Chandler Marrs

Stop the Metformin Madness

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I have never been a fan of Metformin. It seemed too good to be true. Many years ago I had a conversation with a researcher about all of its possible therapeutic indications. His lab was actively pursuing the anti-cancer angle. That should have been a clue that Metformin might be causing more damage than we recognized, but it wasn’t. At that point, I was still enamored with the wonders of pharmacology and hadn’t yet begun my path toward understanding medication adverse reactions. Indeed, it wasn’t until very recently, when a family member began suffering from one of these reactions, that I began my investigation in full. This is what I learned.

Type 2 Diabetes is Big Business

The global profits from Type 2 diabetes medications rested at a paltry 23 billion dollars in 2011 but are expected to grow to over $45 billion annually by 2020. The market growth is bolstered in large part by the ever-expanding demand for therapeutics like Metformin or Glucophage. Metformin is the first line of treatment and standard of care for insulin resistance across all populations of Type 2 diabetics with over 49 million Americans on Metformin in 2011-2012. It is particularly popular in women’s health with an increasing reliance on Metformin for the metabolic dysfunction observed in women with PCOS, PCOS-related infertility, and even gestational diabetes. Metformin is prescribed so frequently and considered so innocuous that it is sometimes euphemistically referred to as vitamin M.

If we quickly scan the safety research for metformin, there is little immediate evidence suggesting any side effects whatsoever. In fact, in addition to controlling blood sugar by blocking the hepatic glucose dump, this drug is suggested to promote weight loss, increase ovulation in women, (thereby helping achieve pregnancy), and prevent an array of pregnancy complications (everything from miscarriage to gestational diabetes, pre-eclampsia and preterm birth). Metformin is argued to prevent cancer and the neurocognitive declines associated with aging, even aging itself. By all accounts, Metformin is a wonder drug. Why isn’t everyone on Metformin prophylactically? Increasingly, we are.

With the increasing rates of obesity and associated metabolic disturbances, drugs that purportedly reduce those indicators are primed for growth. Like the push to expand statin prescription rates from 1 in 4 Americans to perhaps 1 in 3, millions have been spent increasing the therapeutic indications and reach for this medication. Amid all the excitement over this drug, one has to wonder if it isn’t too good to be true. In our exuberance to get something for nothing, to have cake, if you will, have we overlooked the very real risks and side effects associated with Metformin?  I think we have.

Metformin and Vitamin B12 Deficiency

As we’ve reported previously, Metformin leaches vitamin B12 and to a lesser degree B9 (folate) from the body. One study found almost 30% of Metformin users are vitamin B12 deficient. For the US alone, that’s almost 15 million people who could be vitamin B12 deficient and likely do not know that they are deficient. What happens when one is vitamin B12 deficient?

Firstly, inflammation increases, along with homocysteine concentrations, which is a very strong and independent risk factor for heart disease (the very same disease Metformin is promoted to prevent).  And that is the tip of the iceberg.

Vitamin B12 is involved with a staggering number of physiological functions including DNA, RNA, hormone, lipid, and protein synthesis. Deplete vitamin B12 and a whole host of problems emerge, mostly neurological.

Vitamin B12 is critical for the synthesis of the myelin sheaths around nerve fibers. There is a growing relationship between multiple sclerosis, which involves the disintegration of myelin and brain white matter, and vitamin B12 deficiency.  Often the first signs of B12 deficiency are nervous system-related with cognitive disturbances and peripheral neuropathy among the most common.

Additionally, many women have dysregulated hormones connected to vitamin B12 deficiency. In light of the Metformin-mediated vitamin B12 deficiency, one has to wonder if some of the chronic health issues plaguing modern culture are not simply iatrogenic or medication-induced.

Metformin, Pregnancy and Maternal and Fetal Complications

Considering that half the population is female, many of whom are on Metformin and may become pregnant, we must consider the potential effects of Metformin-induced vitamin B12 deficiency during pregnancy. As troubling as the effects of B12 deficiency are on non-pregnant individuals, during pregnancy they can be devastating. Vitamin B12 deficiency during pregnancy leads to an increased incidence of neural tube defects and anencephaly (the neural tube fails to close during gestation). Once thought to be solely related to folate deficiency (vitamin B9) which Metformin also induces, researchers are now finding that B12 has a role in neural tube defects as well.

Scan the internet for Metformin and infertility and you’ll see long lists of fertility centers boasting the benefits of this drug. During pregnancy, the exuberance for vitamin M is palpable, although entirely misplaced. Early reports suggested Metformin would reduce an array of pregnancy complications including gestational diabetes. The data supporting these practices were mixed at best. At worst, however, they were downright incorrect. Metformin, it appears, may evoke the very conditions it was promoted to prevent during pregnancy and then some. Additionally, recent research suggests Metformin alters fetal development and induces long-term metabolic changes in the offspring, likely predisposing the children to Type 2 Diabetes, an epigenetic effect perhaps.

