You can experience nausea from several things. And yes, it can be an uncomfortable ordeal because you feel like vomiting all the time. In most cases, vomiting will relieve you of that discomfort. In this article, we’ll discuss managing nausea from taking metformin, a common side effect. You can start to worry if you notice that you’ve been constantly vomiting for more than two days when taking metformin.
Diabetes
People with diabetes will often get nausea from the medicines they take, but will wear off with time. Whether it’s for type 1 or type 2 diabetes, metformin can help to control blood sugar levels and solve problems with the production of insulin. If diabetes is not treated, you risk having hypoglycemia or hyperglycemia.
It’s really a balancing act for people with diabetes not to get either of these conditions. When your body doesn’t produce enough insulin, this is called hyperglycemia. It can happen when you eat a lot but don’t get enough exercise. Insulin production is usually low in the morning, known as the dawn phenomenon.
Hypoglycemia happens when too much insulin is in the system, leading to a loss of appetite. If not treated, it can lead to troubling complications such as insulin shock, diabetic ketoacidosis, or diabetic neuropathy. Nausea can also result from hyperglycemia or hypoglycemia.
Taking Metformin For Diabetes
The popular choice when it comes to treating type 2 diabetes is metformin. It’s a common prescription given by physicians if you’ve just been diagnosed with diabetes. Metformin is the first choice because it helps your intestines not take too much glucose from your food.
Metformin also instructs your liver to produce less glucose. Its key mechanism of action is that it reduces your insulin resistance. This means it pushes your muscles to manage insulin better. As a result, your muscles absorb the glucose instead of keeping it in your blood. All these operations lower your blood sugar level, which is the ultimate goal for people with diabetes.
At the very beginning of diabetes treatment, you’ll be asked to take an A1C test. This exam will give you and your doctor a better idea of your average blood glucose management over two or three months. Metformin helps by preventing prediabetes from becoming diabetes. Prediabetes ranges from 5.7% to 6.4%; if your A1C result is over 6.4%, then it’s diabetes.
Metformin medications also come under different brand names, such as Glucophage, Glumetza, Fortamet, and Riomet, which is in liquid form.
There are a lot of combined pills that include metformin and other drugs as ingredients. These could be:
- Repaglinide and metformin, which is called Prandimet
- Glyburide and metformin, which is called Glucovance
- Glipizide and metformin, which is called Metaglip
- Sitagliptin and metformin, which is called Janumet
- Pioglitazone and metformin, which is called Actoplus Met
- Saxagliptin and metformin, which is called Kombiglyze
But you should avoid taking diuretics, thyroid drugs, corticosteroids, glaucoma drugs, calcium channel blockers, and birth control or estrogen pills with metformin.
Everybody is different, which will affect the dosage of metformin prescribed. Normally, your doctor will start with a small dose and gradually increase it. It’s very rare to be prescribed more than 2,000 or 2,500 milligrams a day. The normal starting dose is 500 or 1,000 milligrams daily, along with your evening meal. Your dose of metformin will also vary if you’re taking other medications.
Metformin And Nausea
As with all medications, metformin has side effects, but not everyone is affected by them. Can metformin make you nauseous? Yes, if you take it on an empty stomach. But aside from the nausea, it can also cause gas, bloating, constipation, loss of appetite, a metallic taste in the mouth, a stomach ache, and diarrhea. As mentioned, this will all pass; your body needs to get used to it.
Doctors will try not to give metformin to someone who usually has kidney problems. On the other hand, it could still be acceptable to prescribe it to someone with mild or moderate kidney issues.
Taking metformin can heighten your risk of having a urinary tract infection. If your urine starts to have blood or appears cloudy, contact your doctor immediately. Don’t fret if you see the outer shell of an extended-release pill in your stool; this just means that your body has absorbed the medication.
Metformin And its More Serious Side Effects
Hypoglycemia
If you only take metformin, your chances of getting hypoglycemia are lower. But, if you take a combination pill or metformin with other diabetic drugs or insulin, consult your physician to know what your chances of having low blood sugar are.
You may also be at risk of hypoglycemia if you refrain from eating for certain periods (a fast) or if you do heavy sports or other strenuous physical activities.
A Vitamin B12 Deficiency
While taking Metformin, ask your doctor to check your vitamin B12 level regularly, just to be on the safe side. You don’t have to be a diabetic to have a vitamin B12 deficiency, and this can happen to anyone. Metformin increases your chances of having a B12 deficiency over time.
A lack of vitamin B12 can bring about anemia when you have a low count of red blood cells. It can also cause peripheral neuropathy and a tingling sensation or numbness in your legs or feet. This is never a good sign for diabetics in general.
Other symptoms that could be signs of a vitamin B12 deficiency:
- A sore, red tongue
- Mouth ulcers
- Muscle weakness
- Feeling tired most of the time
- Yellow or pale skin
- Problems with your vision
Your doctor will prescribe B12 supplements to help bring your blood sugar levels back to normal, especially if you’re a vegetarian. But you can also easily get your natural supply of B12 through what you eat. Add more beef, chicken, eggs, dairy products, sardines, tuna, and certain cereals to your diet. Beef liver and clams have a higher level of B12.
Lactic acidosis
Lactic acid is a chemical that your red blood cells and your muscles produce naturally. This can become a serious condition when there’s a build-up of lactic acid. Now, if this happens while you are taking metformin, medically, it’s called metformin-associated lactic acidosis.
