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Question about keto and metformin?

UMDaviesUMDavies Posts: 87Member Member Posts: 87Member Member
Hi all,

I'm still new to this way of eating and I was wondering whether it is a good idea to take metformin whilst trying to go fully keto (<20g net carbs)? I understand that nobody on here is a doctor and I do have an appointment coming up where I'll discuss it with my GP, but I'd just like people's opinons in the meantime.

Basically, I'm taking 3000mg metformin per day (1000mg after breakfast, lunch and dinner) to treat PCOS, as prescribed by my doctor. When I was still eating high-carb I could really feel the difference as the metformin stopped the energy crash I would get after a meal. It also helped me break a weight-loss plateau I'd been trying to get off for a while. My understanding of how it worked was that my body was normally insulin resistant, so it had to produce extra insulin in order to process the sugar/carbs I ate. Taking the metformin helps my body respond normally to the insulin, so it only needs a normal amount to process the sugar/carbs. Now, if I go keto my body should transition to the point where it gets its energy from fats instead of carbs, right? So if I carry on taking the metformin, what effect will it have? Am I at risk of low blood sugar if I carry on taking it when my blood sugar would be pretty low anyway from eating keto?

Any ideas/comments would be great!

Replies

  • bluefish86bluefish86 Posts: 842Member Member Posts: 842Member Member
    I would continue to take it while you adapt to this way of eating... but maybe book an appointment with your doctor now to have some tests done to see if you might be able to lower your dose?
  • Raynne413Raynne413 Posts: 1,527Member Member Posts: 1,527Member Member
    I'm on metformin as well, and I would be curious as to what your doctor tells you, if you wouldn't mind reporting back, because I was wondering the same thing. I take my metformin first thing in the morning, after my lunch around 3, and then at bedtime, and I've noticed that by the time I get home from work in the afternoon, around 5, I'm usually feeling sick to my stomach, tired, and shaky, so now I'm wondering if it is from my afternoon dose.
  • KnitOrMissKnitOrMiss Posts: 10,101Member Member Posts: 10,101Member Member
    My doctor recommended staying on Met as it helped with my insulin resistance, but as I added more dairy, it wasn't worth the dumping complication for me personally. Not everyone has that. Since I am doing well staying with my diet plan, and my IR is minimal, I'm able to manage it to 90-95% of the Metformin levels through my Keto diet. I don't believe there is much risk of low blood sugar with it (there was some research a while back), but after adjusting dietarily, you may be able to reduce or stop your dosages eventually. But you may not. Some people's insulin resistance don't get better using diet or it may take a long LONG time to restore your metabolism's "health." So this is very much and individual situation, based on how your body responds.

    However, if you struggle to stay on plan, it is unlikely that you would ever be able to stop this medication, because low carb eating requires patience and persistence for success. It's not a quick fix...

    Metformin only works, as I understand it, by making your body see the insulin it has already created instead of making more and continuing the raging hunger cycle that is IR. So since Metformin doesn't create or increase insulin, there should not be complications with blood sugar. This is as my endocrinologist explained.

    Now added insulin, as a diabetic must take, that would cause low blood sugar with this diet.

    In fact, Metformin WORKS BEST with a low carb diet... So I don't see any risk from my own experiences. I hope your doctor conveys the same.
  • DittoDanDittoDan Posts: 1,850Member Member Posts: 1,850Member Member
    I agree with Knit. Pre-Keto I was on several diabetic meds. All, but Metformin, increase insulin ~ which is a bad thing. With my "Google Degree" I haven't found any bad reviews about Metformin. Its the only diabetic med I still take:

    How I got Off of Diabetic Prescriptions Drugs Since I Started Keto Updated

    Yes, I would love to not take any meds, but, as far as I can tell, Metformin actually helps you without bad side effects. The only side effect it has ~ is diarrhea, but it is temporary. If you get it, DON'T stop taking it, keep taking it, and in a few days the diarrhea will go away. This will happen every time you stop for a few day/start taking it. So consistently take it.

    I hope this helps,
    Dan the Man from Michigan
    Keto / IF / Sedentary
    92 pounds down, 32 to go.
    Previous Discussions on the LCD & Keto Groups
    DittoDan's Keto Sub Groups Blog
    It's Ketogenic or Bariatric Surgery! How I Found the Ketogenic Diet
    Blog #10 Keto: Abbreviations, Acronyms & Terminology Used on the LCD & Keto Discussion Groups Updated
    Blog #13 DittoDan's Milestone's, First's And Good Changes Since Starting the Ketogenic Diet Updated

  • radiiiradiii Posts: 422Member Member Posts: 422Member Member
    KnitOrMiss wrote: »
    Metformin only works, as I understand it, by making your body see the insulin it has already created instead of making more and continuing the raging hunger cycle that is IR. So since Metformin doesn't create or increase insulin, there should not be complications with blood sugar. This is as my endocrinologist explained.