Metformin Inhibits Exercise-Induced Insulin Sensitivity

As if those side effects were not enough to question mass Metformin prescribing practices, it appears that Metformin reduces any gains in insulin sensitivity that normally would be achieved from exercise. I cannot help but wonder if Metformin impairs insulin signaling in general. Cancercancer research suggests that it might.

According to one study, physical exercise can increase insulin sensitivity by up to 54% in insulin-resistant individuals, unless of course, they are taking Metformin. Metformin abolishes any increased insulin sensitivity gained by exercise. Metformin also reduces peak aerobic capacity, reducing performance and making exercise more difficult. Moreover, despite claims to the contrary, Metformin does not appear to be an especially effective tool for weight loss, netting a reduction of only 5-10 pounds over 4-8 months. Regular exercise and a healthy diet net on average a loss of 5-10 pounds per month for most people and are significantly more effective at reducing diabetes and associated health complications without the potential side effects.

Metformin and Mitochondrial Damage

Perhaps most troubling amongst the Metformin side effects is its ability to severely impair mitochondrial functioning.

Recall from high school biology, the mitochondria are those bean-shaped organelles inside cells that are responsible for cellular respiration or energy production. Through a variety of pathways, the mitochondria provide fuel for cell survival. In addition to cellular energy production, mitochondria control cell apoptosis (death), calcium, copper, and iron homeostasis, and steroidogenesis. In essence, mitochondria perform the key tasks associated with cell survival, and indeed, human survival. Damage the mitochondria and cellular dysfunction or death will occur. Damage sufficient numbers of mitochondrion and chronic, multi-symptom illness arises.

As we have come to learn, many pharmaceuticals, environmental toxicants, and even dietary deficiencies can impair mitochondrial functioning and induce disease processes that are often difficult to diagnose and treat. Metformin is no different. Metformin impairs mitochondrial functioning quite significantly by several mechanisms and, in doing so, sets off a cascading sequence of ill effects.

At the center of metformin’s mitochondrial damage is its effect on the most basic of mitochondrial functions – ATP (cellular energy) production. Metformin reduces mitochondrial ATP production in skeletal muscle by as much as 48%. Sit with that one for a moment, a 48% reduction in cell fuel. Imagine functioning at only half capacity. This would make basic activities difficult at best and exercising to lose weight a very unlikely proposition. Imagine similar reductions in ATP production were observed in the brain or the heart or the GI tract (which, when on Metformin are likely), the types of disturbances we might see become quite clear: neurocognitive decline, psychiatric instability, neuropathy, heart rate, rhythm and blood pressure abnormalities, along with gastrointestinal distress to name but a few. Underlying all of these symptoms, and indeed, all mitochondrial dysfunction is an overwhelming sense of fatigue and malaise.

Metformin Alters Immune Reactivity via the Mitochondria

As I wrote in a previous post:

Some researchers argue that the mitochondria are the danger sensors for host organisms; having evolved over two billion years to identify and communicate signs of danger to the cells within which they reside. The signaling is simple and yet highly refined, involving a series of switches that control cellular energy, and thus, cellular life or death. When danger is present, energy resources are conserved and the immune system fighters are unleashed. When danger is resolved, normal functioning can resume.

If the danger is not resolved and the immune battles must rage on, the mitochondria begin the complicated process of reallocating resources until the battle is won or the decision is made to institute what can only be described as suicide – cell death. Cell death is a normal occurrence in the cell cycle of life. Cells are born and die for all manner of reasons. But when cell death occurs from mitochondrial injury, it is messy, and evokes even broader immune responses, setting a cascade in motion that is difficult to arrest.

Metformin alters this process, first by damaging the mitochondrial ATP factory and reducing energy production capacity and then by inhibiting the signaling cascades that would normally respond to the danger signals. The double hit fundamentally alters immune function and I would suspect predisposes those who take Metformin to more infections and an array of inflammation-based disease processes. More details on this in a subsequent post.

Metformin and the Statins: Beware

The mechanisms through which Metformin derails mitochondrial functioning are complex but likely related to depletion of coQ10, an enzyme involved in what is called the electron transport chain within the mitochondria. CoQ10 also referred to as ubiquinol and ubiquinone, is critical for mitochondrial functioning. Recall from a previous post, that statins, like Lipitor, Crestor and others also deplete coQ10 and from a pharmacological perspective these mechanisms are implicated in the development of atherosclerosis and heart failure.

“statins may be causative in coronary artery calcification and can function as mitochondrial toxins that impair muscle function in the heart and blood vessels through the depletion of coenzyme Q10 and ‘heme A’, and thereby ATP generation.”

CoQ10 depletion is also implicated in the more common statin-induced side effects like muscle pain and weakness and in severe cases, rhabdomyolysis. Since Metformin and statins are regularly co-prescribed, the potential for severely depleted mitochondria and significant side effects is very high. Consider muscle pain and weakness among the first signs of problems.

