Tolerating Metformin (nausea problem)

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I tried taking metformin a few years ago for PCOS but found that I felt sick all the time - for weeks on end - even taking slow-release tabs and on a pretty low dose.

Now I want to try it again because I suspect my really bad diet at the time did not help (high fat, high carb, high sugar) and basically I was wanting tips on what to do. I am going to see my doctor next week and will probably let her prescribe the dose (I will tell her about the side effect problem) but what else might help me tolerate it?

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  • KnitOrMiss
    KnitOrMiss Posts: 10,104 Member
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    I can tell you that every single side effect and problem I had with metformin was minimized when I dropped to super low carb (LCHF/Keto), with the exception of dairy interaction, which not everyone has.

    Someone else suggested taking your Met 15-30 minutes after eating to minimize the side effects, but I don't know how that affect efficacy... Definitely discussion point with your doctor.

    I would make certain to explain that if she cannot suggest steps to minimize this side effect, you will not be able to tolerate it. Period. Do not proceed without advice, otherwise you will just stop it again. But, by eating differently, your side effects will be at least somewhat different.

    Also, are you insulin resistant? Did your doc do fasting insulin tests in addition to fasting blood glucose tests? If not, you need to demand that test before starting this medication, or else you could be worsening your own health issues. If you aren't sure, call her office and request a copy of your previous lab work. Others can provide more info on the subject.

    Good luck!
  • soapyraindrops
    soapyraindrops Posts: 2 Member
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    I have no idea if I'm insulin resistant or not, in fact I haven't been to see a GP for many years now. I'm going to see her specifically to ask for metformin because I am at a high risk for diabetes and I think that now I am exercising and have improved my diet it could help me lose weight.

    Aside from being diagnosed with PCOS (via a hormone test and reporting my symptoms) I actually don't have any health problems to speak of. Even my periods have been relatively regular and easy for a year with no medication. The metformin is largely preventative - so not sure how it could make my health worse?
  • Alliwan
    Alliwan Posts: 1,245 Member
    edited March 2015
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    If you have upset tummy with Met try ginger tea or ginger pills. It helps the tummy upset. If its more the constant potty issues then lowering your carbs helps a whole lot along with using the ER version of Met.

    If you arent IR, then Met doesnt help a lot as the only real thing that medication does is help your body process insulin so your pancreas stops over producing so it doesnt burn out. If you dont have a problem processing insulin, then Met is just a pricey way to tear up your gastric system and cause a severe B12 depletion. Met doesnt do anything for PCOS itself, only if you have IR with it.
  • IslandSneezerooo
    IslandSneezerooo Posts: 268 Member
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    I could have written your OP @soapyraindrops. I tried metformin for a year a number of years ago, but continued to eat my usual high carb diet and gained 50 lbs. I was extremely ill for a year with the runs, nausea, stomach pain, etc... I was trying to get pregnant and didn't, so I went off it after a year.

    Fast forward to now, I have had a tubal ligation so obviously not TTC, and my weight is still around the same as it was after going off metformin (280+ lbs), but my cycles have been extra long and irregular since the New Year, so my doc tested my hormones for possibility I'm going into pre-menopause, but I'm not... He started me on a low dose of metformin again last week (500 mg). The pharmacist recommended taking it mid way through dinner. I always forget, so what I've been doing is before bed I eat half of a single serving probiotic yogourt, take the metformin, then finish eating the other half of the yogourt. It's been working really well! I was still eating too much carbs, so I cut it way back the last couple days... Been very tired, but not feeling as nauseous now. I'll take this dosage for a month, then he'll up it to 1000 mg next month...
  • KnitOrMiss
    KnitOrMiss Posts: 10,104 Member
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    I could have written your OP @soapyraindrops. I tried metformin for a year a number of years ago, but continued to eat my usual high carb diet and gained 50 lbs. I was extremely ill for a year with the runs, nausea, stomach pain, etc... I was trying to get pregnant and didn't, so I went off it after a year.

