What Is Metformin Used For?

What is metformin used for, and why is it such a popular topic of conversation right now?

Metformin is a commonly prescribed medicine for the treatment of type 2 diabetes. In type 2 diabetes, cells in the body start to become resistant to insulin’s effects, or the pancreas doesn’t produce enough. Metformin is an oral antidiabetic medicine that helps lower blood sugar levels, improving the body’s sensitivity to insulin. It also works by reducing the production of glucose in the liver.

The primary ways metformin works include:

  • Increasing insulin sensitivity. It helps the body’s cells respond more effectively to insulin, allowing glucose to enter cells so it can be used for energy.
  • Decreasing hepatic glucose production. Metformin reduces glucose production by the liver, which is especially important in type 2 diabetes because the liver can release excess glucose into the liver.
  • It slows down glucose from the digestive tract, and metformin can also reduce glucose absorption from the foods you consume.

Typically taken in tablet form, metformin is often also prescribed with lifestyle changes like exercise and eating a healthy diet. It’s a generally well-tolerated medicine, and it’s increasingly being looked at for benefits outside of type 2 diabetes treatment.

What Conditions Does Metformin Help Treat?

Metformin is used for the following purposes and conditions, both as a standalone treatment and as a combination therapy:

  • Type 2 diabetes: Metformin is one of the most effective and commonly used medicines for managing and controlling high blood sugar levels in people with type 2 diabetes.
  • Prediabetes: Blood sugar levels in prediabetes may be higher than normal but not yet in the range for diabetes. Metformin may be prescribed to prevent progression to type 2 diabetes.
  • Polycystic ovary syndrome: Known as PCOS, metformin is sometimes used to treat this hormonal condition affecting women. PCOS is characterized by irregular periods, insulin resistance and other metabolic problems. Metformin for PCOS can help with the regulation of menstrual cycles and improve insulin sensitivity.
  • Gestational diabetes: During pregnancy, metformin may be prescribed to manage gestational diabetes. This diabetes develops during pregnancy, and metformin can control blood sugar levels. This effect helps reduce the risk of complications.
  • Weight management: Metformin is sometimes used off-label to help with weight loss or weight management.
  • Polycystic kidney disease: There’s investigation into the use of metformin as a treatment to slow the progression of kidney disease in some cases of autosomal dominant polycystic kidney diseases or ADPKD.
  • Non-alcoholic fatty liver disease: Metformin may be helpful in the management of NAFLD. NAFLD is when excess fat builds in the liver. Metformin may reduce liver fat and improve liver function for some people.
  •  Anti-aging and longevity: In recent years, metformin has garnered a lot of attention as a possible anti-aging and longevity-promoting drug.

What is Glucose?

To understand some of the benefits of metformin, it’s helpful to know how glucose works. Glucose is a sugar that’s a primary source of energy for the body’s cells. It’s found in foods we eat, like carbs, such as starches and sugars. When we consume foods that contain carbs, our body breaks them down into glucose, which is then absorbed into the blood.

Increased blood glucose triggers insulin release. Insulin, a hormone, regulates blood sugar.

Glucose plays a critical role in overall health, and levels need to be balanced for optimal functioning.

  • Glucose is needed for proper energy production. It’s the body’s primary source of energy, and cells use it to perform essential functions like brain activity, muscle contractions, and different metabolic processes.
  • The body regulates blood glucose levels to make sure they stay in a relatively narrow range. High blood sugar is known as hyperglycemia, and low blood sugar is hypoglycemia. Both can have adverse effects, with insulin and other hormones helping to maintain balance.
  • There’s a complex relationship between glucose and weight. Excess glucose consumption can lead to weight gain if your body’s not using the energy and it’s being stored as fat. High levels of blood glucose can also trigger insulin release. Over time, this contributes to weight gain and insulin resistance.
  • Abnormal glucose metabolism is associated with diabetes—type 2 in particular. Type 2 diabetes is identified by insulin resistance, so cells aren’t responding to insulin appropriately, leading to high blood glucose levels. Uncontrolled high blood sugar in diabetes can lead to major adverse health effects like heart disease, kidney disease and nerve damage. It’s also linked to obesity and metabolic syndrome.

Does Metformin Help with Weight Loss?

Metformin’s use for weight loss is off-label and not approved for use by the FDA, but there are a number of theories as to why and how it contributes to weight loss. Some of the ways metformin helps with weight loss include:

  • Some people on metformin experience reduced appetite.
  • Metformin improves insulin sensitivity and regulates blood sugar. This can reduce hunger and cravings, making it easier to stick to a healthy diet.
  • Metformin can lower circulating lipid levels, including triglycerides, promoting better heart health and potentially helping with weight loss.
  • There’s some research to suggest metformin can influence the composition of your gut microbiota, helping your metabolism and weight management.

The amount of weight that people can lose when taking metformin varies quite a bit between individuals. Higher doses may have more of an impact on weight, as can combining it with lifestyle changes. If metformin is prescribed for underlying conditions like PCOS or type 2 diabetes, weight loss may be more significant because you’re getting those conditions under control.

