Can't tolerate Metformin

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Paschal

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Hello everybody. Looking for some advice on Metformin. I started taking it a week ago, prescribed 5mg/850mg twice a day but can only manage to take one tablet a day. They are making me incredibly dizzy. Was diagnosed
with Type 2 with a blood test reading of 52. The blood monitor read 7. I asked not to be put on medication but my doctor advised against it as, a few years ago, I had a slight heart attack. I'm really worried that by coming off the meds bad things will happen. I'm fit and lean and do not need to lose weight. I have modified my diet and eating less carbs and sugar. Does anyone see any hope for me? Thanks.
 
Hello. What is the exact name of the medication on the packet? Your doses sound like it might be a combination tablet. Do you take your blood sugar or blood pressure when you are feeling dizzy?
 
Hi. Thanks for the reply. The name is XIGDUO so, you're right, it must be a combination therapy. I've been dizzy since two days after starting it. Feel very lightheaded and tired. My blood pressure readings are generally good as I'm on medication for that.
 
That's a combination of dapagliflozin and metformin I take these 2 but separately and found the dapagliflozin a good tablet but have to keep myself well hydrated personally I would speak to someone from your docters about it.
 
I'm also on Xigduo - The 5mg is the Dapagliflozin component and the 850mg is the Metformin component.

I was started on Metformin only and did not experience any dizziness, though I did experience a little nausea in the beginning. I was then switched to Xigduo 5mg/1000mg and did experience a few brief bouts of dizziness when I stood up after sitting down for a while. I tested my blood pressure and blood glucose at the time and ruled those out as the cause of the dizziness. It stopped happening after a couple of weeks and I currently have no side effects that I can sense.

I would suggest going back to the doctor and talking it through with them, perhaps with a view to getting separate Metformin and Dapagliflozin tablets. If you were to go on Metformin only for some weeks with no Dapagliflozin component and did not experience dizziness that might tell you which of the two medications might be causing the problem.
 
Hi. Thanks for the reply. I guess everyone reacts differently to meds. I know I can't function at all on this tablet and even though my GP is very good, I feel he's not interested in hearing me whingeing about the side effects, namely dizziness and lightheadedness. Since I had a heart issue and because I am not overweight I think he just wants to keep me on meds. As silly as it may sound, I wish I was overweight because, for many, it seems weight loss really works at reducing numbers and achieving remission. I really appreciate your reply. Thank you.
 
PerSpinasAdAstra said:
I'm also on Xigduo - The 5mg is the Dapagliflozin component and the 850mg is the Metformin component.

I was started on Metformin only and did not experience any dizziness, though I did experience a little nausea in the beginning. I was then switched to Xigduo 5mg/1000mg and did experience a few brief bouts of dizziness when I stood up after sitting down for a while. I tested my blood pressure and blood glucose at the time and ruled those out as the cause of the dizziness. It stopped happening after a couple of weeks and I currently have no side effects that I can sense.

I would suggest going back to the doctor and talking it through with them, perhaps with a view to getting separate Metformin and Dapagliflozin tablets. If you were to go on Metformin only for some weeks with no Dapagliflozin component and did not experience dizziness that might tell you which of the two medications might be causing the problem.
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Hi. Thank you for the comprehensive reply. It's great to get advice from someone who is on the same tablet. I might ask my GP to put me on Metformin only. I can see how I tolerate it for a few weeks. I guess I am very worried that all the diabetes meds will make me dizzy. I'm on blood pressure tabs, asprine etc but they have never been an issue with me. Can I ask you another question, please? Have you ever heard of someone who is fit and "healthy" finding remission with a modified diet and, consequently, being able to come off meds?
 
Paschal said:
Hi. Thank you for the comprehensive reply. It's great to get advice from someone who is on the same tablet. I might ask my GP to put me on Metformin only. I can see how I tolerate it for a few weeks. I guess I am very worried that all the diabetes meds will make me dizzy. I'm on blood pressure tabs, asprine etc but they have never been an issue with me. Can I ask you another question, please? Have you ever heard of someone who is fit and "healthy" finding remission with a modified diet and, consequently, being able to come off meds?
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You're very welcome.

Yes I've read many stories on this forum and elsewhere from people who have gone into remission though diet and exercise alone, or even just diet. Type 2 diabetes remission is defined as having a HbA1c test result below 48 mmol/mol for at least 3 months without any diabetes medication.

Unfortunately there is a very wide range of levels of diet restriction that people adhered to in order to achieve that result. Some could eat a moderate amount of carbohydrates per day, while others needed to eat extremely little carbs to keep their blood glucose levels down. There are some who don't eat any fruit, apart from maybe a few berries per day, and don't eat any 'below ground' vegetables, going so far as to exclude things like carrots. We all need to get our daily calorie intake from somewhere or we lose weight and eventually starve to death, so a very low carb diet implies a diet that is high in protein or fat, or both.

