Long-term side effects
Taking metformin can cause vitamin B12 deficiency if you take it for a long time. This can make you feel very tired, breathless and faint, so your doctor may check the vitamin B12 level in your blood. If your vitamin B12 levels become too low, vitamin B12 supplements will help.
Why Shouldn't You Stop Taking Metformin? Metformin works by decreasing the amount of sugar your liver releases into your blood, making your body more sensitive to insulin's effects. If you suddenly discontinue use, it can lead to dangerously high blood sugar levels.
It helps lower your blood sugar levels and can lower your risk of cardiovascular events like heart attacks. It also has a low risk of causing harmful drug interactions and severe side effects. The American Diabetes Association (ADA) also recommends metformin for some people with prediabetes.
More serious side effects are rare. They include severe allergic reactions and a condition called lactic acidosis, a buildup of lactic acid in the bloodstream. The risk for this is higher among people with significant kidney disease, so doctors tend to avoid prescribing metformin for them.
This medicine is not recommended in patients 80 years of age and older who have kidney problems.
Current evidence suggests that the weight change associated with metformin is more likely to be due to decreased caloric intake versus increases in energy expenditure. Metformin appears to impact appetite regulation both directly and indirectly due to its gastrointestinal side effects.
Conclusion: Metformin does not appear to cause or exacerbate liver injury and, indeed, is often beneficial in patients with nonalcoholic fatty liver disease. Nonalcoholic fatty liver frequently presents with transaminase elevations but should not be considered a contraindication to metformin use.
The use of metformin by non-diabetics stems from some evidence that metformin can decrease inflammation, protect against cardiovascular disease and cognitive impairment, minimize cancer risk and progression, and prolong life.
Metformin and weight loss
In a much larger trial in over 4,000 people with type 2 diabetes, it was found metformin use was associated with a 2.4 kg (roughly 5.3 lbs) weight loss over a four-year period. There are a few ways that metformin might impact weight. One is that the medication can reduce your appetite.
Metformin treatment brought about a significant reduction of visceral fat mass compared to controls accompanied by an up-regulation of fat oxidation-related enzyme in the liver, UCP-1 in the brown adipose tissue and UCP-3 in the skeletal muscle.
Do not stop taking metformin without talking to your doctor. If you stop taking metformin suddenly, your blood sugar levels will go up and your diabetes will get worse.
They noted that in observational studies there was a significant association of exposure to metformin with the risk of cancer death, all malignancies, liver, colorectal, pancreas, stomach, and esophagus.
Metformin should be avoided in patients with acute or unstable heart failure because of the increased risk of lactic acidosis. It also should be avoided in patients with hepatic impairment, according to the labeling.
Emerging research shows that the diabetes drug metformin, used in type 2 diabetes treatment, has the potential to inhibit aging by activating AMPK-mediated pathways that promote youthful functioning at the cellular level—making it a potential healthy aging drug.
In fact, a doctor might prescribe metformin for weight loss even if you don't have diabetes or prediabetes.
Metformin is regularly prescribed to treat high blood sugar levels, but its benefits extend beyond diabetes. In addition to treating prediabetes, cancer, cardiovascular and neurodegenerative disease, emerging studies suggest that metformin may also help prevent or delay age-related diseases in healthy individuals.
Here are the other long-term benefits you can expect: You'll have more energy as your body uses insulin more efficiently. Common diabetes-related symptoms, such as blurry vision, being thirsty all of the time, or having to pee a lot, improve or disappear.
In general, for diabetes medications including oral hypoglycemic agents (e.g., metformin) and insulin, if you miss one dose, take the next one as soon as you remember it. However, if you remember close to the time of the next dose, then skip it and take the next dose instead. Do NOT double the dose.