Is metformin good or bad?

Is Metformin Good or Bad?

Metformin is one of the most commonly prescribed drugs in the United States. Doctors prescribe it for many different conditions including diabetes, pre-diabetes and polycystic ovary syndrome. Up to one-third of adults over the age of 50 are now taking this medication. There are plenty of benefits as well as potential side effects. In this article, we are going to discuss the benefits and risks with this drug and answer the question, Is metformin is good or bad?
Here’s what you need to know.

An overview

This is one of the most interesting drugs available today. It is not just for treating diabetes, it has been shown in studies to be cardioprotective and beneficial in the presence of stable congestive heart failure. It also has the potential to become a potent anti-cancer treatment that can be used to both prevent and treat cancer. 

Marketed under the brand name “Glucophage,” Metformin is the first-line treatment for type 2 diabetes, particularly in obese patients. It is also employed in the treatment of Polycystic Ovarian Syndrome. This medication aids in the control of blood sugar levels in people with type 2 diabetes. It does so in many ways, including:

  • Reducing the amount of sugar absorbed by your body from food 
  • Lowering the amount of sugar produced by your liver
  • Increasing your body’s response to the insulin that it naturally produces

The Origin of Metformin

Metformin is derived from French Lilac

French lilac (Galega officinalis) was used by healers in medieval Europe to treat a variety of symptoms, including some that could have been caused by type 2 diabetes. By the 17th century, doctors were recognizing diabetes and treating it with plant extracts. 

It was first synthesized in the 1920s using compounds derived from French lilac. In rabbits, the drug was found to lower blood sugar levels. Glucophage is a brand name that means “glucose eater”. It took until 1994 for the FDA to approve its use in the treatment of type 2 diabetes in the United States. It may now be the most widely used diabetes medication on the planet.

The Good and the Bad (side effects) of Metformin

The Good 

Metformin aids in the regulation of blood sugar levels. It is the first-line treatment for type 2 diabetes in patients aged 10 and above. Controlling high blood sugar levels can help prevent kidney damage, blindness, nerve problems, limb loss, and sexual function issues. Diabetes control may also reduce your risk of having a heart attack or stroke. This medication can help to reduce these side effects of diabetes. Metformin works by restoring your body’s proper response to the insulin it produces naturally. It also reduces the amount of sugar produced by your liver and absorbed by your stomach/intestines. 

Metformin lowers blood sugar levels by improving your body’s insulin response. It is typically prescribed for diabetes when diet and exercise alone have failed to control blood sugar levels. Because of insulin resistance, the liver believes there isn’t enough glucose in the cells and produces glucose to compensate. Metformin stops the liver from making glucose. It can also improve the way the muscles use insulin. This is referred to as increasing insulin sensitivity. Metformin (at full dose) can reduce A1C levels by up to 2% over a three-month period by combining these two actions.

Is metformin good or bad? – It is one of the first line drugs for treating type 2 diabetes.

It has other positive effects in the body and has been shown to improve total cholesterol and LDL cholesterol  numbers. The drug usually causes weight loss in overweight individuals. 

Clinical trials have found that metformin can help with a variety of cancers. It prevents the growth of tumor cells, survival, and metastasis while also altering the tumor microenvironment to suppress cancer development. 

It also has piqued some interest as an anti-aging drug and remains one of the least expensive prescription drugs on the market. 

The Bad (Side Effects)

While Metformin is a good drug, it is not without fault. Just like most drugs, it also has side effects. It is well-known for causing stomach discomfort, diarrhea, nausea, and bloating in some patients. Most often, these side effects tend to resolve after a few weeks.  Is metformin good or bad? – There are a few more serious concerns with this drug.

Lactic acidosis

Lactic acidosis is a rare but serious condition that can occur when taking metformin. Lactic acidosis symptoms include muscle pain and cramping, fast and shallow breathing, stomach pain, and unusual sleepiness. 

Lactic acidosis due to metformin is linked to kidney dysfunction. Individuals taking metformin should have their kidney function (also known as serum creatinine) tested at least once a year to ensure that metformin is still the right medication. Metformin is not advised if your kidney function has deteriorated to a certain level. This is also why this medication should not be taken on the same day as or within 48 hours of a contrast dye imaging study.

Vitamin B12 deficiency

The exact mechanism by which metformin reduces B12 levels is unknown, but there is an increased risk of B12 deficiency in those who have been taking a high dose of metformin for several years. A lack of B12 causes neurological symptoms such as numbness and tingling. The tricky part here is that diabetes can cause these symptoms. B12 levels are easy to check on laboratory testing. It’s usually safe to take an over-the-counter B12 supplement even if you don’t have a lab value to prove you’re deficient. If you’ve been taking this drug for three years or more, ask your doctor what he or she thinks about adding B12 to your medication regimen.

Life extension?

There was mention of taking metformin for life extension. This does have serious concerns. There has not been detailed research to support this claim. Moreover, some researchers have shown that metformin started later if life shortened one’s life span.

Is metformin good or bad? – There is not enough evidence to support taking metformin solely for life extension.

Will metformin aid in weight loss?

The majority of metformin users have type 2 diabetes and need to lose weight, but it should not be used solely for weight loss. Maintaining a healthy diet and regular exercise is the best way for anyone to lose weight. 

Metformin use has been linked to weight loss in studies, but results vary. In some studies, patients lost 4 to 6.5 pounds (lbs.), whereas in others, they lost only about 2 lbs. Weight loss, even if only slight, appears to be the norm, in contrast to the weight gain that frequently occurs with insulin or sulfonylurea treatment. 

In general, while it is a useful drug for controlling blood sugar in diabetes, weight loss due to metformin is unlikely to be sufficient. For type 2 diabetes weight control, individuals should follow a healthy diet and engage in regular exercise.

In conclusion – Is metformin good or bad?

Metformin is a widely used clinical drug that provides numerous benefits via various signaling pathways. The most notable property of metformin is its ability to prevent hyperglycemia. While it has many other benefits, this drug is not without risk and should be used under the direction of a physician. Metformin also should not be used for “off-label” uses such as life extension. As long as people are cautious about side effects and complications, it can be a powerful treatment for diabetes.  

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5552828/

https://care.diabetesjournals.org/content/37/7/1786

https://www.metabolismjournal.com/article/S0026-0495(15)00306-6/fulltext

https://pubmed.ncbi.nlm.nih.gov/15189360/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772077/

https://www.everydayhealth.com/type-2-diabetes/metformin-health-benefits-why-they-likely-go-beyond-type-2-diabetes/