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Discussion Starter · #1 ·
So I’ve been on 500 metformin EXTENDED RELEASE for 4 or 5 days now, I actually forgot. I’m taking it with breakfast because it’s easier got me and I feel it helps control my appetite during the day or cravings for junk food at least. Yesterday evening I started getting some nausea but not too bad and it went away. Today not the same story at all! I took this morning about 6 to 8 this morning and by around 11:00 ish went to Arby’s and had a roast beef and some fries, I did not eat my whole sandwich and only had a few fries, I did have an orange cream shake but not much of that either.
By then I started feeling queasy and have progressively gotten worse as the day went on and now with diarrhea.
I’ve taken this years ago with no problems so what’s going on? I am pre diabetic. I’m just not sure what to do here and I don’t want to go through this. Also can I get keto lactidoses from this?
 

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If you've just started the Metformin ER, were you on any other medications for your diabetes before? (n.b, if you were prescribed Met, I'm sorry to say you probably are no longer considered "pre-diabetic") Metformin ER typically takes a few days to start making its effects noticeable and, typically, a couple of months to settle into what it does in your body.

A portion of the shake aside, what was your liquid intake for the day? What did you eat for breakfast that morning? What I've read and my own experience shows that higher levels of carbohydrates help the body absorb liquid for when it needs it later. If you're not eating many carbs, you either may not be drinking enough liquids to maintain the levels your body needs without its water reserve, or you may be suffering temporarily from "keto flu" as your body adjusts to its new nutrition pattern. I think keto flu is unlikely in your case, but people do encounter it when the amount of carbs they eat goes way down.

For the sake of figuring this out, I will ask if you've had these foods at Arby's before without incident. Was there anything about the sandwich that was different (different sauce on it this time; didn't seem quite hot enough)? I don't know if it's possible to rule out food poisoning and you wrote that you didn't eat much of it, but it could be a possibility.

If this happened to me, I think what I would do would be to drink more than my usual amounts of water to make sure I was fully hydrated and to maybe put a little more salt on my food at meals (to counter for the change in electrolytic balance that comes with not storing so much water in your body). Most often, the gastric issues go away as your body gets used to the effect of the Metformin (I would not expect serious queasiness and diarrhea for two months but a couple of weeks might not be unusual). If the gastric problems persist, other posters here have mentioned that splitting the dose through the day can help (but don't split the pills themselves; they're designed to stay intact to work over many hours). And, for some people, switching to diifferent brand of Metformin helped.

I can understand not wanting to endure this longer than you have to. Many new medications taken for chronic conditions have unwanted effects on us as our bodies adapt to their presence and to what they do in our bodies. Many people have adapted to Metformin successfully. Remember, I'm not a real doctor. But I'd give this a little time to see if it gets better. If it doesn't, then speaking with the doctor who prescribed the Met is your next step.
 

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Here is a link to the Bloodsugar101 info about metformin. It talks about the good and bad of it.

Ketoacidosis is a build up of ketones in your blood and not related to metformin. Lactic acidosis is a build up of lactic acid in your blood and can be caused by metformin or other meds.

In an article I read from New Zealand, it felt that doses up to 1700 mg were OK but above that, be aware of symptoms.

Lactic acidosis is rare, but does happen and may be related to problems with renal malfunction.

I know when I started regular metformin, I would get some terrible cramps that just came on. It put me on my hands and knees one day when I was out walking. Thought I was going to have to jump over a guard rail and drop my drawers right there on the shoulder of the road but managed to make it home in time. It was regular metformin. It take a while for the digestive issues to go away but they finally did. ER version is supposed to be more user friendly.
 

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Discussion Starter · #4 ·
If you've just started the Metformin ER, were you on any other medications for your diabetes before? (n.b, if you were prescribed Met, I'm sorry to say you probably are no longer considered "pre-diabetic") Metformin ER typically takes a few days to start making its effects noticeable and, typically, a couple of months to settle into what it does in your body.

A portion of the shake aside, what was your liquid intake for the day? What did you eat for breakfast that morning? What I've read and my own experience shows that higher levels of carbohydrates help the body absorb liquid for when it needs it later. If you're not eating many carbs, you either may not be drinking enough liquids to maintain the levels your body needs without its water reserve, or you may be suffering temporarily from "keto flu" as your body adjusts to its new nutrition pattern. I think keto flu is unlikely in your case, but people do encounter it when the amount of carbs they eat goes way down.

For the sake of figuring this out, I will ask if you've had these foods at Arby's before without incident. Was there anything about the sandwich that was different (different sauce on it this time; didn't seem quite hot enough)? I don't know if it's possible to rule out food poisoning and you wrote that you didn't eat much of it, but it could be a possibility.

