with metformin and hair loss but there are a few isolated reports of eyebrow and eyelash hair loss in those taking Metformin and another diabetes drug, sitagliptin. However, it is not clear if the medicine caused hair loss.
Is termeric good to drink i tea like people with type 2 diabetic
Yes Jacqueline, turmeric is a great spice to use as it’s anti-inflammatory. We have some info about turmeric here.
I was diagnosed with prediabetes two weeks ago and put on metformin and it has given me an awful cough I have lost my sense of taste also it gives me a low grade fever and heart palpations
You should address these concerns with your doctor, Tammy. While metformin is usually pretty well tolerated, it seems this is not the case for you.
My family doctor told me to take metformin 500 mg twice a day (after breakfast and dinner). Is It okay to take 250 mg after breakfast, 250 mg after lunch and 500 mg after dinner?
You should always take medication exactly as it was prescribed by your doctor. Check with him or her if you have concerns about the metformin regimen they prescribed.
can I drink beer or red wine if I’m taking Metaformin 500mg
In general, alcohol is not encouraged on a healthy diabetic diet.
The reason being is that alcohol is actually a toxin to your body, and it offers absolutely no nutrition to your cells. Metformin and alcohol both put excess strain on your liver, so in excess you could be at risk for liver complications. I would advise you to check with your doctor for more specific recommendations, and to check for any other potential interactions with any other medications you may be taking.
If and when you do choose to indulge, make sure to check our these articles are wine and beer!
I do not agree with taking metformin. After all, it still is a drug. What is far better than taking metformin, is taking Berberine, a suppplement. I refused medication on metformin, I use the supplement. And even my doctor has to admit I’m doing fine.
Glad to hear you’re able to effectively manage your blood sugar/A1c without any medication, although this is certainly not the case for every person with diabetes. I think you may find this article on berberine interesting as well.
i was diagnosed with type 2 many years ago following aggressive cancer treatment. i’ve been able to keep my diabetes under control with exercise and diet (complex carbs but not low carb) and a small amount of oral meds. i was recently diagnosed with kidney disease. the recommended foods for CKD seems to be completely opposite of what is suggested for diabetes. after meeting with a dietician thru my HMO there doesn’t seem much left to eat. i’m mid-sixties, not overweight, and i don’t have a lot of time for shopping or meal prep. any information or suggestions would be greatly appreciated.
Joel, did you raise this concern with the dietitian you met with? While those with kidney disease do have different nutrition requirements, the recommendations vary significantly depending on what stage CKD you have, and how your potassium/phosphorus levels are. Here is some basic information on kidney disease and diabetes- but my best suggestion is to continue working with a dietitian who specialized in CKD and diabetes.
thanks for the information. i’m early stage 3, but my potassium and phosphorus levels are within normal range. like the diabetes, the CKD is probably a long-term result of the intense chemo I had several years ago. even though it is a very large HMO, the dietician was not very helpful. she made one set of recommendations of foods to avoid for diabetes and another set to avoid for CKD. they seemed largely contradictory, knocking out just about everything in the grocery store. for example, suggested whole grain breads or brown rice to diabetes, but white bread and white rice for CKD. no follow-up without a referral from my primary care doc, and he is very stingy with referrals. his only advice was a keto diet. i’m lost and confused
The whole wheat- white bread “debate” is the classic contraindication I think of when ever I speak to people in your same situation. But remember, in order to help slow the progression of kidney disease it’s critical you keep your blood glucose under control and that means probably avoiding both types of bread! (Carbohydrates are the nutrient that most impact our blood glucose, limiting things like bread, pasta, and rice can be one of the easiest ways to get blood sugar under control.)
Here are the foods that will lead to best blood sugar control. If you doctor and/or dietitian hasn’t recommended a protein restriction at this point, then you don’t need to worry about that. The healthy fats listed in the article should all be fine to consume as well. With regards to vegetables, I would suggest googling “vegetables lowest in potassium”. Even though your numbers are normal now, you will probably be better off picking more often from the lower potassium list, and uses the other ones to mix in for variety. The same thought process would go for fruits, although we encourage people to limit their overall fruit intake for best blood sugar results.
