Metformin Side Effects: Keep an Eye out for These Symptoms

Metformin Side Effects: Keep an Eye out for These Symptoms

Metformin, a widely used medication for treating Type 2 diabetes, is generally safe and effective. It can even be combined with other diabetes medications, including insulin, to manage blood sugar levels more effectively [1]. However, like any medication, it comes with potential side effects, particularly over the long term.

Common long-term side effects of metformin include chronic diarrhea or gastrointestinal discomfort, such as nausea, flatulence, heartburn, and abdominal pain. Some patients may experience these symptoms months or even years after starting the medication [1][2][4].

Another potential long-term issue is vitamin B12 deficiency, which can result from reduced absorption due to metformin use. This deficiency may lead to anemia, neuropathy, or memory problems [2].

Rare but serious complications of metformin include lactic acidosis and hypoglycemia. Lactic acidosis, a buildup of lactic acid in the blood, can occur in patients with kidney impairment, heart failure, or excessive alcohol intake. Symptoms include abdominal pain, vomiting, fast or shallow breathing, muscle cramps, unusual tiredness, and require immediate emergency medical attention [2][3][4].

Hypoglycemia, or low blood sugar, is more likely to occur when metformin is taken in combination with insulin or other diabetes medications like sulfonylureas. Symptoms of hypoglycemia include shakiness, sweating, fast heartbeat, and confusion [3][4].

To manage these side effects, gastrointestinal symptoms may improve by adjusting the metformin dose, switching to an extended-release form, or dividing doses throughout the day. If diarrhea or GI upset persists chronically, consult your healthcare provider to evaluate the cause and consider alternative treatments [1][2].

Periodic testing for vitamin B12 deficiency may be recommended, especially if symptoms such as numbness or weakness occur. People with kidney, liver, or heart problems should be carefully monitored, and alcohol intake should be limited to reduce the risk of lactic acidosis [2][3].

In summary, while metformin is generally well-tolerated and safe for long-term use, monitoring and managing gastrointestinal symptoms, vitamin B12 status, and being alert to signs of rare but serious complications like lactic acidosis are key to optimal treatment. Always consult your healthcare provider about any persistent or severe side effects.

If you have kidney disease or other kidney conditions, notify your healthcare provider before taking metformin. If you've taken metformin for four years or more, you're at higher risk for vitamin B12 deficiency [2]. Most people handle metformin with little to no mild side effects [4].

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