Fighting Back Against Metformin Gut Woes

Fighting Back Against Metformin Gut Woes

From the Desk of Dr. Z: AgelessRx Co-founder and Chief Medical Officer, Dr. Sajad Zalzala offers his insightful perspective on topics related to longevity. With a wealth of experience and a deep-seated passion for disease prevention and extending healthy lifespans, Dr. Z is dedicated to sharing his knowledge on the secrets to longevity. Today, he shares the most effective strategies for reducing potential gastrointestinal side effects of Metformin.

Here is what we’ll cover in this post:

  • How Metformin’s most common side effects are Gastrointestinal (GI) related
  • How symptoms resolve within two weeks
  • Expert tips for mitigating GI side effects
  • How Metformin causes GI effects

If you’ve ever heard of Metformin, then you’ve probably also heard that it’s one of the most promising longevity treatments available. But equally as popular as the treatment itself is metformin stomach issues. Many hesitate on starting with Metformin, worrying that the potential side effects will make their quality of life even worse.

My name is Dr. Sajad Zalzala, but you can call me Dr. Z. As the Chief Medical Officer of AgelessRx, I’ve been prescribing Metformin for over 20 years. Metformin side effects are mild and often go away on their own. More importantly, the potential benefits of Metformin are also much greater than the potential side effects.

Here are some tricks to help reduce Metformin side effects that I learned in my years of clinical experience.

Is Metformin Safe?

Metformin is overall a very safe medication. Metformin is listed on the World Health Organization’s List of Essential Medicines as one of the safest and most cost-effective treatments available. In 2020, the annual number of Metformin prescriptions exceeded 90 million, making it one of the most prescribed treatments as well.

But some people experience irritating Metformin stomach issues, especially after getting started with the medication. The good news is that most side effects are mild and go away on their own. Though there are some serious Metformin side effects, the most common side effects are nothing to worry about.

The most common Metformin side effects are gastrointestinal. Gastrointestinal side effects with Metformin are only seen in about 20-30% of patients, in my clinical experience. With more than 90 million prescriptions per year, that’s still about 2 million people suffering with nausea, bloating, loose stools, diarrhea, abdominal cramps, and vomiting.

Metformin side effects are typically more bothersome than they are severe. The number of patients who discontinue Metformin as a result of side effects using the ER version is less than 3% in my experience. At AgelessRX, we always recommend Extended Release (ER) Metformin to new patients. This way, you have the best opportunity to have the best results with Metformin.

The bottom line is that Metformin side effects are unlikely to impede your quality of life. If they do cause you trouble, relief is only a stone’s throw away with simple lifestyle adjustments and OTC medications.

How Long Do Metformin Side Effects Last?

Metformin side effects usually last up to two weeks. They’re only likely to return if a patient increases their dosage too quickly, or if they’ve go back to using the Immediate Release (IR) version of Metformin.

If you experience side effects with Metformin, rest assured that they’re temporary. Metformin stomach issues are most common right after starting treatment, and become less common as your body adjust to the medication.

Ultimately, experiencing side effects with Metformin is relatively uncommon. If you do experience symptoms, or they persist after two weeks, there are several simple steps to help relieve your symptoms.

How to Reduce Metformin Side Effects

  1. Take Metformin with a meal. You’re less likely to experience discomfort if your stomach is full when you take Metformin, so take it with the largest meal you consume.
  2. Take Metformin on a schedule. If you consistently miss doses, your body can’t adjust to the dose as well.
  3. If you’re taking the Immediate Release (IR) version of Metformin, switch your prescription to Extended Release (ER). This allows Metformin to be released slowly into your system rather than all at once.
  4. Slow your dose to avoid side effects. If your prescriber approves, start with a quarter of a tablet and increase each week by another quarter to slowly increase to the full 500mg dose. It may take longer for you to experience the full benefits of Metformin by going this route, but the road will be much more pleasant.
  5. Try taking gas and bloating relief substance simethicone with your Metformin. This can help to reduce gas and bloating that may be caused by Metformin. You can by reliable options like Gas-X over the counter at most pharmacies.
  6. Enterically coated peppermint oil is can also help with gastrointestinal symptoms of Metformin. You can easily purchase this type of peppermint oil at vitamin stores or online retailers.
  7. For nausea specifically, try Ginger tea, capsules, or chewable candies such as Gin-Gins. These can be found at any grocery store or pharmacy.
  8. If you’re experiencing gastrointestinal cramping, ask your physician to prescribe dicyclomine or Bentyl. AgelessRx can also provide a prescription for Ondansetron (Zofran) 4mg tablets, (1 tab up to three times per day as needed). For these requests, please contact us via your AgelessRx Portal.
  9. Lower the amount of carbohydrates in your diet. Many patients find that keeping their overall carbohydrate intake under 150g a day directly correlates with less gastrointestinal side effects.

Why Does Metformin Cause Gastrointestinal Side Effects?

The exact mechanisms that cause Metformin stomach issues are unclear.

One of my favorite hypotheses is that Metformin causes favorable changes to the bacteria in your intestines. Other hypotheses include the increased stimulation of serotonin production, which in turn increases gut motility.

Metformin may also decrease the amount of glucose your body absorbs. Glucose is a solute, and the more solute there is moving through the large intestine, the higher the likelihood that water will be pulled in, which can potentially cause diarrhea.

Though scientists aren’t sure why Metformin causes side effects, they’re also not sure why Metformin is such an effective anti-aging agent. What is clear are the results. See for yourself what Metformin can do for you, and get started with a free visit today.


Note: The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.