Hi,
Currently I am taking 1 X 60 mg Diamicron XR before the breakfast and 2 X 1000 mg Gluoformin after the dinner.
Should I continue with the above or start taking 1 X 60 mg Diamicron XR before the breakfast and 1 X 1000 mg Gluoformin each after the breakfast and dinner?
Kindly help me in this regard.
Kind regards,
Gyan
Gyan, do not make any changes to your medication regimen until you speak to your doctor; they will always be your best resource when it comes to specific questions about your medication!
Thanks a lot, Dr. Emily. I will do so.
I have been told I havesugar problem, I have TRIED many diabetic meds , none has worked, I break out wit measle like red itchy rash, these meds include, metformin, itchy armpits, glimperide red rash on LEGS, and very itchy, januviasame thing, in one week,lanolin pen, savere respiratory problems, finally, VICTOZA, nausea, disclosing of skin, and spreading, I stopped it, puzzling, no answers, my body rejects them all.
Well if that’s the case Ricky then your best options are to be very proactive making diet and lifestyle changes as these can control blood sugar very well.
Very helpful article thank you
Glad you found the information useful!
I was prediabetic till my doctor put me on warter tablets then i my blood sugar rose from 5.9 to 20.6 I was put on metamorphism Xmas I’m on 2.000 a day its down into 7 and 8 know but still stugling will what to eat I have lost weight down from 10 12 to 9.8
We encourage people with prediabetes/type 2 diabetes to consider following a low carbohydrate diet. Based on research we have reviewed at DMP, we believe this is one of the more effective ways to gain control over blood sugar levels.
If you’re struggling to maintain weight, take a look at this information.
Anxious to know what your breakfeasts are like. Sick of eggs. My favorite is when i do have is one slice toast avacodo mash spread and 2 eggs on top. Just need new ideas cause every thing spikes !!! Thhanks,
Taking metorform slow release not doing much good but but weight loss good.
We have tons of low carb breakfast ideas. One of my favorites is a yogurt parfait! If you’re looking for a way to change up your eggs try this breakfast pizza as well.
Does ADA have an A1C chart with blood sugar numbers as a reference guide available?
Check out this article on the DMP website for a great conversion chart, plus some more information about A1c levels.
Thank you for your very helpful article. I do have a couple of questions. I take 2 metformin tablets in the morning as I kept forgetting the one with dinner. Is the metformin still effective throughout the day?
Also, I will be starting chemo for breast cancer in a couple of weeks. Are there different guidelines for diabetics during chemo or just continue with same low carb diet?
You need to take medication as prescribed by your doctor- if they prescribed once in the morning and once in the evening then that is the only way you should take it. Set an alarm on your phone to remember your evening dose!
You can continue your same diet during treatment. Some patients may begin to lose weight with a cancer diagnosis- if this applies to you and your weight begins to drop too low then give this article a read.
Setting a reminder on my phone to avoid forgetting my metformin was Huge!!!
I never seemed to remember my daytime dose until I set an everyday ‘alarm’ on my phone.
I don’t think I’ve missed more than 3-4 doses in the past year thanks to that!
The few I missed were when I was stuck someplace w/o my pills & didn’t remember when I got home.
Glad to hear and make sure to keep it up!
I have to disagree with you on any food to not eat with Metformin. I have been to diabetes classes and every one I have been to they have said you cannot eat grapefruit or drink grapefruit juice when taking Metformin. The grapefruit/juice negates the effects of the Metformin.
Hi Jimmie. There is no contraindication for consuming grapefruit juice with Metformin. (However, grapefruit juice can interact with some other medications, so it is important to be aware of all the medications you are on.)
Consider checking with your doctor as there may be another medications that requires you to avoid. If you prefer to play it safe then you can certainly eliminate grapefruit from your diet and still follow a healthy diabetic diet.
Yes I was told that to a long time ago.