Ask HN: Metformin

16 points by iambateman 5 days ago

This morning I saw a tweet about metformin being generally used by a lot of people. Then I googled it and Harvard medicine had an article praising it. So now I’m curious…what is your experience with it?

psychphysic 5 days ago

Don't ask people for anecdotal advice around drugs. The bias is absurd. Just look up the summary of product characteristics or better yet talk to a doctor and you'll even get a blow by blow of how common they are.

That said if it doesn't give you the runs and you aren't trying for a kid it's probably the closest thing to exercise in a pill I'm existence.

svillar 5 days ago

Berberine is a natural over the counter alternative that is equally as effective to lower your blood sugar. (Studies and research available online that shows this same finding, I am not making this up).

I tried Metformin before switching to Berberine (I am not a diabetic), did it because I kept reading about longevity benefits. Problem was that since I was not a diabetic, it was hard to find a dose that did not lower my blood sugar too much and didn't make me dizzy and since I failed, it was easier to switch to Berberine.

If your goal is to improve your blood sugar then I suggest looking into improving insulin sensitivity via fasting, exercise, improved sleep, lowered stress and if you are up for it, switching to a whole food plant based diet (low carb high in vegetables to start and then open it up) this is the approach that I have seen work for others in my family.

Last but not least, get a CGM, fantastic. I use the freestyle libre 3.

  • nikolay 5 days ago

    Berberine is so much more expensive than metformin.

PaulHoule 5 days ago

See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351883/ for an important part of the story.

The short of it is that Metformin does seem to induce good metabolic changes but it also reduces the physiological response to exercise which is also great for your metabolism, function, mental health, etc.

  • chrislaco 5 days ago

    Look into Mounjaro. (I'm not a Dr)

    I know a few folks who were on metformin long term for diabetes related things, and after the switch, lost a TON of weight from metabolic changes in just that year compared the entire past.

    As with both generally, they're starting to clamp down on prescribing/filling for non-diabetic folks (aka, people using it just for weight and not clinical diabetes itself).

    • PaulHoule 5 days ago

      The story for weight these days is The use of GLP-1 agonists like Semaglutide, prescribing for these is picking up. The criteria for getting them are also at BMI levels that are not crazy high for an American population, particularly if you have any signs of ‘metabolic syndrome’ such as high blood pressure, pre diabetic high blood sugar, etc.

      The advantage here is that this is not ‘off label’ at all for many people today.

    • danielfoster 5 days ago

      Just to confirm, you mean they lost weight after switching to metformin?

      • loupol 5 days ago

        From the first result I skimmed through searching Mounjaro, I would assume GP meant switching away from metformin to Mounjaro :

        "...Mounjaro can be used on its own in patients who cannot take metformin (another diabetes medicine)..."

Culleredo 5 days ago

I use a glucose monitor in order to force myself to eat healthy, and I noticed that I don't get glucose spikes anymore when I'm on metformin. Good medicine. Also look into acarbose!

LinuxBender 5 days ago

I personally prefer the non-RX alternative Berberine as it has less risk of lactic acidosis in the liver. I use 1.5G/day and it helped in conjunction with a hybrid of healthy-keto + paleo and intermittent fasting to reduce insulin resistance for me. But that is just my preference and I take about 50 other supplements and that would confound any studies.

  • thebigspacefuck 5 days ago

    How do you measure the impact on insulin resistance?

    • LinuxBender 5 days ago

      It is a glucose test that is repeated 3 times an hour apart and the blood glucose levels are measured each time after consuming a high glucose drink. With insulin resistance the glucose spikes twice and without it the glucose spikes once and falls. The test model is called HOMA-IR Homeostatic Model Assessment of Insulin Resistance

fcoury 5 days ago

I see a lot of praise for Metformin on the comments here. I did a quick search and it seems that the only long term side effect listed is B12 deficiency. I also saw a comment talking about lactic acidosis in the liver.

Are there any other known short and long term side effects? Did anyone have a bad experience while taking it?

  • thejteam 5 days ago

    My mother is taking it (for diabetes) and one of her doctors suspects it may be the cause of some long term diarrhea issues she has been having. But that is still to be determined. My mother is also having liver issues, and I had not heard about the lactic acidosis problem before. I will pass that along.

    • danudey 5 days ago

      I'm on metformin for diabetes as well, and diarrhea issues are the biggest concern my doctor has. I can't tolerate too high of doses (when we tried I ended up laying in bed for an entire weekend because I felt so terrible), so I'm hopefully going to Ozempic or similar soon, but stomach upset and associated issues are the biggest reason to move onto another medication (or a lower dose of metformin combined with something like glyburide).

  • solresol 5 days ago

    I had various bowel problems while on it, which were slightly unusual and hard to relate back to taking metformin, but they all cleared up when I stopped taking it.

    It's a very well-known drug, and a lot of patients have taken it for a long time. Side-effects are rare.

CommanderData 5 days ago

I learned if you're a long term user there's a protocol to follow to wean youself off it or there may be some short term side effects.

thesneakin 5 days ago

Take it as prescribed. My grandma was taking it before bed with the rest of her pills which isn't the best time to bottom out your blood sugar. She was riding a roller coaster of highs and lows until my mother took over filling her pill case.

nikolay 5 days ago

I've been taking metformin for years alongside HMB (hydroxymethylbutyrate) naively thinking that it could prevent the muscle loss associated with it.

nisegami 5 days ago

I think they should put it in the water in my country.