My Two Cents

When we contrast the reduction in glucose mediated by Metformin with the damage this medication does to the mitochondria and immune signaling, along with its ability to leach vitamin B12, block insulin sensitivity and reduce aerobic capacity, one cannot help but wonder if we are causing more harm than good. Admittedly, obesity and hyperglycemia are growing problems in Western cultures. As we are coming to learn, however, obesity itself is not linked to the diseases processes for which many drugs like statins and Metformin are promoted to protect against – the obesity paradox. Growing evidence suggests that obesity is indicative of mitochondrial dysfunction and chemical exposures which then may provoke impaired insulin sensitivity and hyperglycemia and continued fat storage versus metabolism. If this is true, simply reducing circulating glucose concentrations, in an effort to reduce obesity and the purported health problems associated with obesity, will do nothing to treat the underlying problem.

Insulin resistance and the associated hyperglycemia are environmental and lifestyle-mediated problems that should be reversible with environmental and lifestyle changes. Having said that, those lifestyle and dietary changes will fail unless we consider the underlying mitochondrial damage initiated by dietary choices, pharmaceuticals, and other environmental exposures. For that, we must dig deeper into mitochondrial functioning and correct what we can.

I believe obesity and hyperglycemia are symptoms of damaged and dysfunctional mitochondria, partly mediated by lifestyle, partly iatrogenic (pharmaceutically induced), and likely epigenetic. If we are to solve the ‘obesity’ problem and prevent the damage mediated by hyperglycemia, we have to address these variables. Failing to do so serves no one except those who profit from our continued ill-health.

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Chandler Marrs MS, MA, PhD spent the last dozen years in women’s health research with a focus on steroid neuroendocrinology and mental health. She has published and presented several articles on her findings. As a graduate student, she founded and directed the UNLV Maternal Health Lab, mentoring dozens of students while directing clinical and Internet-based research. Post graduate, she continued at UNLV as an adjunct faculty member, teaching advanced undergraduate psychopharmacology and health psychology (stress endocrinology). Dr. Marrs received her BA in philosophy from the University of Redlands; MS in Clinical Psychology from California Lutheran University; and, MA and PhD in Experimental Psychology/ Neuroendocrinology from the University of Nevada, Las Vegas.

49 Comments

  1. Metformin lowers your energy levels making it difficult to exercise.
    Exercise is critical to staying healthy to offset the effects of diabetes.
    This drug absolutely effects libito levels and lowers testosterone. The pharmaceutical companies know this because as soon as they prescribe this medicine very soon after they peddle the sex pills for ED.
    ED medication is a billion dollar industry.
    They design drugs for cause and effect.
    One drugs causes a side effect and the other drug fixes it but it may damage your liver. In time you will need a transplant and that procedure nets thousands of dollars per patient. It’s all a money game at our expense. I did my own research and had my doctor change my medicine to Glipizide. It’s let harmful and my energy levels have returned to normal.
    My athletic output has increased so has my fitness.

  2. Having read studies where Metformin can possibly help depression and anxiety I looked into this as an alternative to srri medications and my doctor agreed to trial it. However, having read about the way it can deplete vitamins I’m very wary. Could the Q10 depletion be adequately offset by taking Q10 supplements?

  3. I wonder whether this post is still read. Searching HM, I came across it and believe that I have something to add. Thiamine and B 12 have been implicated. A few years ago, it was found in pregnancy that if B12 and folate were increased above their normal concentration in the mother’s blood, it predicted that autism would be later diagnosed in the yet unborn child. The mass of chemistry in the body makes us functional, but I believe that it can be reduced to a relatively simple concept—-energy. Thiamine burns glucose to make ATP, the energy currency of the body. But, like cars, we have to consume energy for function and folate and B12 operate in the chemical pathway known as transmethylation, the equivalent of a transmission in a car. Both folate and B12 require ATP to function so they depend on energy production. Thiamine is used to produce ATP and if folate and B12 have ATP deficiency, they “pile up” in the blood and are inactive. My suggestion is that metformin damages thiamine and causes folate and B12 to be inactive. If this is the right explanation, we would find B12 and folate to be elevated in the patient’s blood.

  4. 2 years ago i used metformin for weight loss, i lose wieght but got ice pick headach which i never experienced in the past, after that i got grey hair in th area of ice pick headache. Than i stop using metformin and from past 1 and half years im using vitamin B12 sublingual, Now i get less pain and some of grey hair turn black. But now due to my stress and depression nothing works, my hair turns grey faster and headache become routine. Im 32. Now what can i do. Also premature grey hair is not in my family genetics .

  5. I’m 44 years old, just started Metformin on 1/17/2020. I was feeling fatigued but able to do what I needed to do. Then after dose 6, I noticed by heart was racing and bp was way high and I ended up in the ER. I never had this experience except for when I was given an antibiotic with penicillin in which I wasn’t feeling right and my bp was crazy high, ended up in Urgent Care and another time when my doc tried me on Lisinopril, back in ER. Coincident, not sure. Anyone have similar experiences?

