By: Lindsey VanDyke, DO, FACOI, FEAA
Metformin is my all-time favorite drug in all of medicine. Ever. Everybody who knows me knows that. Here’s why:
- It’s been around for years and has a long standing safety record.
- It’s dirt cheap.
- It’s a powerful anti-inflammatory.
- It promotes cellular recycling, which is why it has been called the first “anti-aging” pill.
- Covid patients on metformin have better outcomes than patients not on metformin.
- Metformin produces a small bone-building boost.
- It puts your body into a catabolic state–it’s basically like exercise in a pill.
- Let’s not forget it’s a great diabetes medication with low risk for hypoglycemia.
But it never fails that the internet decries the use of metformin and I meet patients every day who are adamantly opposed to using it.
So let’s explore the risks/benefits/alternatives for the use of metformin and bust some myths.
The Benefits of Metformin
In addition to my bullet points above, know that Metformin is renowned for its ability to regulate blood sugar levels effectively. By enhancing insulin sensitivity, it helps the body utilize insulin more efficiently, reducing the risk of high blood sugar. Apart from managing diabetes, metformin has shown promising results in treating polycystic ovary syndrome (PCOS) and even aiding weight loss. It’s a versatile medication that has benefited countless individuals worldwide.
Potential Risks and Side Effects
Metformin is NOT for everyone. Most of the sources that vilify Metformin refer to the known phenomenon of lactic acidosis, which is a significant medical problem. However, when someone has normal kidney function, is not critically ill, is not undergoing surgery or procedures involving contrast, we just don’t see lactic acidosis happen.
Like any medication, metformin does come with potential risks and side effects. However, it’s important to note that these occurrences are relatively rare and often outweighed by the medication’s benefits. Some individuals may experience gastrointestinal issues such as nausea, diarrhea, or an upset stomach when starting metformin. However, these symptoms often subside over time, can be managed with reduced doses or may disappear with the use of the extended release formulation.
Alternatives to Metformin
While metformin is a commonly prescribed medication, it might not be suitable for everyone or may cause unwanted side effects. In such cases, there are alternatives available. Other oral medications, such as dipeptidyl peptidase-4 (DPP-4) inhibitors, sodium-glucose linked transporter 2 inhibitors (SGLT2), or glucagon-like peptide type 1 agonists (GLP-1) may be considered. It’s crucial to consult with your healthcare provider to determine the best option for your specific needs.
Busting the Myths
Now, let’s address some common myths surrounding metformin. One misconception is that metformin damages the kidneys. In reality, metformin is generally safe for individuals with healthy kidneys. However, if you have pre-existing kidney issues, your healthcare provider might need to adjust the dosage or consider alternative medications.
Seeking Professional Guidance
As always, it’s essential to consult with your healthcare provider before starting or discontinuing any medication. They will consider all of the variables–your medical history, current conditions, and potential drug interactions–before determining the most suitable course of action for you.