Major Health Problems From Taking Metformin HCL

Metformin, sold as Fortamet or Glucophage, is a treatment for Type 2 diabetes. The medication's primary feature is to decrease both insulin and glucose in patients. While the long-term use of Metformin lowers the risk of heart diseases related to high insulin levels in Type 2 diabetics, it can cause lactic acidosis in some cases, as well as other health conditions associated with Vitamin B12 deficiency.

Function

• Metformin (Glucophage) is a treatment for type 2 diabetes, a condition in which individuals cannot properly digest sugar due to insulin-resistance or when their bodies do not produce enough insulin. Left untreated, the disease may be fatal.

  This medication is also used off-label in the treatment of Polycystic Ovarian Syndrome PCOS, a leading cause of infertility in women. While the FDA has not approved Metformin for the treatment of this condition, the most common off-label use of Metformin is for the treatment of PCOS.

History

• Metformin is in the drug class known as biguanides, along with phenformin. Both medications were developed in 1957 but phenformin was on the market first. Shortly thereafter, phenformin was pulled from the U.S. market due to incidents of drug-induced lactic acidosis deaths.

  Because Metformin was in the same drug class as phenformin, health authorities were reluctant to approve Metformin for public use. Eventually, enough data showed that Metformin was 20 times less likely then phenformin to cause lactic acidosis and then it became available first in Europe in the 1960s and later in the United States in 1995.

Lactic Acidosis

• Lactic acidosis occurs when there is not enough oxygen in the bloodstream to metabolize the glucose. The body ends up converting the glucose into lactic acid, a metabolic byproduct that can become toxic if it builds up faster than the body can process it. Intravenous administered sodium bicarbonate is used to treat lactic acidosis.

  The rate of getting lactic acidosis from taking Metformin is extremely low -- three out every 100,000 people who take Metformin will develop this condition. Lactic acidosis is most likely to occur in people with diabetes, kidney or liver disease, on multiple medications or suffer from severe dehydration or chronic stress. As a result, Metformin is not indicated for use in these populations.

  Lactic acidosis can build up slowly, and in cases of acute lactic acidosis, an individual will not have any symptoms. When acidosis occurs at a faster rate, the most common sign is abnormal breathing. In severe cases of lactic acidosis, symptoms include nausea, vomiting and malaise.

  In severe cases in which lactic acidosis is triggered suddenly, it can cause cardiac dysfunction with low blood pressure and shock, abnormal rapid heart rates and coma. in chronic cases individuals may suffer from bone demineralization disorders. Individuals with these symptoms should contact their doctor or go to the emergency room immediately.

  Furthermore, because of the increased risk of lactic acidosis that can be induced with Metformin treatment, this medication is not recommended for use in individuals with heart, liver, kidney or liver disease, anemia and in those who have had surgery to remove part of the small intestine. Other conditions associated with a greater risk of Metformin-induced lactic acidosis include cardiac failure, alcoholism and hypoxia - a condition in which the body or parts of the body do not get adequate amounts of oxygen.

Vitamin B12 Deficiency

• Underabsorption of Vitamin B12 occurs in 10 to 30 percent of individuals on Metformin therapy. The medication interferes with the process in which cells absorb the vitamin, which results in low absorption.

  Vitamin B12 helps to produce the body's energy and also to maintain healthy nerve cells and red blood cells. It is also essential in the proper growth and function of every cell in the body. Insufficient intake of Vitamin B12 is also linked to cardiovascular disease.

  Because the effects of Vitamn B12 deficiency develop insidiously, there may be no symptoms. Nonetheless, long-term vitamin B12 deficiency can have severe health implication such as peripheral neuropathy and dementia.

Anemia

• When Metformin interferes with the necessary intake of Vitamin B12, it can induce or contribute to the development of megaloblastic anemia, causing dysfunctional red blood cells to be circulated into the blood stream. This condition occurs when the bone marrow in one's body does not have enough B vitamins to make red blood cells.

  Anemia is not common among people taking Metformin. However, because individuals with anemia already suffer from insufficient levels of Vitamin B12 prior to Metformin treatment, Metformin increases the same risks as those associated with long-term Vitamin B12 deficiency.