  6. This is excellent. The hardest part about being educated on these medications is finding objective information. Your references are from high-quality sources and interpreted reasonably.

    I am a non-medical person in a family of doctors trying to convince a very indoctrinated (albeit loving and concerned) family that the root cause of my mother’s diabetes is the fistful of medications she takes every day. She is not overweight, her diet is minimally-processed and vegetarian, and she exercises regularly. But when her blood sugar medication stopped being effective after a decade of use, her doctor predictably increased her dose! She has had neurological issues due to blood sugar issues.

    I tell them she has a drug addiction, not diabetes. The goal now is a practical cessation strategy that doesn’t cause misery and danger due to huge blood sugar swings. Did you just start cutting the pills into smaller pieces to take marginally smaller doses?

    • Sam, when approaching any medication cessation program, one must be very careful to reduce the dosage gradually, over an extended period of time. In older folks, that period of time may be longer than in younger ones. Given her longstanding metformin use and her vegetarian diet, is likely severely vitamin deficient. Metformin blocks vitamin thiamine (B1) and B12, among others and vegetarians in general are deficient in both of these vitamins. In effect, it is a double hit, maybe a triple hit as diabetes depletes B1 on its own, because diabetics tend excrete more of it than non-diabetics. The neurological symptoms she is experiencing are relative to the thiamine deficiency (magnesium too). Here’s more on metformin. https://www.hormonesmatter.com/metformin-mitochondrial-damage/, search thiamine and thiamine diabetes on the blog and we have dozens of articles. We also wrote a book about this. I suspect you’ll see many of your mother’s symptoms. It’s listed in the side bar of the blog.

  7. Hi,
    I just read your article about Metformin. I’ve been on it for over 10 years! I was diagnosed with Type 2 Diabetes in 2004. I was prescribed Metformin and referred to a Diabetic Management class. There, I learned about nutrition for Diabetics, how to use the glucose monitor and the importance of exercise. Over these years I had been doing pretty well as far as lowering my A1c. But life gets in the way and I’m an emotional eater.

    Today, I am still a Type 2 Diabetic still on 1000 mg of Metformin 2 x Day, plus 5mg of Glipizide x Day, and 35 mg of Humulin N Insulin. I feel terrible! I’m always fatigued.

    I need help!

    Who can I turn to for help? My doctor just keeps adding more medicines. I’ve turned into a binge eater too!

  8. I got short of breath, a symptom I’ve never had in my life. I stopped metformin. It went away immediately. Google metformin shortness of breath and it is a side effect

  9. Hi
    Interesting dialogue.
    But we (and I personally with family metab syndrome) have used metformin, a natural extract of an ancient medicinal plant galega officinalis, safely for the 50 years I have been in practice.
    Four simple rules for all drugs:
    1. Start low and slow, eg 1/4 of 500mg tab/d.
    2. Titrate up to eg 10mg/kg eg 850mg bd if tolerated for eg prevention or Pcos, or for resistant diabetes to eg 3gm/d OR LESS if intolerance eg bloating, nausea, diarrhea.
    3 warn pt always to stop it briefly if ever nausea, bloating or diarrhea, then retitrate up slowly to tolerance.
    Ideally, as with many therapies eg vit D3, lithium, we should be monitoring metformin levels, but with sense this is essential only in case of suspected severe Overdose.
    4. Always combine with baseline health and lifestyle strategy eg sugar-free more goodfat than carbs eating, vigorous dly exercise, and supplements of common deficiencies ie fishoil, coconut oil, and a good 30+multisupp plus xstra magnes, zinc. Iodine, seleniunm; vits D3, K2, BCo, B12, C and K2; coq10, NAC, etc..
    As numerous massive prevention and diabetes studies have shown for 50 years, incl the 30yr followup of the Ukpds trial Collins ea and 10yr followup of the USA DPP prevention trial Knowler ea, and the other massive Indian and Chinese DPP,s, and longterm Canadian followup analysis,
    metformin never produces serious adverse effects with the above controlled Integrative approach. In fact it halves premature mortality, and reduces lactic acidosis illness and mortality from all the major causes by 95%.
    Yes, it’s use as a 10% transdermal cream was patented, and we tried it, but it’s obviously less bother orally – remembering that some half of us lack the gene or kidney function for fast rxcretion/metabolism, thus have much lower tolerance that thus needs far lower dose, to be found simply by sensible trial and error.
    Considering that it halves most cancers, obesity-vascular and metabolic pregnancy problems, it is vastly more useful and safe than commonly abused commonly lethal poisons like aspirin, paracetamol, alcohol, and designer synthetics eg statins, more modern antidiabetic, psychotropes, bisphosphonates,, PPIs, opioids, antiinflammatories etc.