    That's always been my understanding as well.
  • UMDaviesUMDavies Posts: 87Member Member Posts: 87Member Member
    Thanks for the replies everyone! Unfortunately my doctor has gone off sick so I've cancelled my appointment - the next one I could get was in a month and a half's time when I'll be on holiday, so I'll probably just rebook it when I get back. However, I've been low-carb/keto for the past few weeks and taking my metformin as usual and I haven't noticed any negative side affects - only good ones! Jimmy Moore also recommends it in his Keto Clarity book, and Phinney/Volek also talk about eating keto whilst taking it, so I'm sure it'll be fine :)
  • toadqueentoadqueen Posts: 592Member Member Posts: 592Member Member
    I took Metformin 500-1000mg per day off and on for years white eating LC/Keto and stopping insulin. I've run out now. I didn't notice any physical difference. I never did with it but my dr recommended I stay with it even though my BC and A1C were both within normal range.

    I thought it helped with suppressing my appetite but I am the same without it.

    I wouldn't worry about it. Nice explanation KnitOrMiss.
  • smslogan317smslogan317 Posts: 39Member Member Posts: 39Member Member
    I still take my Met, I am prescribe 500 3x a day but usually only need to take it 1-2 times, I usually take mine post workout or before bed.
  • psenarighipsenarighi Posts: 33Member Member Posts: 33Member Member
    Regular glucose checks are your best bet. Since I've really got my carbs down this week my spot checks have been great. I was afraid of low blood sugar with trying to be in that 30-50mg carb range but I'm holding steady.
  • Kimmygirl40Kimmygirl40 Posts: 4Member, Premium Member Posts: 4Member, Premium Member
    I take 1000mg morning and 1000mg evening. I started Keto after been diagnosed with Type 2. 1250 calories, Macros: 5% carbs, 20% protein and 75% fat. After 3months i had dropped 25kg and my HbA1c count went from 101 to 34. Doctor was extremely impressed. Beside the meds helping, i give alot of credit to the Keto lifestyle.
  • JessicaLCHFJessicaLCHF Posts: 1,265Member Member Posts: 1,265Member Member
    I was on a much lower dose of metformin (750ER) but it caused me to crash one day at church. Was very scary. Couldn't think, sweaty, and weak, confused and almost passed out, room was "rolling". Hubby is an RN and immediately got me some sugar packets. My doc took me off the metformin and my a1c has been steadily improving without it (from 9 to 6 current) over the past year. Being off it also makes me very consistent with my diet since it's the only thing controlling my blood sugars.

    The metformin stopped my body from recovering from a low sugar dip (it was a busy day and I had skipped Bfast). Not sure if it's because it was ER (extended release). The ER was easier on my tummy tho.
    edited August 2015
  • jpwood32jpwood32 Posts: 1Member Member Posts: 1Member Member
    I've been reading some of these old posts. I just recently completed a diabetes education class. I take 1000mg 2 times a day WITH FOOD no on an empty stomach. For a good while, I was faithful to take it twice a day am and pm, I didn't actually understand until recenltly that the instructions were to take it with food. Metformin which is a biguanide type drug. Metformin "sensitizes the body to use the insulin it makes effectively, keep the liver from releasing excess glucose, especially during times of stress" from YOUR GUIDE TO UNDERSTANDING DIABETES MANAGEMENT, Author: Pam Wollenburg, A.P.R.N., C.D.E.. This is a great resource. I am taking metformin and and just started my first attempt at Keto dieting. Eating food with metformin is important for the efficacy of the drug, not just a suggestion.
  • KnitOrMissKnitOrMiss Posts: 10,101Member Member Posts: 10,101Member Member
    jpwood32 wrote: »
    I've been reading some of these old posts. I just recently completed a diabetes education class. I take 1000mg 2 times a day WITH FOOD no on an empty stomach. For a good while, I was faithful to take it twice a day am and pm, I didn't actually understand until recenltly that the instructions were to take it with food. Metformin which is a biguanide type drug. Metformin "sensitizes the body to use the insulin it makes effectively, keep the liver from releasing excess glucose, especially during times of stress" from YOUR GUIDE TO UNDERSTANDING DIABETES MANAGEMENT, Author: Pam Wollenburg, A.P.R.N., C.D.E.. This is a great resource. I am taking metformin and and just started my first attempt at Keto dieting. Eating food with metformin is important for the efficacy of the drug, not just a suggestion.

    @jpwood32

    That's particularly interesting, because most docs suggest you take the Metformin approximately 30 minutes before you eat. I only did that a couple times before I realized how miserable that made me... I've pretty much always taken it with food.
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