People who are overweight or obese when they start taking metformin may also have more potential for weight loss than someone who’s already at a reasonably healthy weight.

How Long Does It Take to Start Losing Weight on Metformin?

The timeline for weight loss from metformin varies, and it’s not considered a quick fix. For example, for some people, weight changes can start to occur within a few weeks, but it can take longer for others. Higher doses are associated with faster and more significant weight loss but also increase the risk of side effects.

Metformin and AMP-Activated Protein Kinase (AMPK)

The relationship between metformin and AMPK is critical to its mechanism of action in the body. AMPK is an enzyme that regulates metabolism and energy balance. Metformin is thought to have the beneficial effects it does through the activation of AMPK.

AMPK is often called a cellular energy sensor, monitoring the energy status of the cell. It regulates different metabolic processes to maintain cellular energy homeostasis. If your cellular energy levels are low, AMPK becomes activated, and the activation has the following effects:

  • Activated AMPK promotes glucose uptake into cells, especially in skeletal muscle cells. This helps to lower levels of blood glucose by removing glucose from the bloodstream.
  • AMPK inhibits glucose production by the liver, reducing glucose released into the bloodstream.
  • The activation of AMPK promotes the breakdown of fatty acids and their use for energy-lowering lipid levels in the blood.
  • AMPK inhibits processes like protein and lipid synthesis, which can reduce fat accumulation in cells and improve insulin sensitivity.

Metformin for PCOS

Metformin for PCOS is a common treatment approach. PCOS is a hormonal disorder impacting many aspects of a woman’s health, including fertility, menstrual cycle and metabolism. The relationship that supports using metformin for PCOS includes the following features:

  •  Insulin sensitivity: Women with PCOS often have insulin resistance, meaning their bodies don’t respond to insulin as effectively as they should. This can raise insulin levels in the blood and then stimulate the ovaries to produce more androgens, which are male hormones. That can disrupt the normal menstrual cycle. Metformin improves insulin sensitivity and can lower insulin levels, helping to regulate the menstrual cycle and reduce PCOS symptoms.
  • Hormone regulation: Metformin can help to reduce androgen levels in women with PCOS. High androgen levels can lead to symptoms like excessive hair growth, acne and irregular periods. By improving insulin sensitivity and levels, metformin can indirectly help lower androgen levels.
  • Menstrual regulation: Metformin may help with the regulation of menstrual cycles in PCOS, increasing the chances of ovulation and potentially helping fertility.

Metformin for Anti-Aging Benefits

Recently, metformin has gained considerable attention as a potential anti-aging medication, although research is ongoing. The interest in metformin as an anti-aging medication stems primarily from its impact on metabolic and biological pathways linked to aging and aging-related diseases.

  • Metformin appears to influence cellular processes, including insulin sensitivity, inflammation and metabolism. These are implicated in the aging process and the development of age-related diseases.
  • There is some evidence to suggest that metformin mimics the effects of calorie restriction, a dietary approach to extending lifespan in some species.
  • Mitochondrial function plays a role in cellular energy production. Age-related changes in mitochondrial function are associated with various age-related diseases, and metformin impacts mitochondrial function.
  • Metformin has been studied for its potential to reduce the risk of diseases linked to aging, like cardiovascular disease and some cancers. Reducing the risk of these conditions could contribute to a longer lifespan.
  • Chronic inflammation is a factor of aging and is associated with many age-related diseases. Metformin may reduce systemic inflammation in the body.

How is Metformin Beneficial for Cancer?

Metformin for cancer has been the subject of ongoing research and clinical studies. The evidence can’t yet be considered definitive, but there are studies to suggest metformin has benefits that reduce the risk of some cancers and influence cancer outcomes.

Metformin may influence cellular processes related to cancer, including cell growth, inflammation and metabolism. Research has shown the use of metformin is associated with a minimized risk of developing certain types of cancer, especially in people with type 2 diabetes. The cancers most often studied in this context include breast, prostate and colorectal cancers.

There’s current research into the use of metformin as an adjuvant therapy for cancer, especially when combined with traditional approaches like chemotherapy and radiation. Some studies have found the potential for metformin to improve cancer treatment effectiveness and reduce side effects.

The mechanisms through which metformin may have anti-cancer benefits involve its impact on insulin and insulin-like growth factor pathways and its effects on inflammation and cellular metabolism.

Ozempic vs. Metformin

Ozempic is undoubtedly getting an enormous amount of attention as a weight loss drug right now, but it’s often paired with metformin. Some people also wonder how Ozempic vs. metformin compares to one another.

Ozempic’s generic name is semaglutide. Both are used to treat type 2 diabetes but work differently.

Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist. It works by stimulating GLP-1 receptors in the body, leading to increased insulin release, reduced glucagon release, reduced appetite and slower gastric emptying. Ozempic is effective at lowering and controlling blood sugar levels, and it’s associated with weight loss in most people who use it. Ozempic is typically administered as a once-a-week subcutaneous injection.