    • I’m sorry to disagree but recently I came to the conclusion that Metforminis causing my debility. I was wondering why when I exercised after lockdown at the local Therapy Spa I didn’t bounce back as before. After a few months I went off Metforfin and low and behold my energy and motivation increased dramatically. Unfortunately so did my sugar levels so I went back on Metformin till oi can get in to see my doctor.
      Doctors can tell by blood tests if a drug works. What they can’t know is how it makes us feel. Most people would not think that there level of well-being is reduced by this drug.

    • Of course you’re going to tell us how wonderful metformin is. It’s your job. I just started taking metformin 2 weeks ago. I stopped taking it as of yesterday. I had fatigue absolutely no energy to exercise. Terrible headache everyday and I very seldom get headaches. From what I’ve read about metformin. Everything it says it’s good for well seems like it’s just the opposite. Keep your metformin..

  10. There’s not much profit in metformin- it’s a cheap, long used, well studied medicine. It’s true that for almost any medicine, supplement, or anything we put in our bodies, there will be individuals who don’t tolerate them. There are also people who seem to be intolerant of any medication. I suggest that the thing to do is to have good communication with your health care provider. Metformin, like any medication has benefits and drawbacks that need to be tailored to each individual, based on their unique needs.

  11. Helping my 87 yo dad try to stay alive and well, and was pleased that an endocrinology consult includes a recommended reduction in metformin. However, he has been extremely fatiqued upon decreasing. Is this normal? Can’t seem to find a lot of accounts of that.

    The plan is to increase insulin units if needed, because these are very low right now.

  12. My doctor prescribed transdermal Metformin to help lower my blood sugar, because the extended release gave me nasty side effects. Have you done any research on transdermal Metformin in respect to potential side effects and absorption issues?

  13. I know this thread is a couple of years old but I’m curious about something. I’ve been using Metformin (2.5 grams per day) for 14 years (I’m 37) with no noticeable negative health consequences. In fact, I can run a marathon in 2 hours 45 minutes. I wondered what effect Metformin might be having on my athletic performance which is how I stumbled on this. It hardly seems like it’s reducing my aerobic capacity. I also found this site which mentions a study that concluded an increase in anaerobic capacity and performance: http://suppversity.blogspot.co.nz/2015/10/first-study-to-demonstrate-ergogenic.html
    Is there in merit in that study or would I better served by just going off the metformin? I’m pretty sure i could get away with it as these days I have a low carb diet.

  14. After researching Berberine (berberis aristata), I have replaced Metformin with 1,500 mgs a day or 500 mg per meal each day. I told my doctor what I was going to do, even though my B12 status tested very high, I do not like to take drugs because I believe what nature provides can help me. I am also on a ketogenic diet that keeps high and medium glycemic foods off my plate. I have given up starches and sugars in all forms, and eat no grains, corn, peas, beans, rice, pasta, wheat, barley, oats or artificial stuff. My doctor has asked me to come back in 2 months for an A1C blood test to see what I have been able to accomplish with Berberine. I do take a multitude of supplements, especially vitamins C, D, and a B complex as well as a multi vitamin and some specialties as well such as extra minerals like chromium, zinc, selenium, magnesium, potassium and not so much calcium because I get that in abundance in my diet. I have had the fatigue syndrome before, and getting off of one of my blood pressure meds helped fix that (calcium channel blockers). I decided 34 years ago to take control of my own health with diet and exercise rather than leaving my fate up to the medical organizations. I do lots of research and have learned that, as a diabetic, there is much I can do to control my own life and blood glucose readings.

    • My story is similar to yours and I wondered how you test results turned out. I have been on metformin for two weeks but follow keto strictly now and exercise daily. I’m just curious about how you’ve progressed. Thanks

    • Hello, I am intrigued by your approach. I was diagnosed with POS at the age of 25, i am now 37 and am taking it very serious. My physician never explained the severity of POS and therefore i just thought i would have irregular periods and issues with conception. I had a partial hysterectomy after my second child 8 years ago. In the last year i gained 51 lbs and thought perhaps it was the huge stress I was under the last year, I do not eat bad. Try to stay away from fast food, sugar and carbs. But now I have High blood pressure, high cholesterol , I am not diabetic but i assume thats coming. I work out hard but the scale seems to be stagnet. Please if you dont mind could you share with me all that you do to maintain a healthy life style.

    • Hi Marie,

      What was the result of your shift to Berberine? Did it work for you successfully? Are you still using it?

  15. Hi,

    I feel very fortunate in coming across your site and this post as I am deathly ill after only one dose of Metformin, I can’t recall feeling so ill without full blown morning sickness or a horrific flu shot induced nausea as for me I am always debilitated by the prevention less than ever I have been a flu. This of course could be luck on my side however, I’m never so lucky taking such shots. If I take Pneumonia shots I get it so I’ve stopped taking any of these. Your post fills me with so many questions as I’ve been diagnosed with Lupus (2008) after a heart attack and open heart surgery in 2005 at the ripe old age of 36. I have no good cholesterol but even still the bad isn’t nearly in the high range. My health has steadily gotten worse but I was worse off after following the med regimines. I went from 105 to 168 in weight it was horrible. I quit the Meds and the lipids and life began to get better. The last 3 years though I’ve went through and am basically over Menopause. I’ll be 48 in October but my womanhood left me in 2012 and she’s not returned since other than my periods but now they have been gone sine 2014. They have given me a natural hormone supplement cream to begin and just diagnosed me with diabetes this week.

