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Causes and Treatment of Metformin-Induced Diarrhea

Metformin lowers blood glucose in different ways, and it does its job well. As soon as you start taking this commonly prescribed diabetes medication for Type 2, your liver makes less glucose, your liver absorbs less glucose from food, and your body uses its own glucose supply better. Also, the drug is very unlikely to cause low blood sugar or weight gain. But, these benefits do come with some pitfalls or downsides.

While it’s generally well tolerated, gas, diarrhea, and nausea may occur. Diarrhea is by far the most common. It is, fortunately, rare for this type of intestinal discomfort to last long. In this article, we are going to discuss the causes of this condition and practical solutions to manage it. If you are currently considering it as a treatment option, you can buy Metformin from Canada.

Why Does Metformin Cause Diarrhea?

The drug belongs to a class of drugs called biguanides that treat type 2 diabetes by regulating blood sugar levels. It is commonly linked with gastrointestinal side effects such as Diarrhea. The exact cause of metformin-induced diarrhea is not fully understood. It is believed, however, that the drug’s impact on the gut microbiome plays a key role. Its use can alter the microbial composition of the intestines, causing inflammation and irritation.

The medicine has also been found to increase liver bile acid production. Bile acid is necessary to digest and absorb fats. Nevertheless, excessive bile acid can accumulate in the colon, stimulating water secretion and causing loose stools. There is also the possibility that Metformin alters the movement of certain gut chemicals, such as serotonin and histamine. Diarrhea can result from this.

It is important to note that not all those who take the drug experience diarrhea. Individual factors such as gut microbiota composition, dosage, and duration of Canadian pharmacy metformin use may affect diarrhea severity and frequency.

How Common Is Metformin-Related Diarrhea?

Diarrhea is a common side effect of the medicine. If you have experienced diarrhea from taking it, you are not alone. According to the Food and Drug Administration, diarrhea occurs in more than half of people who take Metformin. In a random controlled test published in Frontiers in Endocrinology in 2022, drug use was associated with a higher risk of abdominal pain, diarrhea, and nausea compared to other antidiabetic drugs. 

This side effect can be inconvenient and limiting for some people, disrupting their daily routines. As the drug is taken for longer periods of time, gastrointestinal tract-related side effects are less likely to occur.

How Long Does Diarrhea from Metformin Last?

It is most common for people to experience diarrhea after taking the medication for the first few weeks. However, these first few weeks can be challenging. About 5% of people stop taking Metformin because of gut-related side effects, according to the National Library of Medicine. In the following weeks, however, it tends to get better.

You should consult your healthcare provider if diarrhea caused by the medicine becomes particularly problematic. As a way to prevent and manage diarrhea, you can discuss possible dose adjustments with them.

How Can You Manage Diarrhea Induced by Metformin?

It is recommended to adjust the dosing and the time of the medicine, switch to an extended-release formula, and avoid foods that aggravate diarrhea as part of treatment for Metformin-induced diarrhea. Let’s discuss these treatment options one by one:

1. Take It with the Meal

The golden rule of Metformin is to take it with a meal or immediately after eating. Taking the drug on an empty stomach is more likely to result in gut-related side effects, such as nausea and diarrhea. From the very first dose, it’s a good idea to take it with food. You can build this habit by pairing it with meals or storing it near your kitchen or dining table in a secure location.

Take your missed dose of Metformin as soon as you remember if you missed a dose with your usual meal. It may be necessary to eat a snack if you just had a meal in order to avoid taking it on an empty stomach. In case it’s almost time for your next dose, leave the one you missed and continue taking your next dose. You do not need to take two doses at the same time.

2. Avoid Rapid Increase of the Dose

There is a dose-dependent relationship between Metformin and diarrhea. There is a greater chance of side effects (including diarrhea) at higher doses of the drug. Diarrhea can occur as a result of recent changes in the dosing. You should discuss the issue with your doctor if you think diarrhea was caused by a recent increase in the dose. It is typically taken once or twice every day with food in a dosage of 500 mg. To reach your target dose, you should increase the dose by no more than 500 mg every 1 to 2 weeks.

By doing so, your body gets time to adjust. The risk of diarrhea can be increased if the dose is increased too quickly or by too much. Increasing the dose gradually or returning to the previous dose may be an acceptable alternative. You can wait a few weeks if the diarrhea is not severe. During the first few weeks following a change in the Canadian pharmacy metformin dose, mild diarrhea may occur.

3. Switch to the Extended-Release (Xr) Metformin

Metformin comes in two different forms:

  • Immediate Release (IR) formula action occurs rapidly, duration is shorter, and gastrointestinal side effects are more common.
  • Extended-release (XR) formula is longer-acting and less likely to cause diarrhea and other side effects.

Ask your doctor if you should switch to an extended-release metformin formula if you are taking an immediate-release drug. A note that you cannot split or chew the XR tablets is worth noting. Using Metformin ER may improve your tolerance to the drug. A longer release and a lower risk of diarrhea can be achieved by swallowing the entire tablet. 

In a 2022 study published in Frontiers in Endocrinology, the risk of bloating and diarrhea was higher with the immediate-release than with the extended-release formulation.

4. Ask Your Doctor About Reducing the Dose

It is possible to develop intolerance to metformin years after first taking the drug. The side effects (including diarrhea caused by the drug) can be reduced by reducing the dose in such cases. It is important that you work with your healthcare professional to ensure that the drug is the reason for diarrhea and to determine the best method for controlling it.