If this happened to me, I think what I would do would be to drink more than my usual amounts of water to make sure I was fully hydrated and to maybe put a little more salt on my food at meals (to counter for the change in electrolytic balance that comes with not storing so much water in your body). Most often, the gastric issues go away as your body gets used to the effect of the Metformin (I would not expect serious queasiness and diarrhea for two months but a couple of weeks might not be unusual). If the gastric problems persist, other posters here have mentioned that splitting the dose through the day can help (but don't split the pills themselves; they're designed to stay intact to work over many hours). And, for some people, switching to diifferent brand of Metformin helped.

I can understand not wanting to endure this longer than you have to. Many new medications taken for chronic conditions have unwanted effects on us as our bodies adapt to their presence and to what they do in our bodies. Many people have adapted to Metformin successfully. Remember, I'm not a real doctor. But I'd give this a little time to see if it gets better. If it doesn't, then speaking with the doctor who prescribed the Met is your next step.
I just have to say I will NEVER EVER take this metformin again! Ever! I read all your questions and as for Arby’s we’ve eaten there and my husband and digs had same foods and no one else got sick. I tried so hard to drink more water but I couldn’t even bring the water to my lips to drink without feeling like I was going to throw up. I couldn’t even eat one thing. Things got worse as evening and on with diarrhea and these awful big air burps that have this awful smell. I am not in keto. I had to sleep sitting up but I think I got a couple hours of sleep. I still don’t feel good at all. I am managing to drink some water though and as hungry as I feel still nothing sounds good but I did nibble half a frozen waffle. I didn’t care if it was carby because I’m not taking anymore metformin and I seriously need some food. I do wonder if I have the acidosis thing. Do you think it would be uncommon for someone to have this as a metformin side effect for this long? It’s been 24 hours since I took it yesterday.
 

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Discussion Starter · #5 ·
Here is a link to the Bloodsugar101 info about metformin. It talks about the good and bad of it.

Ketoacidosis is a build up of ketones in your blood and not related to metformin. Lactic acidosis is a build up of lactic acid in your blood and can be caused by metformin or other meds.

In an article I read from New Zealand, it felt that doses up to 1700 mg were OK but above that, be aware of symptoms.

Lactic acidosis is rare, but does happen and may be related to problems with renal malfunction.

I know when I started regular metformin, I would get some terrible cramps that just came on. It put me on my hands and knees one day when I was out walking. Thought I was going to have to jump over a guard rail and drop my drawers right there on the shoulder of the road but managed to make it home in time. It was regular metformin. It take a while for the digestive issues to go away but they finally did. ER version is supposed to be more user friendly.
Oh my goodness I’m sorry I can’t help but laugh at that visual lol

do you think it’s common to have this as a side effect for 24 hours and then some? I was up all night with diarrhea and crazy bug airy burps and still have the same burps and my stomach is still feeling off andeven though it’s growling and I’m so hungry nothing sounds good yet. I wonder if something else is going on but I can’t figure out what. I will never take metformin again! This is the extended release version so so much for being gentle.
 

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Do you think it would be uncommon for someone to have this as a metformin side effect for this long? It’s been 24 hours since I took it yesterday.
I do think it would be uncommon for this to be a Metformin side effect for 24 hours. However, not hydrating or eating something most substantial than half a waffle likely is extending your misery. ;)

I know when people feel that badly that they have little interest in eating and drinking, but our bodies depend on it, especially the water part. Even ice chips melted in the mouth provide some water. Or electrolyte drinks like Gatorade (the variety without added sugar), just sipped, not guzzled. If you're not eating keto you can be on the "BRAT" diet (bananas, rice, applesauce, and toast) for a day or two to provide some nutrition without further challenging your stomach.

And, certainly, contact your doctor about this and ask them what other options you might have instead of this particular version of Metformin. If this is the Met doing this to you, your doctor can advise you on how temporary these effects are or can prescribe something else to help you manage your blood glucose. Or you can go the route so many of us have by eating low-carbohydrate or keto and, possibly, avoiding the Metformin (and other meds) altogether.
 

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Discussion Starter · #8 ·
So, @alfmaxmollyjack, how's it been going with the Metformin? Have you been able to arrange for a change in dosing?
Hi there! Thank you for asking!
At first my ductus said to wait three days then take half a dose, I reminded him I’m on extended release and can’t cut them in half so then he tons me to wait two weeks to restart. We’re going out of town from the 4th to the 10th so I’m going to wait until after that. Although I’m starting New medication tonight called topamax that can interact with metformin. I may have to choose. There is only a slight risk of interaction but not sure I want to risk anything. At least I have a few weeks or so to think about that. Thank you for caring to ask. 😃
 
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