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Metformin and Lactic Acidosis

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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Carina1962

Well-Known Member
Relationship to Diabetes
Type 2
I've never read the leaflet that comes with my Metformin tablets, until now. I'm shocked it mentions Lactic Acidosis and that was one of the issues I had last week when I was admitted to hospital - my lactate level in my blood was raised. Has anyone else had the misfortune of experiencing lactic acidosis? Very scary!
 
From memory, it started with a really strong taste in my mouth. I then found it difficult to breath and became very dizzy. The next thing I remember is being on the back of an ambulance. I have also had DKA and they were quite similar.
 
To be honest, I'm a bit worried now taking Metformin after what's happened to me. I think I need to see my GP to discuss my concerns. I honestly didn't think that a severe case of S&D would cause this problem for me. Is it because I'm diabetic do you think that these 'complications' came up? I'm not entirely sure why I ended up having a raised Lactate level in my blood. I've actually posted a separate thread about accessing my medical notes from my hospital admission.
 
carina62 said:
To be honest, I'm a bit worried now taking Metformin after what's happened to me. I think I need to see my GP to discuss my concerns. I honestly didn't think that a severe case of S&D would cause this problem for me. Is it because I'm diabetic do you think that these 'complications' came up? I'm not entirely sure why I ended up having a raised Lactate level in my blood. I've actually posted a separate thread about accessing my medical notes from my hospital admission.
Click to expand...
You do need to find out, I am now listed as allergic to Metformin.
 
carina62 said:
To be honest, I'm a bit worried now taking Metformin after what's happened to me. I think I need to see my GP to discuss my concerns. I honestly didn't think that a severe case of S&D would cause this problem for me. Is it because I'm diabetic do you think that these 'complications' came up? I'm not entirely sure why I ended up having a raised Lactate level in my blood. I've actually posted a separate thread about accessing my medical notes from my hospital admission.
Click to expand...
I think others mentioned that dehydration, which would certainly occur with S&D, could cause raised lactate levels. My guess (but I don't know!) would be that somehow the metformin can, in rare circumstances, make it more difficult for the body to rid itself of the lactate and result in levels climbing too high. In a similar way, lack of insulin can cause ketosis and high blood sugar levels, leading to raised ketone levels which the body finds more difficult to remove...when there is a lack of insulin, eventually resulting in diabetic ketoacidosis (DKA). Ordinarily, ketosis will occur at low levels whenever a person is not eating properly, but if there is sufficient insulin it doesn't become a problem.

Definitely something to quiz your GP about, if only to allay your concerns 🙂
 
On this page

http://patient.info/health/advice-for-people-with-diabetes-when-unwell

it has the following advice
  • If you take metformin and you become very lacking in fluid in the body (dehydrated), you should stop taking metformin and contact your GP for advice.

I know at one point I was on both insulin and metformin (they were going through a phase at my hospital to have Type 1s take it. I had some issues with high BMs as I was ill and when I finally got to speak to the DSN she said that as soon as I became ill and was having issues controling my BM with insulin, I should have stopped the metformin till I was better.
 
margie said:
On this page

http://patient.info/health/advice-for-people-with-diabetes-when-unwell

it has the following advice
  • If you take metformin and you become very lacking in fluid in the body (dehydrated), you should stop taking metformin and contact your GP for advice.

I know at one point I was on both insulin and metformin (they were going through a phase at my hospital to have Type 1s take it. I had some issues with high BMs as I was ill and when I finally got to speak to the DSN she said that as soon as I became ill and was having issues controling my BM with insulin, I should have stopped the metformin till I was better.
Click to expand...

I've got an appointment with my Pharmacy today to go over my medication with them and will mention my hospital admission. I've also made an appointment with my GP for next Tues and will go over her notes on what happened and mention my high HR at the same time. I honestly feel like stopping taking all my medication which I know would be foolish but I want to cut out as much as I can but can't think what I can cut out as I take the following:- Ramipril (small dose 2.5mg for BP); Omeprazole (which I don't take every day anyway); Atorvastatin (I have been on this for years and I feel that my numbers haven't come down enough for me to stop taking this); Nortryptyline (which I hope to come off in January once I've seen the Consultant) and of course Metformin (x2 tablets daily, which I now have an issue with after my hospital admission).