Lactic acidosis is a rare side effect while taking metformin, but it can happen if:
- You drink a lot of alcohol
- Are hydrated
- Have kidney or liver disease
- Have serious congestive heart failure
- Have diarrhea, fever, or vomiting
- Over 65 years of age
- Have had a previous episode of lactic acidosis while taking metformin
Not everybody will be exposed to these serious side effects, but monitor yourself. Especially if you’ve had a heart attack or heart failure, problems with blood flow, a serious infection, problem breathing, alcoholism, liver or kidney problems, or you don’t have your diabetes under control yet.
The rarest side effects ever reported with taking metformin are nightmares, unusual or lack of sleep, difficulty concentrating, drowsiness, and drunk-like behavior.
Can Metformin Cause Nausea?
Metformin is the go-to drug that doctors prescribe to type 2 diabetics because it has so many advantages that help to bring down your blood sugar level. However, as with any drug, it has some side effects.
In general, it has been known to cause some gastrointestinal problems. Metformin and nausea are always associated with gas, bloating, diarrhea, and vomiting. Once again, not everybody gets these side effects. You might get one or another symptom that happens at different frequencies and may not be too serious compared to another person.
For those who are concerned, you’re probably still screaming out, why does metformin cause nausea? Well, here’s a simple explanation. At the start, the benefits of taking metformin were mentioned. All these pros were linked to lowering your blood sugar level, the first goal of managing diabetes.
But metformin also increases the secretion of glucagon-like peptide-1 (GLP-1), which controls your appetite and activates insulin production. Over time, metformin also changes your gut microbiome, causing dysbiosis. These two reasons alone can already trigger metformin nausea.
Dysbiosis happens for three reasons:
- When there’s not enough bacterial benefits
- When there are too much pathogenic microorganisms (bacteria that make you sick)
- When there isn’t a diversity of microbial species
Dysbiosis can happen in any organ of your body. But you could get nauseous when there’s an imbalance, a lack, or too much bacteria in your gut. This sudden change to your gut microbes causes your body to be defensive at first. This is because it’s a new substance in your system.
In Biomedicine and Pharmacotherapy, a 2022 study was done on six bacterial species. This was spread out among a group of type 2 diabetic patients who are either intolerant in the early stages, tolerant, or intolerant to metformin. They suggested that dysbiosis happens in those who are intolerant to metformin.
But how this happens and why is still a wonder. Different studies had similar outcomes, but researchers are still trying to find strong evidence of this occurrence. It’s very difficult and unclear because researchers compare animal and human subjects.
Helpful Tips And Tricks To Reduce Metformin Nausea
Probiotic Supplement
To get metformin nausea relief, you could try a probiotic supplement. A 2023 trial found that taking a probiotic with metformin reduced or even stopped side effects while keeping your blood sugar level normal. This is thanks to the activity of GLP-1 secretion in the intestine and more bacteria that produce SCFA (short-chain fatty acids) to assist with lower blood sugar.
One of the benefits of taking metformin is a larger production of the glucagon-like peptide hormone. This hormone slowly delays food traveling through the digestive system. Without this gastrointestinal movement you would have nausea and vomiting.
Combined with metformin, this could lead to a build-up of unabsorbed carbohydrates in the large intestine, which then causes gas or bloating. This only happens in the large intestine because metformin can naturally stop the digestion process of carbohydrates in the small intestine.
Smaller Doses
Your question at the start was, does metformin cause nausea? And now you know the answer. If you have just been prescribed metformin, you can ask your doctor to start giving you small doses. This is if you know you have another disease (kidney/liver problem) or you would just like your body to get used to the drug. Once more, don’t forget that not everybody gets side effects when taking metformin.
Metformin With A Meal
We are all different; someone can take metformin without any side effects. However, taking it with a meal is generally advised to eliminate the risk of gastrointestinal problems.
Relaxation
When taking metformin, try not to stress yourself out, but relax and rest if you can. Regarding your diet, start eating smaller but constant meals during the day. Placing a hot water bottle or a heating pad can also help you to relax.
Try The Extended-Release Form
If you have uncomfortable side effects, you can ask your doctor to try the extended-release form of metformin. Extended-release pills take time to break down and enter your system so that the side effects aren’t so strong. This is why you’ll need to take this type of tablet once every day.
When To Stop With Metformin
If you experience any of these symptoms, you should stop taking metformin and call your doctor:
- Weakness
- Discomfort
- Dizziness
- Lightheadedness
- Feeling cold in your hands and feet
- Shortness of breath
- Fast or slow heartbeat
- Deep and fast breathing
But never stop taking metformin alone because your blood sugar levels won’t be controlled. Future complications, such as nerve damage, vision problems, and heart disease, could arise. If you really can’t take the side effects from metformin then see your doctor for other alternatives.
Another reason you might be advised to stop taking metformin is if your kidney function is too slow. Metformin doesn’t affect your kidneys if they work normally. Diabetes is an incurable disease, but by making good lifestyle changes, your body might not need metformin anymore.
In Closing
Diabetes is a very manageable disease. The best things you can do for yourself are to take your meds, eat healthy, and keep fit. Also, try to respect your visits to the doctor and laboratory. You’ve seen how metformin is the first-line drug physicians prescribe to their type 2 diabetes patients because it’s very effective.
Metformin gets straight to the point and performs operations that will lower your blood sugar level. Of course, it may come with disturbing side effects for some people. But if you can focus on what it’s doing for your overall health, try to pull through, as these symptoms usually disappear. But if things are dangerously uncomfortable for you, your collaboration with metformin was not meant to be.
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