Hello, welcome back to my blog. Metformin is a first line medication to treat Diabetic type 2 since approved by the FDA in 1995. However, people have abused it because of the potential to cause weight loss. However, there is a serious side effect that you need to be aware of prior to use it: explosive diarrhea. Let’s find out

What is Metformin?

Metformin is a medication used to treat patients who are diagnosed with type 2 diabetes and gestational diabetes. 

An estimated 10.5 percent of the US population (roughly 34.2 million people) have diabetes.

How is Metformin used in a clinical setting?

There are 2 type of diabetes:

• Type 1: The pancreas produces little or no insulin
• Type 2: The pancreas produces enough insulin but the body can’t process it.

There is a difference between treatment for type 1 and type 2. With type 1, the treatment often starts with insulin injection. But with type 2, initial treatment is oral medication and Metformin is the first line of treatment. 

Metformin can be used for both prevention and treatment of type 2. For treatment, the initial therapy is 500 mg (which is 1 tablet) once or twice a day by mouth. 

Do I need a doctor’s prescription to get it?

Yes

How much does Metformin cost?

Metformin is available as 500mg, 625mg, 850mg, and 1,000mg. 

30 tabs of Metformin 500mg cost $3.90, which is $0.13 /tablet. The price is from CostPlus drug company by Mark Cuban, which is an amazing company whose mission is to make prescription medication more affordable. 

You can check out my blog about Cost Plus Drug company here if you are interested:

MARK CUBAN COSTPLUS DRUG COMPANY: CAN YOU REALLY SAVE MONEY?

What are the side effects of Metformin?

Most common side effects are: diarrhea, flatulence, nausea and vomiting. More than 75% of those who take Metformin will experience gastrointestinal side effects. 

How to stop diarrhea from Metformin?

GI side effects will be lessened if you take Metformin with a high protein meal or snacks. Please don’t take Metformin on an empty stomach. For instance, since Metformin is often prescribed twice a day, you should take it right after breakfast and dinner. 

Should I use Metformin to lose weight?

First off Metformin isn’t approved by the FDA as a medication for weight loss. In regards to weight management, Metformin is indicated to treat Antipsychotic-induced weight gain, but as an off-label use. One of the typical side effects of Antipsychotics weight gain. So if you are taking Antipsychotic medication, talk to your doctor about Metformin. 

In general,it depends on a lot of factors. Here are the evidences:

For type 2 diabetes:  Large cohort studies have shown weight loss benefits associated with metformin therapy. You can find the study here.
For overweight and obese populations: Metformin was found to significantly decrease body mass index percentile (BMI) and had a tendency to decrease BMI (kg/m2) and weight (kg). You can find the study here.
For non-diabetic individuals with obesity: Metformin is an effective drug to reduce weight in a naturalistic outpatient setting in insulin sensitive and insulin resistant overweight and obese patients. You can find the study here.

 In conclusion

Metformin requires prescription from a doctor anyway so please see your primary care provider if you decide to use Metformin to lose weight. For individuals who obtain Metformin without a prescription and use it to lose weight, there isn’t a FDA approved indication for it and you might experience severe side effects such as diarrhea if you take it incorrectly. 

References:

Yerevanian, A., & Soukas, A. A. (2019). Metformin: Mechanisms in Human Obesity and Weight Loss. Current obesity reports, 8(2), 156–164. https://doi.org/10.1007/s13679-019-00335-3

Hui, F., Zhang, Y., Ren, T., Li, X., Zhao, M., & Zhao, Q. (2019). Role of metformin in overweight and obese people without diabetes: a systematic review and network meta-analysis. European journal of clinical pharmacology, 75(4), 437–450. https://doi.org/10.1007/s00228-018-2593-3

Seifarth, C., Schehler, B., & Schneider, H. J. (2013). Effectiveness of metformin on weight loss in non-diabetic individuals with obesity. Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association, 121(1), 27–31. https://doi.org/10.1055/s-0032-1327734