    I took the metformin yesterday and as stated am deathly ill, I don’t want to take this if anything I want more than anything to omit medication in my life as to me it seems the more they give the shorter our life spans are probably becoming especially as women. I am always in need of b12 and vitamin D and no my diet isn’t perfect as if anything I’ve become fearful of food bc of my sugar going haywire as well as mixing that in with the hot flashes of Menopause and you end up ready to take a vacation at the nuthouse.

    I love this article and thank you for it but may I ask for those of us who aren’t really up to speed on what we can do on our own vitamin and supplement wise if you would be so kind as to share with us some regiments we should be using in general just to be healthy as well as if you see yourself falling to ruin as so many of us seem to be with so many commonalities here what we can begin to take to restore our bodies and maybe avoid these medications all together. It may seem shocking for me to be so naive as to what to do but run of the mill folks don’t get the time with doctors we would like and when we finally do the last thing on their mind is vitamins and supplements because who would pay their office rent or pay off their vacation homes if we could get our good health from nature? It’s a sad but very real way of the medical profession and drug industries but what’s worse is we are the lab rats of the medical profession.

    I’m sure I’m not alone in wanting more than anything to find healing in that which god gave us to heal with or at least have the chance to try to be self aware and self sufficient in healing what so many doctors are destroying within us. After reading this it makes me wonder if I’m suppose to have sugar problems, be done with Menopause and no longer hopeful of ever feeling better than I do now but only to suffer a quickening of my final days arrival if I’m not already within them. It is so disheartening when you wake up knowing you’re just 47 and you don’t know if you will ever have a full life ahead of you anymore.

    Would you share with us a way to come back to life and good health if it’s just to get us started in what we can begin as a regiment that’s not something Larry king is selling on an infomercial (unless it works as therein lies the problem when you can’t trust doctors to care and not be pharmaceutical bonus hounds and the only other source we have is infomercials because we don’t have access to naturalist or holistic doctors who try nature to nurture first). It’s scary for us and very intimidating and it’s not because we are uneducated or lacking in sense it’s fear of the unknown and unease of the products we have access to. I am a college educated woman with my degree and then some …but I’m missing the most important other some, please share if you can how you came to normalize your b12 levels, what we can start out with that will boost these in us from nature and restore at least that part of us. It seems it should be so easily done but I guess I’m just weary and worn down from all no one cared to help us do as well as oftentimes angry because I feel so stupid for not knowing where to begin to bring my body back to some happiness again.

    Thank you very much and know your post is so appreciated and I am so hoping to see more about this from you. Thank you for sharing and caring enough to give those of us the resources we aren’t always able to get or know where to or how to begin to ask for.

  16. I am going to ask a “could it be” question. I will seek advise of my physicians before any changes but need to know. Since my heart surgery in 2013, I have experienced extreme muscle fatigue and wasting. This seemed to be epsidoic but we were removing and adding back meds a lot trying to find a cause(none found yet) I have had tons of very extreme testing done and during the corse of all this found COQ10 to be a huge help. Just recently I was feeling great for about 3 months. This month I went back on Metformin, within 2 weeks I couldn’t even walk without total exhaustion.
    I am back off it now and feeling better but we will attempt to reintroduce it in the future to find out if its the culprit.
    Could Metformin deplete energy or something in some peoples mitochrondial and not others?

    • My mom had a similar experience with metformin. She had been on it and other meds for years, declining health. We eventually got her clean and she did great for 3-4 years and then went back on metformin (against my wishes). Within a few weeks, she was confused, weak and couldn’t stand. Her experience is what prompted me to dig into the research and write this. I have another article on metformin mechanisms, you might consider reading it before re-introducing it. Metformin does all sorts of things that are contraindicated with diabetes. Dietary changes would be better. Also consider reading my article on thiamine and diabetes (almost all diabetics are thiamine deficient). Thiamine tends to control blood sugar quite well, among other potential benefits b/c of its role in mitochondrial energy production. Good luck.

  17. I had a HbA1c of 16.5 and next test got it to 5.4. My doc said it was a great result for metformin but it was my work to find solutions again and he does not know but I am off it. I did have issues with lipids but fatty liver and work through it myself, not taking his statins, not taking valporate not telling him as he will not understand.
    So it is LCHF, but with greens, I am unsure about dairy as I am bullish about fermented foods and make kefir, viili, kombucha and sauerkraut. It is coming together. I dropped 20kg and excercise is key to maintaining my focus and mood, and intermittent fasting. I would advocate that for autophagy benefit. So as well visualise your goal. I like the focus on mitochondrial function, tie it in to gut health and be kind, it is a process.

