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Slow release Metformin worries

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Cookieones

Cookieones

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Relationship to Diabetes
Type 2
Hi all, diagnosed as type two in October, HBA1C of 71 put on to Metformin but after two months of suffering with Diarrhea & bad flatulance I returned to my Dr. I was the. Put on to Metformin slow release tablets @ 2000mg per day. That’s when my troubles began, just over a week in I became really ill, I ended up vomiting blood & passing black stools, I was rushed into hospital on two’s & blues. I was kept in for 4 days & given a transfusion, released & ended going back in 4 days later and given another transfusion, I have undergone an endoscopy & ct scan, the results showing a slight scaring of the liver but no signs of a bleed. I’m still passing black stools so obviously bleeding from somewhere, I’m due back in for a colonoscopy on the the 4th of January, prior to the 2000mg of slow release Metformin I was perfectly healthy with my diabetes under control with regular bg levels of 5 to 6.8 with the occasional spike, could the Metformin be a contributing factor? Your views & comments would be greatly appreciated. Kind regards Allan.
 
Hi Cookieones, welcome to the forum 🙂 Very sorry to hear about the problems you are experiencing :( It's not a problem I have heard of, and although metformin can have some uncomfortable side-effects it is so widely used that I'd be surprised if it was the cause. What does the GP say? Might it be worth stopping the metformin (on doctor's approval) to see if things improve? Might there be other ways you can manage your blood sugar levels, such as making adjustments to your diet and reducing carbohydrate intake? What sort of diet have you been following since diagnosis, have you made many changes?

Sorry for all the questions! 🙂
 
Welcome to the forum Cookieones. You're right to be worried by bleeding from your gastro intestinal tract. I hope your colonoscopy on 4th Jan gives some answers. In the meantime, unless you've been advised otherwise by your doctors, then you should stick with your current treatment.
Please let us know how you get on.
 
Thanks for the encouragement, the hospital put a halt to the Metformin & replaced it with Xelevia @ 100mg a day. My take on the subject is that I should have been slowly introduced to Metformin slow release @ 500mg a day to see how my body coped with it, then a gradual increase instead of 2000mg x 1000mg2 twice a day. The pharmacist who gave me my new drugs seemed to think that the Metformin was responsible for my problems.
Kind regards, Allan.
 
Cookieones said:
Thanks for the encouragement, the hospital put a halt to the Metformin & replaced it with Xelevia @ 100mg a day. My take on the subject is that I should have been slowly introduced to Metformin slow release @ 500mg a day to see how my body coped with it, then a gradual increase instead of 2000mg x 1000mg2 twice a day. The pharmacist who gave me my new drugs seemed to think that the Metformin was responsible for my problems.
Kind regards, Allan.
Click to expand...
Hadn't realised you were put on the maximum dose from the start Allan, it is normally introduced slowly over a number of weeks, as you describe. I hope that the colonoscopy helps find a cause and a good solution for you 🙂
 
Spot on thx again
 
Okay time for an update, I’ve undergone more tests camera both ways and absolutely nothing found apart from a couple of small polyps that they removed during the procedure.
Back to see the consultant who confirmed a clean bill of health apart from my liver not fully functioning as it should be, so I have been booked in next month for a fibroscan on my liver to try and find out what the problem if any is.
Feeling a lot better now but still not firing on all cylinders due to a low blood count, 4 on admission to hospital, 9 on my second release and now at 12, so tend to run out of a bit of oomph during the day, my count before my episode was 16, so definitely on the way up.

Back to the Dr’s for my three monthly, well four due to my hospitalisation and fearing the worst as hospital food is not really diabetic friendly, and was quite pleased with the results, Hba1c of 36 & cholesterol at 3.5.
The fight continues with my diabetes, with a huge thank you to this forum & it’s contributors you have been such an inspiration for me. And not forgetting my wife for all her help & support during this very difficult time since being diagnosed, shopping now takes her twice as long!
 
I had the same experience @Cookieones last year when I was diagnosed. My husband was with me and we both thought the Dr said to be taking the maximum dose by the end of the week. I also landed in hospital - but when they started talking scopes I said no thank you!! I still have trouble keeping my potassium levels up. But I won't be in the same room as a box of Metformin.
S.
 
Well at least I know I’m not on my own @ Sadhbh. Every Dr & consultant that I have seen tell the same story, no Metformin will not do that, well I beg to differ. I was as fit as a fiddle apart from being diagnosed last October with diabetes, I had that under control with diet & keeping fit with long walks (took my dog by surprise, never had so many walks) and using my treadmill plus metformin prescribed & 500mg to start & working up to 1500mg per day, then a week latter I had to visit my Dr’s for another problem and he looked at the dose the other Dr had prescribed and said no you need to be on 2000mg per day. Luckily I only took 2 tablets a day as I could not tolerate the side effects.

I returned to my GP a few weeks latter as I found the side effects unbearable from the metformin, the Dr that prescribed the 2000mg then put me on s/r metformin @ 2 tablets a day, so of course I automatically assumed that he had halved the dose not realising that each tablet contained 1000mg, within a few days I went down like a bag of spuds and at one point the defibrillator was called for by the ambulance crew that attended to me at home, and I can’t thank them enough, I feel sure they saved my life.

I’m now taking sitagliptin @ 100mg per day with no side effects and apart from feeling tired and not sleeping to well I seem to be over the worst fingers xd.
I have lost quite a bit of weight and now tip the scales at 89kg with a HbA1c of 36 (down from 75 @ dx) and cholesterol’s @ 3.5, I’m finding it very hard with being a newbie to all this but the battle continues
Allan.
 
The thing is; if you look at the BNF guide for Metformin then those are not it's possible side effects. But, it's not just Metformin you are taking. The Metformin is mixed with other chemicals (especially in SR to slow it down) and it's possible that you are reacting to one of those. I have read some stories of people having reactions to specific brands because of what is in them as the filler.

You are doing good with your HbA1c!

Have you changed you diet? Transitioning to low carb can make you tired for a while until your body adjusts (it's a bit cold turkey).
 
Yes complete change of diet, the tiredness is due to the low blood count I am suffering at the moment but that is now gradually increasing. I lost quite a lot of blood due to internal bleeding that required me having two transfusions. When discharged from hospital I was given my new medication with the pharmacist telling me that you will not be taking metformin as they were the cause of your problems.
Allan.
 
There are cases of gastrointestinal bleeding with Metformin in the literature. It is very rare, but it can happen. In general, Metformin is exceptionally safe.

I suppose because it so very rare, it doesn’t appear in the routine lists of side effects.
 
@mikeyB, sounds about right for me! Lol, just hoping now that it has not done any permanent damage to my liver, also puzzled as to why they did not start me off on a low dose and build up instead of straight on to the max dose of 2000mg?
 
So am I. Puzzled, that is. You should always titrate upwards with dosages depending on response. Why take the max if half will do?

The liver is far and away the best organ in the body for self repair, don’t worry.
 
Thanks for the reassurance Mike, it has certainly been a worrying few weeks but hopefully when I have my liver test next month it will be good news, in the meantime the battle continues with my diabetes, I’ve learnt a lot these last few weeks from the excellent contributors on this site. Thank you for all the good advice and help.
Allan.
 
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