Hi all, looking to see if anyone has had any side effects while taking Metformin. After a trip to the Diabetes Nurse last week, I found myself agreeing to start to take 1 500mg tablet per day for a week before moving to 2 tablets in week 2. However, I have had a severe unrinary infection about 5 days of starting to take it and while the doctor has said it is not linked, the extreme nature of the infection has me worrying that the Metformin may have played a part in the problem.
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Metformin Side Effects
- Thread starter JimmyBlue
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@Lucyr my average daily BG according to my CGM is around 6.4. I am normally below 8.5 two hours after meals although I have had a few spikes of late but I have a good idea of what is causing them. The pressure for me to take Metformin is down to the high initial HbA1c (82) back at the end of September, since then I have followed a low carb diet which may even have been to low considering my weight loss (which I didn't need).
I have a call with the Diabetes nurse tomorrow and will discuss it with her, but for my own reassurance I am tempted to say I want to avoid Metformin until after my next HbA1C in early January.
There is some research out there that says that Metformin can increase the risk of UTIs although there is also evidence that it reduces the risk. As always there is no straight answer.
I have a call with the Diabetes nurse tomorrow and will discuss it with her, but for my own reassurance I am tempted to say I want to avoid Metformin until after my next HbA1C in early January.
There is some research out there that says that Metformin can increase the risk of UTIs although there is also evidence that it reduces the risk. As always there is no straight answer.
saffron15
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I am slightly jealous of those allowed to try without medication. I started off well before medication losing 10 kg. I was on 500 mg slow release metformin increasing by one tablet a week until I was started on an SGLT2 and the metformin was reduced to two tablets. The first two weeks of metformin i was bunged up a bit 5 days for first poo and 8 until the second although when I did poo that time stools were smooth and neat. However over the next two weeks things loosened up so the metformin was reduced when I went on the SGLT2. Apart from one occasion every time I pooed it was diarrhea. I saw the HCP on 30 Sept and told him about diarrhea but conceded I couldn't say if it maybe stress or something I ate. Last week it stopped but I am now passing motions more frequently. I have rebelled today and not taken the statin as I am fed up with my aching legs and hips. I felt well on metformin even when the diarrhea started. It was never watery and I was getting good sleep as I was peeing less and losing weight modestly. Since then I can say I have never had a day when I have felt completely well. I'm due a foot check and hba1c Tuesday from a nurse who caused me stress on Friday but I'm hoping she was just having a bad day. She should have checked my BG at the request of my consultant but only checked my blood pressure saying no appt for blood glucose and any way wasn't I monitoring my BG. I said yes and told her the last reading, to which she said she didn't know anything about diabetes!! Not looking forward to Tuesday. Don't have follow up as diabetes nurse off sick.
Rant over! In general I haven't had a problem with metformin. I have been warned UTIs are common with the SGLT2 but not had one yet. My hba1c was 69 end of June and 64 end of July. 58 start of September and possibly 51 ended of September
Rant over! In general I haven't had a problem with metformin. I have been warned UTIs are common with the SGLT2 but not had one yet. My hba1c was 69 end of June and 64 end of July. 58 start of September and possibly 51 ended of September
PerSpinasAdAstra
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I haven't read anything substantial linking Metformin with UTIs. 5 days after starting is also very quick for a UTI to take hold and become extreme. No proven or speculated mechanism by which Metformin works that I know of might link the two things. Metformin is basically a mild and very particular kind of 'poison' - it doesn't feed bacteria and it doesn't increase sugar in the urine (which an SGLT-2 inhibitor, a medication ending in 'flozin' will do).
UTIs can happen to anyone of course but in diabetics it's about sugar in the urine. The sugar feeds pathogens and allows them to 'grow their way up the pipe', if that makes sense. Every time you pee you flush them out but if there's a lot of sugar in your urine is leaves a kind of trail of food for pathogens to spread deeper over time. This is purely a guess but that guess would be that it started some time ago when your blood glucose levels were higher and is just now reaching the point where it's extreme and causing problems. I imagine that once the UTI is treated and so long as you drink plenty of water to dilute any sugar that might be in your urine - more flushing and less 'food left in the pipe', you probably won't be at much greater risk of UTIs than anyone else with your blood glucose levels.
As regards weight loss and whether Metformin will help - if your fasting BG level is above 5 mmol/L or so then Metformin may help as it probably reduces insulin resistance in the liver which should probably drop your fasting level a bit. If you have any kind of a belly - if you don't have a 'six pack' basically, then weight loss may also help. It's not about weight so much as about body fat percentage and where in the body that fat is sitting. If you are muscular, active and fit with no belly fat then weight loss is probably a bad idea. If you are under-muscled, haven't been active over the past few years and have a bit of a belly then weight loss may be both helpful and fine. BMI and body weight don't always match up with 'adiposity' - how fatty your body is. In my own case I am technically not overweight now on the BMI scale but I have very skinny arms and my belly still sticks out a bit. I've lost 5 stone since diagnosis and I did solve the liver fat problem and so dropped my fasting levels nice and low, but in my current shape and if I was diagnosed tomorrow I could probably drop 6 to 8 Kg and still have a health body fat percentage, and perhaps drop my liver fat levels and my fasting BG levels and improve my lot.