  18. If metformin interferes with the development of insulin sensitivity, how do people such as your mother and many others manage to wean off it with diet and exercise? Ipsofacto, their insulin sensitivity had to increase to allow their blood glucose levels to normalise to the point where they could go off metformin. I am very curious about this, as I would like to wean off metformin. Going off it abruptly was a disaster, so I’d like to be able to increase my insulin sensitivity before trying to wean again. I have PCOS and horrible insulin resistance, which is fully controlled by metformin and diet.

    • She worked with a physician who specialized in functional medicine. He put her on a whole host of supplements. It took a while and is still not fully stabilized (plus, she doesn’t always follow her diet strictly). Also, we weened her off but reducing the dosing gradually, over many months so that her body could re-equilibrate. With any medication, especially if one has been on it for a long time, there has to be a very slow and gradual reduction so that the body’s own systems can come back online. How long it takes, depends a lot on the drug, the length of time one has been on the drug and the individual’s unique body chemistry and lifestyle considerations.

      • Weaning was a smart idea. I went off cold turkey and became very ill. What type of diet does your mother do? I am very curious about the exercise aspect – does being on met truly prevent any improvement in insulin resistant? Seems like exercise would be a useless tool for weaning then. I wanted to try Berberine, but have read bad things about that too. It’s so frustrating!

        • She swims daily and that seems to help. Exercise is important for a number of reasons and it helps with insulin sensitivity, even as you are weaning. She is supposed to be on a gluten free, mostly starch free diet. She was tested for food allergies/sensitivities and we learned that she had several. She doesn’t follow it as well as she should and when she doesn’t she often gets sick w/ digestive issues. Organic foods are important as many of the chemicals in the commercial foods damage gut bacteria where nutrients are absorbed. I don’t know anything about berberine, so I cannot help there. What I can say, is do your homework, be smart about how you approach this and take control. It’s possible to be healthy, it just takes some work.

  19. My husband and I both take metformin. I am more worried about him. He has CMT disease,(high arches and muscle weakness) which from what I understand strips the mylin sheath from his nerve endings; but since starting Metformin his feet seem to be numb all the time. It is doing veery little to nothing to regulate his sugars and he is really being “a good boy” when it comes to eating properly. Since reading this article I am wondering if perhaps he could regulate the sugar on his own without the Metformin, or should we possibly get a different drug for him.?

    • See a physician who specializes in functional medicine. He or she can help you to come off of the medication safely and fix your diet or other nutritional deficiencies so that you no longer need metformin.

  20. Ive been on metformin which is generic for glucaphage. Was in biabetic coma in 1997.
    Im still on metformin twice a day,along with glimipride
    I have blood test every 3 months, and no signs of any problemd

  21. Hi. I have been type 2 diabetic for 10+ years. My doctor suggested I start taking Metformin a couple of years ago. I did for one week. I had diarrhea so bad that I was weak. I went back to my doctor, gave her back the pills and told her she could keep them! We, as adults, have the choice to refuse any medication that the doctor offers. After all, it’s our body. Right? Don’t allow your doctor to bully you into taking certain medication! Make an informed decision about what medication you put into your body. Do your own research, don’t depend on some pamphlet available through the company that manufactures the medication. Of course they are not going to tell you the negative things about their product. Find a resource that is honest about the medication, the good and the bad.

  22. This article is very disturbing. I’ve been on metformin for a few years now… first I was on HBP meds and about 6 mos after that my BS kept running about 125-150ish so Dr put me on metformin. Many years before these diagnoses I was diagnosed with fibromyalgia, as a couple of the other commenters mentioned. I am eating Keto to try to get off of all meds but it’s soo difficult to be 100%. This article makes me want to strive even harder to be 100%. It is very disappointing to hear about working out… I am half tempted to go off the metformim after reading this. My Dr knows my concerns about taking meds and assures me I’m taking a low dose but this article doesn’t say anything about any dose being more or less dangerous and how long it takes for damage to be done.

    • It is disturbing. It’s not clear from the research how long it takes for the damage to be done or undone once the medication is stopped. I did the research and wrote this article because my mother was on this medication and began having problems. She had been on it for years, along with a bunch of other medications and began having all sorts of problems all at once. I guess she had reached her limits. We gradually got her off of each of the meds over the course of a year or so and cleaned up her diet. She was great for a few years, healthy, exercising regularly, and then her blood sugar began creeping up again. Rather than change her diet, which had fallen back into old habits, her doctor put her back on metformin. Within a few months she had deteriorated so badly that she couldn’t walk, was confused and was generally becoming very ill, very quickly. We stopped the metformin, found her another doctor who has taken a more holistic and functional approach, cleaned up her diet again, put her on a bunch of supplements and helped to rehabilitate her. It took several months for her recover, but she is once again, doing quite well. She swims regularly and is back to where she was prior to the metformin. I would suggest finding a physician who specializes in functional medicine. They seem to have the appropriate knowledge and perspective to tackle these types of issues, more so than the more traditionally trained physicians.

