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Writer's pictureDr. Barbara Chen

metformin: the low down

Updated: Mar 10, 2022


French Lilac from The National Gardening Association

Did you know? Metformin was first discovered from a plant called French lilac. This medication has been available for the last 80 plus years and is life changing for people with diabetes. However, you will see its use in many fields in medicine due to its anti-inflammatory properties.


how it works

Metformin helps your body process the carbs you eat such as cookies, sugar, and pasta. It helps with carbs in healthy foods as well such as beans, peas, and quinoa.


More technically, metformin works by:

  • Improves your liver's ability to manage carbs

  • Decreases your absorption of carbs

  • Improves insulin sensitivity which helps you process carbs

what to expect

There are 2 versions of metformin--extended or immediate release. Typically immediate release is taken prior to meals to enhance its efficacy. You can also take the extended release version prior to meals as well. Your physician will advise you to increase your dosing slowly to allow your body to adjust to the changes of improved metabolism.


Most common side effects (these side effects typically resolve over time):

  • stomach cramping

  • loose stools; diarrhea

  • passing gas

Less common side effects:

  • vomiting

  • lactic acidosis

things to know when taking metformin

  • If you eat unhealthy with larges amounts of sugar and carbs like pasta, you can experience more cramping, loose stools, and farting.

  • Stop metformin prior to surgery.

  • Stop metformin when you are sick with an infection (ie pneumonia, appendicitis).

  • Remember, the common side effects typically do go away, so be patient!

  • It does not typically cause low blood sugar, or hypoglycemia (compared to insulin).

  • Take B12 and check a B12 level after prolonged use, since metformin affects B12 absorption.

  • It's super cheap! A 90 day supply costs only $10 typically.

who can use metformin?

Just about everyone. Most individuals tolerate this medication well especially when it is slowly titrated.


Typically, metformin is used in the treatment of diabetes. One of the largest issues in medicine today is delay in intervention, which then leads the patient to fulminant diabetes. For example, if a patient is prescribed metformin when she has diabetes, the hard truth is that she should have started this medication or any form of intensive lifestyle intervention when she was already diagnosed with pre-diabetes or insulin resistance.


Metformin is found in other fields in medicine due to its improvement of inflammation:

  • Skin: acne, hidradenitis suppurativa (HS)

  • Cancer (Oncology): breast cancer, possible breast cancer prevention or recurrence prevention; colorectal cancer survival.

  • Gynecology: polycystic ovarian syndrome, infertility, endometriosis.

  • COVID 19: study showing fewer deaths in persons with diabetes on metformin with active COVID.

  • Overweight/Obesity: commonly used for weight loss and weight maintenance.

The goal at pillarMD is to address metabolic diseases through health and wellness to achieve weight loss and weight maintenance. Metformin is commonly used to help a person prevent long term chronic diseases like diabetes as well as maintain their good health. This of course is our focus at pillarMD. If you are interested, connect with our obesity-medicine trained physicians to discuss whether you can take metformin.

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