I haven’t started taking metformin yet but i do have a prescription my doctor prescribed because i am pre diabetic and i gained a lot of weight last year and my blood sugar went back from normal to prediabetic. however i want to do rolling 72’s consistently for the next 2 months to lose weight and lower my blood sugar. maybe even some 5 day or 7 day fasts if i can extend those 72’s as i’m pretty experienced with fasting. but idk if i should start taking metformin right now or perhaps wait until may when i’ll start doing OMAD? it says on the bottle to take 1 tablet once a day with a meal
Don’t be afraid to ask your doctor if you can try diet and exercise before trying metformin. One of the reasons doctors have started prescribing metformin to pre-diabetic patients is because of a pervasive, and unfortunately evidenced based, belief that a lot of people won’t make the changes necessary to get back to normal blood sugar levels. But also talk to your doctor about fasting too. I’ve seen medical studies out there about fasting and a couple of them show lowered blood sugar levels for longer fasts, but others have shown an increase in insulin resistance after coming off of a fast. It might be better to go on a restrictive diet, intermittent fasting/omad or your doctor might say if you can handle long fasts go for it. But it is important you have that conversation with someone who can assess your health and how it will affect you personally. You may want to ask for a referral to a dietician if your doctor is more generalized and doesn’t have any nutritional background.
In principle, metformin shouldn’t cause hypoglycemia, which should be your main concern when fasting.
As others have pointed out, however, it can be harsh on your stomach and give you nausea, but that varies from one person to another. I personally used to take it on an empty stomach, and aside from some mild nausea, was able to tolerate it well for the most part. Your best bet is to try and see how it goes for you.
Metformin is known to cause nausea, diarrhoea, vomiting and other unpleasant side effects, which, when you’re fasting and your electrolytes are already likely to be somewhat deranged, could lead to serious complications. Metformin is supposed to be taken with food for a reason.
Also - this is something you need to discuss with your Dr. Pretty much every medication has side effects and needs to be taken as prescribed. Going off piste can cause serious issues.
I am not a doctor, and I am not qualified to give medical advice. I advise you to discuss this with your doctor, as well as do your own research and assess your numbers etc.
That said, I was diagnosed with T2 in 2008 and have been taking Metformin since, 1000-2000mg. /day. Although it didn’t agree with my digestion at first, I got to tolerate it well. Still, I tend to not take it if I don’t eat; I take it in the morning if I ate the previous night, and then I take it in the evening with a snack or dinner; if I haven’t eaten, or I’m fasting, I generally skip that dose. My understanding is that it slows release of glycogen from the liver, so it reduces the blood glucose spike. It also increases insulin sensitivity, and…..protects the kidneys? I don’t see a big downside in taking it, but avoid it on an empty stomach. That being said, I’m fasting because I want to drain the glycogen out of my liver, so it starts burning liver fat. My glucose doesn’t go over 140 when I’m fasting (usually under 110), so I don’t think the Metformin is protecting, say, my retinas. I wish I had known about IF/EF/Keto when I was diagnosed. My opinion is that the Metformin is treating a symptom; if you can reverse the fatty liver/obesity/insulin resistance with diet and exercise, that is the course to take.
My mother can NOT take metformin while doing rolling 36 hr water fasting (12 hr feeding), since her blood sugar drops too low. She’s using a continuous glucose monitor (freestyle libre) which makes determining that, very easy.
From what I have heard, It is suggested to take it after a carb heavy meal. So, I wouldnt take it when Im fasting, but if on refeed I eat a whole pizza. Im thinking about it. Well ill be using poor mans metformin since we can’t get it over the counter in the states.
I don’t remember which episode, but Huberman labs had a doctor on who takes metformin regularly and hes nowhere near diabetic. But, he does intermittent fasting not extended.
Personally, if I was prediabetic. I would just do the fasts. Go get tested again in a month. I bet you won’t be prediabetic anymore.
I am not a doctor, this is not medical advice.