Metformin’s drug class is a biguanide. It works by improving insulin sensitivity. It also reduces glucose liver production and slows down digestive tract absorption of glucose. Metformin is considered weight-neutral, or it may lead to modest weight loss in some people.

Natural Supplements That Work Like Metformin

There aren’t natural supplements that work precisely like metformin, but there are natural compounds with benefits for managing blood sugar and improving insulin sensitivity. Some of these include:

  • Berberine is a compound found in plants that can improve insulin sensitivity, lowering blood sugar. It may have effects similar to metformin in some people.
  • Cinnamon, and especially cassia cinnamon, is thought to lower blood sugar. It may improve insulin sensitivity and manage blood glucose levels.
  • Chromium is a mineral that’s part of glucose metabolism, and it may have modest beneficial effects on insulin sensitivity.
  • Alpha-lipoic acid is an antioxidant that might help improve insulin sensitivity and minimize oxidative stress in people with diabetes.
  • Fenugreek is an herb that’s traditionally been used for lowering blood sugar. It may improve insulin sensitivity and blood glucose levels.
  • Sufficient magnesium levels are required for blood sugar regulation and insulin function.
  • There’s emerging research to show that probiotics and gut health can influence blood sugar regulation, insulin sensitivity and metabolic health.
  • Foods high in soluble fiber, like oats, vegetables and beans, can promote stabilized blood sugar and slow down the absorption of glucose from the digestive tract.

What Are the Side Effects of Metformin?

Metformin is considered a generally well-tolerated medicine, but it can have side effects. These can vary between individuals, and most people experience either no side effects or mild symptoms. Potential metformin side effects can include:

  • Gastrointestinal issues: The most frequently experienced potential side effects of metformin are associated with the digestive system. Diarrhea, nausea, vomiting and abdominal discomfort may occur, especially when you initially start using the medicine, but they tend to get better over time for most people.
  • Appetite changes: Some people experience a reduction in their appetite when taking metformin, contributing to the weight loss effects.
  • Hypoglycemia: Also known as low blood sugar, metformin itself doesn’t usually cause hypoglycemia, but it can enhance the effects of other medications that lower blood sugar.
  • Lactic acidosis: This is rare but can be a serious potential side effect of metformin, more common in people with kidney problems or other medical conditions. Lactic acidosis symptoms can include weakness, muscle pain, problems breathing, tiredness and dizziness.
  • B12 deficiency: Long-term metformin use raises the risk of vitamin B12 deficiency.
  • Liver function: The kidneys are primarily responsible for excreting metformin, but it does undergo some metabolism in the liver. In rare instances, metformin may affect liver function, elevating liver enzymes.

Can You Drink On Metformin?

A common question that comes up with regard to metformin is whether or not you can drink on it. While moderate alcohol consumption isn’t usually contradicted by metformin use, it’s still important to talk to your healthcare provider. Considerations to keep in mind as far as drinking on metformin include:

  •  If you do choose to drink while taking metformin, do so in moderation. Excessive consumption of alcohol can affect blood sugar levels, which may not be well-tolerated when you’re taking metformin.
  • Alcohol lowers blood sugar levels, so when combined with metformin, it could raise the risk of hypoglycemia.
  • The liver and alcohol metabolize metformin, which can also affect liver function. If you have any pre-existing liver conditions or concerns about your liver health, be careful with your alcohol consumption.
  • If you take other medicines in addition to metformin, be aware that alcohol can interact with them, affecting their safety or efficacy.
  • Alcohol can contribute to dehydration, and dehydration can affect blood sugar control.

Metformin Frequently Asked Questions

Can metformin be used for weight loss?

Metformin isn’t a weight loss medicine, but some people with conditions like type 2 diabetes or PCOS may experience modest weight loss. This is considered a secondary effect of metformin because the medication’s primary purpose is to manage blood sugar levels.

How much weight can I expect to lose on metformin?

There’s a lot of variation in weight loss with metformin among individuals. Some people report losing a few pounds, while others experience weight loss of up to ten pounds. The amount of weight someone loses on metformin often depends on things like the dosage, individual responses, baseline weight, and whether they also make lifestyle changes.

Can I lose 20 pounds on metformin?

It’s unlikely that you would lose 20 pounds on metformin alone unless you were very overweight when starting it. Losing 20 pounds would probably require the use of medicine like Ozempic or significant changes in diet and lifestyle. Metformin has a supportive role.

How long does it take to start losing weight on metformin?

The timeline to lose weight on metformin varies, with some people starting to notice changes in a few weeks. It can take longer for others.

Final Thoughts—What Is Metformin Used For?

There’s a lot of current discussion about metformin and its benefits, which, along with helping type 2 diabetes, may include anti-aging properties. While metformin does have a lot of benefits, it’s not primarily for weight loss. Metformin can help with PCOS weight loss and weight loss when you have diabetes, but it may not help with weight loss otherwise.

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