    Fast forward to now, I have had a tubal ligation so obviously not TTC, and my weight is still around the same as it was after going off metformin (280+ lbs), but my cycles have been extra long and irregular since the New Year, so my doc tested my hormones for possibility I'm going into pre-menopause, but I'm not... He started me on a low dose of metformin again last week (500 mg). The pharmacist recommended taking it mid way through dinner. I always forget, so what I've been doing is before bed I eat half of a single serving probiotic yogourt, take the metformin, then finish eating the other half of the yogourt. It's been working really well! I was still eating too much carbs, so I cut it way back the last couple days... Been very tired, but not feeling as nauseous now. I'll take this dosage for a month, then he'll up it to 1000 mg next month...

    Cutting carbs (dramatically, for me) and avoiding dairy 4 hours either side of Met helped me, too...
  • KateinDC2015
    KateinDC2015 Posts: 1 Member
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    I tried metformin two years ago and was extremely sick to the point where I couldn't be in the office or workout. I was way too dehydrated. This past fall, I decided to try again. I purposely started it at the beginning of November where I knew my client work would be slower and I had time off. The biggest thing I can say is that I stuck it out and it was worth it. Doctors usually tell you it takes 2-4 weeks for symptoms to go away. That wasn't the case for me. It took 3 months but it was worth it. Now I have no side effects. I also found that taking both my pills at lunch time was best for me where as before when I tried it I took one dose in the morning and one at night. I do this because I workout in the morning so the metformin doesn't impact my workouts any more.
  • IslandSneezerooo
    IslandSneezerooo Posts: 268 Member
    edited March 2015
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    @kateinDC2015 What dosage did they start you on? My doc has me on 500 mg for a month, then upping to 1000 mg for a month, and so on till we find the highest dosage I can comfortably tolerate. I've had little to no intestinal issues on this dosage, just one afternoon of nausea after eating too much carbs one day.
  • stefne888
    stefne888 Posts: 113 Member
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    Does anyone feel really hungry while taking Met?
  • ALNoog
    ALNoog Posts: 413 Member
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    I agree.. Low carb while on metformin has helped minimize nausea for me ... Also eating and waiting half an hour and then taking it helps immensely... But that goes for all medications that say "take with food"... Eat, let the fold settle for a bit and then take it. Works wonders!
  • aSearch4Me
    aSearch4Me Posts: 397 Member
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    Also ditto to the low-carb thing when starting metformin. I was already low carb when starting it (<20%/day, around 40g net, & had been for around a month), and had zero problems with nausea on a daily basis. BUT...even on my full dosage now (1000mg ER b.i.d. AM & PM), if I have a carb level day that is closer to "standard diet"...I am horribly nauseated & miserable from a GI standpoint.

    I also found out that I can't have milk now (including half & half as I'm discovering this week), or I get HORRIBLY nauseated, even if it's just an 1oz serving. Once this carton of half & half runs out, I'm switching back to actual cream for my coffee. Yogurts have the same effect for me (I miss Fage Greek Yogurt SO much). Cheeses don't seem to have the same effect.

    So long story short, if you are already lower carb when you start back on metformin and are nauseous you might want to consider cutting out milk/dairy to see if that helps.
  • aSearch4Me
    aSearch4Me Posts: 397 Member
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    stefne888 wrote: »
    Does anyone feel really hungry while taking Met?
    Unfortunately, no. It has the opposite effect on me where often times I have to remind myself it is time to eat (which is contrary to my entire life existence up til this point, my hunger pangs & cravings controlled my life). The only exception to this is that near my TOM, I still fight the urge to "eat the entire world"...but I don't think that's Metformin's fault. lol

    You might want to talk to your doctor about what your experiencing? It looks like some people get backed down on their dose if that is still happening after the first few weeks? (as gleaned from poking around a couple of other PCOS sites).