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.
The American Diabetes Association (ADA) also recommends metformin for some people with prediabetes. Generally, if you're prescribed metformin, you'll be on it long term. That could be many decades, unless you experience complications or changes to your health that require you to stop taking it.
Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear, and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure.
Risks of stopping metformin
impaired vision, or diabetic retinopathy. kidney problems, or diabetic nephropathy. nerve damage, or diabetic neuropathy. heart problems.
Recently, Samira et. reported no increase in the risk of acute kidney injury in patients receiving metformin compared to those without metformin treatment by baseline eGFR [11]. However, in the present study, continuous metformin therapy was shown to worsen renal function in patients with DM and moderate CKD.
The human pharmacokinetic data point to the liver, kidney and intestines as the key target organs of metformin and in this review we will primarily focus on the liver and intestines, particularly when referring to the beneficial impact of metformin on metabolism and inflammation.
Nausea, vomiting, and diarrhea are some of the most common side effects people have when they first start taking metformin. These problems usually go away over time. You can reduce these effects by taking metformin with a meal.
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.
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.
Recent studies have also found that metformin has a positive effect on cardiovascular protection [8,9,10,11,12]. Metformin also lowers risk factors for cardiovascular disease such as blood fats [13,14,15], body weight and blood pressure.
Side effects
Nausea, vomiting, stomach upset, diarrhea, weakness, or a metallic taste in the mouth may occur. Metformin usually does not cause hypoglycemia; however, low blood sugar may occur if this drug is used with other anti-diabetic drugs.
Coming off medication in diabetes remission
Some people are able to stop taking diabetes medication like metformin, by putting their diabetes into remission. This means that blood sugar levels are in the non-diabetes range without needing any medication.
It is recommended that metformin should be discontinued once eGFR falls below 30 ml/min/1.73 m2 and to decrease the metformin dose in mild to moderate renal impairment (eGFR 30–60 ml/min/1.73 m2).
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.
This medicine is not recommended in patients 80 years of age and older who have kidney problems.
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.
Metformin is a synthetic derivative of galegine and/or guanidine, natural products found in the herbal medicine Galega officinalis that was used in medieval Europe.
Conclusions: People with diabetes taking metformin were less likely to report back, knee, neck/shoulder and multisite musculoskeletal pain than those not taking metformin. Therefore, when treating these patients, clinicians should be aware that metformin may contribute to fewer reports of musculoskeletal pain.
Keeping up a moderate weight, eating a healthy diet, and exercising are the best ways to help lower your blood glucose. If you can manage these through lifestyle changes, you may be able to stop taking metformin or other diabetes drugs. Doctors typically measure remission with an A1C blood test.
Diabetics should avoid fruits with a high GI or eat them in moderation so that their blood sugar levels do not spike abruptly. Pineapple, watermelon, mango, lychee, and banana have a high GI, so these are the worst fruits if you are diabetic.
How to check if metformin is working. A medical provider can run a few tests to see how metformin is affecting your health: Blood work can check if your glucose, insulin, and HbA1C levels are in range. If they are, the medication is working.