    • This article is the most biased article on Metformin I have come across so far. Do not believe this article except that it leaches Vit. B12. We have to take sublingual Vit. B12 tablets everyday to cover up the deficiency this metformin causes.

      Metformin is a real wonder drug even though the author of this article do not believe it. This is because there have been numerous studies done on it since 2 decades and it has amazing benefits. Most of the diabetics are taking it and have benefited from it taking if for years.

      I have been taking it myself and even my weight reduced considerably when I started the Metformin after being diagnosed diabetic.

      Low carb diet may get your sugar control in normal range but if you find your sugar levels are going little above normal or yr HbA1c is more than 5.8, pl continue taking Metformin. Maximum dosage you can take is 2.5 g in a day. Take sustained release form and always take it after meals

      • Yes. I agree! This article is dangerous and offers no suggestions to taper or supplement. Annoying that because you hold a title you can manipulate people to go off a medication proven to help diabetics and disregard treatment by doctors. Not everyone can exercise regularly and make long lasting lifestyle changes.

  23. This is a concerning article. I am a type II and due to weight gain my endo has suggested I go from taking only insulin but combine it with metformin slow release. The normal stuff made me quite ill. Its a vicious circle. Insulin, weight gain, control and this with lots of exercise. Very,very difficult to control it all

  24. I have Neuropathy in my legs and feet. I have been taking Metformin for years. I need to use a cane to walk because of balance. You did not talk about the Neuropathy part of it in this newsletter. What can I do. I am just getting worse each year. Thanks. Can I just stop taking Metformin? The doctor says I am pre diabetic.

    • Alice,

      I deal with many people in pre-diabetic state and also with diabetes mellitus already. The best thing you can do is do everything in your power to reverse diabetes. I do have a question though: it is striking me odd that you have neuropathy and taking Metformin for years in pre-diabetic state.

      Neuropathy can also occur from being “floxed” which means having taken antibiotics in the quinolone family of drugs of which the most commonly prescribed ones are:

      Ciprofloxacin (Cipro)
      Gemifloxacin (Factive)
      Levofloxacin (Levaquin)
      Moxifloxacin (Avelox)
      Norfloxacin (Noroxin)
      Ofloxacin (Floxin)

      Normally, neuropathy develops after several years of full blown diabetes 2 and not in pre-diabetic state. It is also not typical for pre-diabetes the use of Metformin. If you are in true pre-diabetic state, it is commonly reversible by stopping all sugars and sugar substitutes (anything that is sweetened by anything) and reducing/stopping high insulin spiking grains (wheat, corn (as dry used as popcorn or flour, the fresh corn is OK), barley, rye, rice and several more that are less inflammatory) and reduce those fruits that have high sugar content (persimmons, pomegranate, watermelon, etc.,), stop all juices and smoothies, shakes, alcohol, and increase fresh produce and low sugar/high fiber fruits like berries, and organic meats and water.

      Most people with neuropathy benefit from magnesium supplements, so read some of the articles on what “floxed” people do to help themselves; you find many articles on that subject at hormonesmatter.com

      I hope you find this helpful!

      Angela

    • Hi Alice,
      The metformin neuropathy can be caused by a multitude of factors, all of which inevitably begin with damaged mitochondria, which is induced by, believe it or not, vitamin and mineral deficiencies. Vitamins/minerals act as co-factors in a number of processes that influence cell function and when they are deficient, those functions slow or cease altogether and dysfunction and illness ensue. Metformin in particular, depletes coq10, B12, but also thiamine. We have several articles on neuropathy that you might consider, simply search neuropathy on the site that they will appear. Here is one that might help. http://www.hormonesmatter.com/diabetes-thiamine-treatment-opportunity/

  25. I’ve known about Metformin as a treatment for insulin resistance and PCOS for some time. I had no idea of its potential for ill effect. It seems just another example of a drug that masks or makes worse underlying health problems.

  26. This article is of interest to me…one who has been on metformin for several years (I’d have to check how many). I am now on glimeperide and also 10 units of Levemir a day. I have been diagnosed with Fibromyalgia, IBS, and have almost no energy at all. These are only 2 of the problems besides diabetes that I have. My question: Is it possible to go off of metformin with the help of my endocrinologist? Thank you and I sure would like to see the next article, hope to see it in my inbox. Sincerely ,
    L Mercer (age 65).

    • I am not a physician, so I am afraid I cannot give medical advice. Physicians who specialize in functional medicine can help you safely adjust or come off your medications and treat the root causes of your illnesses rather than simply treat the symptoms. You might look here for a physician in your area https://www.functionalmedicine.org/
      I should note, your symptoms are not uncommon to mitochondrial dysfunction.

    • Oh my. I too have been on Metformin for years now for Diabetes. I also have Fibromyalgia, DDD, and beginning to have other autoimmune issues as well

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