To stop diarrhea, reduce the dose of Metformin (for example, take 1000 mg instead of 2000 mg). Adding an alternative drug or adjusting the dose of other anti-diabetes medications is recommended. You should not change the dose of your diabetes medication without medical advice. Altering the dose of the medicine without your doctor’s consultation can lead to poor blood sugar control.

5. Ask Your Doctor About a Metformin Holiday

In cases of severe diarrhea, a doctor may implement a “metformin holiday,” temporarily halting or permanently discontinuing the use of medicine. This interruption allows for the evaluation of the diarrhea’s severity and its potential link to the medicine. Reintroducing Metformin at a lower or the same dosage after a break can often lead to an improvement in diarrhea symptoms. Always consult with your healthcare provider before making any changes to your medication regimen.

6. You Can Try a Probiotic

It is possible for Metformin to cause gastrointestinal side effects due to a number of reasons. Microbiome changes in the gut are one of these causes. The gut microbiome consists of beneficial microorganisms (primarily bacteria) that live inside your intestines. Your gut health and digestion depend on the balance of your microbiome. The drug alters this balance directly or indirectly by increasing bile acids in the intestine. Diarrhea is the result of this increased bile juice. 

Live bacteria and yeast, known as probiotics, may be helpful to our health, especially our digestive system. Their use can improve gut bacteria composition, restore the balance of the microbiota, and reduce inflammation, thereby reducing diarrhea caused by the drug. A 2019 study published in the BMC Gastroenterology Journal found that a combination of four Lactobacillus strains could significantly reduce metformin-associated diarrhea. 

7. Avoid Foods That Trigger Metformin Diarrhea

The simplest way to prevent diarrhea is to avoid common foods that cause it. This may help control metformin-induced diarrhea. Reduce your consumption of the following foods:

  • Foods with spicy flavors, such as chili peppers and curry blends.
  • Coffee, energy drinks, and others contain caffeine, which stimulates the digestive system and increases diarrhea.
  • Among diabetic patients, sugar substitutes (like aspartame, saccharin, and sucralose), as well as sugar alcohols (like mannitol, sorbitol, and xylitol), are commonly used.
  • Garlic and onions
  • Fast foods
  • Alcohol
  • Dairy products
  • Broccoli and cauliflower

Ask your doctor or dietitian about the best diet to avoid diarrhea and manage your blood sugar at the same time. Common foods that contain artificial sweeteners are diet sodas, sugar-free candies, low-sugar cereals, chewing gum, and low-sugar condiments, like coffee creamer and ketchup.

8. Keep Yourself Hydrated

Dehydration can result from diarrhea, so it is important to consume adequate fluids during diarrhea. Keeping hydrated promotes better health and minimizes the impact of diarrhea by replenishing lost fluids and electrolytes. In addition, Oral rehydration solutions containing glucose and electrolytes have been found to be effective in treating severe diarrhea. According to a trial published in Current Gastroenterology Reports 2019, oral rehydration solution (ORS) remains the anchor of acute watery diarrhea and dehydration management worldwide. 

The report reviews the scientific rationale and modifications of ORS and barriers to universal application. It also mentions that glucose-containing ORS increased the absorption of water and electrolytes and significantly improved survival rates during severe diarrhea.

Can You Take Antidiarrheals to Stop Metformin Diarrhea?

There are several effective antidiarrheal medicines on the market, including Imodium (Loperamide). The drug is used to stop diarrhea (such as that caused by irritable bowel syndrome) in various diseases. It is theoretically capable of stopping diarrhea induced by the medicine. You can, however, reduce metformin-induced diarrhea by adjusting the drug dosage or finding an alternative with your doctor. The use of Imodium for diarrhea is not recommended for long-term use.

It can cause constipation and aggravate gastrointestinal symptoms such as nausea and bloating. You should not use Imodium for diarrhea unless your doctor prescribes it. While antidiarrheals can offer relief, they should complement, not replace, professional medical advice in managing metformin-induced diarrhea for optimal diabetes care.

When Should You Contact a Healthcare Provider?

Talk to your healthcare provider if you still experience stomach-related side effects after taking Metformin for a few weeks. It may be recommended that you lower your dose, switch to the ER formulation, or take the drug right after a meal. Additionally, they may recommend ways to treat medication-induced diarrhea, such as antidiarrheal medications, while your body adjusts to the drug. You should Seek medical attention as soon as possible if your diarrhea is severe or persistent, as well as if you experience symptoms like abdominal pain, fever, or dehydration.

A side effect or underlying condition that requires medical attention could be causing these symptoms. You may be advised to stop taking the medicine altogether and try another diabetes medication if none of these changes work. It’s essential, however, not to stop taking the medicine on your own. In addition, you can buy Metformin from the best Canadian online pharmacy, Polar Bear Meds, for the most genuine and affordable prices.

To Sum Up

While Metformin is an efficient medication for managing blood glucose in those who have type 2 diabetes, it may come with the common side effect of diarrhea. It is important to understand the causes and implement practical solutions to significantly improve one’s experience with this medication. Taking the drug with meals, adjusting the dosage gradually, considering extended-release formulations, and consulting with healthcare providers for personalized advice are crucial steps. Maintaining proper hydration, incorporating probiotics, and avoiding trigger foods can contribute to managing metformin-induced diarrhea. 

It’s essential to communicate openly with healthcare professionals, ensuring a collaborative approach to finding the most suitable solutions. In some cases, a temporary break from the drug or exploring alternative medications may be recommended. While antidiarrheal medications can provide relief, they should be used under medical guidance. Regular follow-ups with healthcare providers help monitor progress and make necessary adjustments.

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