Do you agree? any thoughts?
 
I'm not meaning to be cheeky Carina but had you had any alcohol before the episode because that apparently exacerbates lactic acidosis. One of the reasons I didn't fancy metformin.
 
carina62 said:
I've got an appointment with my Pharmacy today to go over my medication with them and will mention my hospital admission. I've also made an appointment with my GP for next Tues and will go over her notes on what happened and mention my high HR at the same time. I honestly feel like stopping taking all my medication which I know would be foolish but I want to cut out as much as I can but can't think what I can cut out as I take the following:- Ramipril (small dose 2.5mg for BP); Omeprazole (which I don't take every day anyway); Atorvastatin (I have been on this for years and I feel that my numbers haven't come down enough for me to stop taking this); Nortryptyline (which I hope to come off in January once I've seen the Consultant) and of course Metformin (x2 tablets daily, which I now have an issue with after my hospital admission).

Do you agree? any thoughts?
Click to expand...

Unfortunately having no medical background - I cant help with your questions other than to say - make sure that the pharmacist or gp gives you a good overview of what eveything does and ask about potential alternatives Talk about the side effects of taking the various tablets (but you also need to find out how common or rare those side effects are). You also need to talk about what the consequences of not taking the medicines are. You can then look at a list of pros & cons and make an eduated decision. It might help to formulate a list of questions that you want answers to. It might be too late to do this for the pharmacy appointment but you can do it before you see your GP.
 
Amigo said:
I'm not meaning to be cheeky Carina but had you had any alcohol before the episode because that apparently exacerbates lactic acidosis. One of the reasons I didn't fancy metformin.
Click to expand...

I had no alcohol at all No.
 
Well had my appointment with the Pharmacist today. As I thought, she said it is best to carry on taking the medication I take and the only thing she can think of is when I see my GP on Tuesday to mention whether I can change to slow release Metformin. The BP tablet (Ramipril) is only a low dose one as it has been decreased from 5mg to 2.5mg as my BP has gone down since losing weight but I do hope to come this eventually. Regarding my Nortryptyline, I see the consultant in January so will discuss this with her then. She advised I continue with the Omeprazole especially as I have a hiatus hernia and as for the statins, I have been on these for years and can't see me coming off these as my numbers are still not as great as they should be regarding cholesterol, trigylcerides etc so all in all a bit of a waste of time as she said it is not a good idea to stop the medication as I could be worse off if I did. Can't help but feel a bit down about it all to be honest :-(
 
carina62 said:
Well had my appointment with the Pharmacist today. As I thought, she said it is best to carry on taking the medication I take and the only thing she can think of is when I see my GP on Tuesday to mention whether I can change to slow release Metformin. The BP tablet (Ramipril) is only a low dose one as it has been decreased from 5mg to 2.5mg as my BP has gone down since losing weight but I do hope to come this eventually. Regarding my Nortryptyline, I see the consultant in January so will discuss this with her then. She advised I continue with the Omeprazole especially as I have a hiatus hernia and as for the statins, I have been on these for years and can't see me coming off these as my numbers are still not as great as they should be regarding cholesterol, trigylcerides etc so all in all a bit of a waste of time as she said it is not a good idea to stop the medication as I could be worse off if I did. Can't help but feel a bit down about it all to be honest :-(
Click to expand...
Sorry it was not a more positive experience.
 
Hopefully, the assessment in January will enable removal of one of the meds 🙂 When I was diagnosed I was put on 11 different meds as well as insulin. I felt quite poorly all the time for several months but it was so difficult to pinpoint the culprit or culprits. Eventually I managed to come off them one by one and things improved 🙂 I now just have insulin plus candesartan for BP, but at a low dose and feel much better generally 🙂 Hope you get there eventually too - keep up your good work and I'm sure you will make it! 🙂
 
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