It is my personal view that eliminating very high carb foods and meals makes perfect sense. I have stopped eating pizza, chips and bananas for example, and I have switched to red lentil pasta instead of the plain stuff and eat it in small quantities in order to reduce my carb intake a bit. I believe that excluding too much in the way of fruit and many vegetables and eating lots of fatty foods to make up the missing calories may however be going too far as it may not be ideal for maintaining long-term health. I'd personally rather be on Metformin and be able to eat an apple and have carrots with my dinner than to exclude apples and carrots from my diet altogether.

As your test result of 52 (which I assume is your HbA1c result) is not extremely high you might find that relatively small changes to your diet might be enough to do the trick. It all depends on where you currently get your calories from. To give one example - a big serving of cooked pasta might have the same calorie content as a smaller serving that is drowned in olive oil. The smaller serving will have less carbs, less impact on your blood sugar levels, and olive oil is thought to be about as healthy as a source of fat gets. Those are the kinds of changes I have personally chosen to make as a reasonable compromise, those I feel are unlikely to do me any harm in the long term.

Best of luck

*edited for typos
 
Have you changed your diet at the same time as starting this medication?

The reason I ask is that a low carb diet can cause your blood pressure to become lower and if you are already on BP meds, they may now be taking you too low. Do you test your BP at home? If so, it would be important to test when you feel dizzy like this. It may be that your BP medication needs lowering, so do talk to your doctor and get checked out.
 
Am I right in thinking you were mentioning this problem in another thread but hadn't mentioned it was a combined medication. I think it is important to drink plenty when taking a medication which encourages the kidneys to flush out excess glucose via urine otherwise you can become dehydrated.
I thought you were going to try to speak to your doctor about changing the medication as it does seem a bit excessive when your HbA1C is not desperately high.
 
Hello. That was a much appreciated reply. You have made many interesting observations. I've already started to reduce carbs greatly. For example, I only have, on average, two small slices of low carb bread a day. I've cut out all cakes and biscuits etc. Smaller servings seem like a good idea; I hadn't thought about that. Yes, 52 is my HbA1c reading. I just wish Metformin agreed with me but I'll stick it out and give it more time in the hope that I adjust to it. Like everybody, a diabetes diagnosis is the last thing I wanted! "Per spinas ad astra" reminded me of my school days where Jesuit priests had my peers...and myself... write that phrase out a 100 times as punishment for some slight misdemeanor! You can't beat a Catholic education! Lol. Yet, it's a great phrase facing diabetes 2! Thank you once again and all the best for your health.
 
rebrascora said:
Have you changed your diet at the same time as starting this medication?

The reason I ask is that a low carb diet can cause your blood pressure to become lower and if you are already on BP meds, they may now be taking you too low. Do you test your BP at home? If so, it would be important to test when you feel dizzy like this. It may be that your BP medication needs lowering, so do talk to your doctor and get checked out.
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Hi Barbara. Thank you for the reply and making a very good point. I have a home blood pressure machine and I'll test my BP more regularly to see if it's getting too low. Metformin seems like poison to my system but l'll keep taking it in the hope it causes less side effects with time. I wish you well and thank you again for your advice.
 
Leadinglights said:
Am I right in thinking you were mentioning this problem in another thread but hadn't mentioned it was a combined medication. I think it is important to drink plenty when taking a medication which encourages the kidneys to flush out excess glucose via urine otherwise you can become dehydrated.
I thought you were going to try to speak to your doctor about changing the medication as it does seem a bit excessive when your HbA1C is not desperately high.
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Hi. Yes. I had forgotten to mention that it is a combination medicine; I guess the clue was in the name Xigduo! Mind feels a bit addled these days. You might have hit the nail on the head with the dehydration idea. I drink very little water but now realise the importance of the kidneys flushing out the excess glucose. Unfortunately, I had a slight heart attack 7 years ago and had some stents put in, so this is why my GP prescribed meds so quickly. I spoke to him about not taking the tablets but he dissuaded me. I just hope I get used to Metformin. Thanks for the great advice and I wish you well.
 
Also, thinking about it, your combination drug contains a "flozin" diabetes medication by the sound of it. This works by encouraging your body to remove glucose through your kidneys via your urine. As a result it makes you wee more to get rid of the excess glucose. If you are removing more fluid from your body than you are putting in, that can also drop your BP, so that might be the culprit for your dizziness.
Are you making sure to drink extra fluids whilst you are on this medication? I know at this time of year I tend to drink less water because it is cold and I simply don't fancy it, whereas when it is hot weather, I want to drink water to cool me down as well as hydrating me. With Dapagliflozin it is really important to drink plenty to flush the glucose out.
 
Hi. Thanks again. I am the world's worst water drinker. I simply hate the stuff! Lol. However, you've made me reach for the Evian bottle! I'll definitely start drinking more and maybe this will combat the lightheaded and dizzy feeling. If all else fails I'll try another med. Thanks once again.
 
Paschal said:
Hi. Thanks again. I am the world's worst water drinker. I simply hate the stuff! Lol. However, you've made me reach for the Evian bottle! I'll definitely start drinking more and maybe this will combat the lightheaded and dizzy feeling. If all else fails I'll try another med. Thanks once again.
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I have a feeling they recommend you drink 2 litres a day, I don't think it need to be just water but could be other low carb drinks as well.
 
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