From everything I've gathered, and with the caveat that this is entirely unproven, it is the ratio of muscle to fat in the body along with how frequently that muscle is exercised which influences how much fat and glucose is stored is muscle tissue and how receptive your fat cells are to storing it after eating. This influences how much ends up being stored in the liver. Excess glucose and fat after meals ends up in the liver - like a short-term storage depot for energy. Excess fat in the liver causes insulin resistance in that organ and raises fasting levels. Dropping fasting levels soon after diagnosis appears to be all about changing the balance between energy entering the liver and being stored as fat, and fat exiting the liver and being burned by cells or stored in fat cells or in muscle. This is just a theory of mine and probably not worth much but it is based on research. It would explain why low muscle mass is a known risk factor for NAFLD, why exercise appears to make a big difference for some in achieving long-term stability, and why weight loss can bring about remission. Also a couple of weird cases I found on Reddit where people claim they achieved remission by lifting weights and building muscle. If it's all about liver fat then it all fits together. I believe that Roy Taylor's Personal Fat Threshold has exercise and muscle mass components in addition to body fat levels and genetics.
UTIs can happen to anyone of course but in diabetics it's about sugar in the urine. The sugar feeds pathogens and allows them to 'grow their way up the pipe', if that makes sense. Every time you pee you flush them out but if there's a lot of sugar in your urine is leaves a kind of trail of food for pathogens to spread deeper over time. This is purely a guess but that guess would be that it started some time ago when your blood glucose levels were higher and is just now reaching the point where it's extreme and causing problems. I imagine that once the UTI is treated and so long as you drink plenty of water to dilute any sugar that might be in your urine - more flushing and less 'food left in the pipe', you probably won't be at much greater risk of UTIs than anyone else with your blood glucose levels.
As regards weight loss and whether Metformin will help - if your fasting BG level is above 5 mmol/L or so then Metformin may help as it probably reduces insulin resistance in the liver which should probably drop your fasting level a bit. If you have any kind of a belly - if you don't have a 'six pack' basically, then weight loss may also help. It's not about weight so much as about body fat percentage and where in the body that fat is sitting. If you are muscular, active and fit with no belly fat then weight loss is probably a bad idea. If you are under-muscled, haven't been active over the past few years and have a bit of a belly then weight loss may be both helpful and fine. BMI and body weight don't always match up with 'adiposity' - how fatty your body is. In my own case I am technically not overweight now on the BMI scale but I have very skinny arms and my belly still sticks out a bit. I've lost 5 stone since diagnosis and I did solve the liver fat problem and so dropped my fasting levels nice and low, but in my current shape and if I was diagnosed tomorrow I could probably drop 6 to 8 Kg and still have a health body fat percentage, and perhaps drop my liver fat levels and my fasting BG levels and improve my lot.
From everything I've gathered, and with the caveat that this is entirely unproven, it is the ratio of muscle to fat in the body along with how frequently that muscle is exercised which influences how much fat and glucose is stored is muscle tissue and how receptive your fat cells are to storing it after eating. This influences how much ends up being stored in the liver. Excess glucose and fat after meals ends up in the liver - like a short-term storage depot for energy. Excess fat in the liver causes insulin resistance in that organ and raises fasting levels. Dropping fasting levels soon after diagnosis appears to be all about changing the balance between energy entering the liver and being stored as fat, and fat exiting the liver and being burned by cells or stored in fat cells or in muscle. This is just a theory of mine and probably not worth much but it is based on research. It would explain why low muscle mass is a known risk factor for NAFLD, why exercise appears to make a big difference for some in achieving long-term stability, and why weight loss can bring about remission. Also a couple of weird cases I found on Reddit where people claim they achieved remission by lifting weights and building muscle. If it's all about liver fat then it all fits together. I believe that Roy Taylor's Personal Fat Threshold has exercise and muscle mass components in addition to body fat levels and genetics.
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@everydayupsanddowns Hi I have gone the Metformin route so back on one tablet a day and will see how I feel. Not sure about moving up to two tablets a day. The other big pointer from my call was that my evening meal contained too little fat which was a potential factor in my weight loss. I now eat at one chocolate mousse based on the Freshwell app recipe (basically chocolate and cream) that my wife has become an expert in making. For now, monitoring my weight, checking my ketones, although they seem pretty stable and below 0.6 now, and reducing my running but upping my gym time where I do weights to try and build muscle mass.
Having agreed to all this, I now have to go to Germany for a few days to say goodbye to my colleagues and hand my laptop back. At least that will be the end of a major source of stress and my next HbA1c test will be on 7th Jan, so fingers crossed that the work I have been doing delivers a big improvement. Hopefully under 50 for the HbA1c.
Having agreed to all this, I now have to go to Germany for a few days to say goodbye to my colleagues and hand my laptop back. At least that will be the end of a major source of stress and my next HbA1c test will be on 7th Jan, so fingers crossed that the work I have been doing delivers a big improvement. Hopefully under 50 for the HbA1c.
silver minion
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Hope everything starts improving for you @JimmyBlue and your hbA1c test in January reflects the hard work you have put in to get your blood sugars down. I will quite often have a snack of a couple of dark ryvita crispbreads with either cream cheese and gherkins or sliced chicken and avocado. I have increased my fat and protein intake to replace carbs as I am trying to gain weight. The chocolate mousses sound good though.
Hi @silver minion one of the problems I have with my diet/change in food habits is that I am not a lover of cheese or eggs which makes things a little different. However, mozzarella is something I can deal with and I make the Freshwell Fat head dough rolls (almond flour and mozzarella) which means I can have a nice bacon roll in the morning or tuna and avocado in the afternoon for lunch. Can see that being my lunchtime meal while back in Germany as Gefluegelrolle is definitely a no-no now.
silver minion
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Yes I would be stuck for a lot of meals if I didn't eat cheese or eggs. The bacon roll sounds nice. I think the Gefluegenrolle is pretty high carb. A lot of German food is dominated by sausages and bread or potatoes. I miss the potato soup served with sliced wurst and rye bread, even though I wouldn't eat it now.