Side Effects Of Stopping Metformin

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Nice Guidance - Metformin In Type 2 Diabetes

NICE guidance states that: start metformin treatment in a person who is overweight or obese (tailoring the assessment of body-weight-associated risk according to ethnic group ) and whose blood glucose is inadequately controlled by lifestyle interventions (nutrition and exercise) alone metformin should be considered as an option for first-line glucose-lowering therapy for a person who is not overweight metformin should be continued if blood glucose control remains or becomes inadequate and another oral glucose-lowering medication is added the dose of metformin should be stepped up gradually over weeks to minimise risk of gastro-intestinal (GI) side effects. Consider a trial of extended-absorption metformin tablets where GI tolerability prevents continuation of metformin therapy in adults with type 2 diabetes, review the dose of metformin if the estimated glomerular filtration rate (eGFR) is below 45 ml/minute/1.73m2: Stop metformin if the eGFR is below 30 ml/minute/1.73m2 Prescribe metformin with caution for those at risk of a sudden deterioration in kidney function and those at risk of eGFR falling below 45ml/minute/1.73m2 benefits of metformin therapy should be discussed with a pe Continue reading >>

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  1. Aranah

    Hey all,
    Firstly i apologize if this is in the wrong place.
    I've been on metformin for around 6 months now for PCOS. I fell pregnant and my GP told me to stay on it. I since saw another GP for various reasons who was really great, but he told me that I shouldn't be taking metformin at all during pregnancy and should have stopped it when I found out. I know there's two school's of thought with doctors of whether you should be on it or not.
    I am now 9 weeks and been off metformin since Monday. Since I stopped, I have had the most horrific migraine that won't go away. This worries me because I just don't get migraines in pregnancy, they are a hormonal thing that I only get the week of my period. I rang my GP as I was concerned that this somehow means that because I stopped metformin that my progesterone is dropping which is what triggers a migraine. He said metformin doesn't control hormones, it makes you lose weight which is what fixes hormones (I lost 15 kg in the 6 months on metformin, also using a low carb diet) so that stopping it won't cause anything and it's just a coincidence.
    My bleeding was worse today, I've had constant bleeding since 5 weeks due to a blood clot under the placenta, but the migraine and worseing bleeding is worrying me.
    So I have a couple of questions for anyone who has had any experience with conceiving after PCOS and metformin:
    -did you stay on your metformin in pregnancy, if so how long?
    -did anyone experience withdrawal symptoms like migraines when stopping metformin?
    Any information or experiences in general with this would be much appreciated.

  2. shellshell

    Firstly, congrats on the pregnancy... and hope it sticks. Sorry to hear about the bleeding.
    I have PCOS as well and have been on Metformin for 6 months as well (although am still not pregnant).
    If you have PCOS /IR and conceived on Metformin, generally docs consider the benefits of staying on it during the pregnancy to outweigh the risks. I think most women stop at 14 weeks, but some, if their blood glucose levels are rising during the pregnancy, will stay on it for the whole pregnancy.
    I don't know anything about the relationship between Metformin, PCOS and migraines. But what your docs says about Metformin doesn't sound 100% right... it is an insulin-sensitising drug and insulin is a hormone. My understanding is that the endocrine system is a perfectly assembled orchestra and if one hormone plays out of tune the others try to compensate for it. So I would say that Metformin has more of an effect on hormones that we tend to think, simply because it is helping to control your insulin.
    **RANT**I have a big dislike of the whole "metformin just makes you lose weight" line! I am a "normal" weight woman with insulin resistance... my weight doesn't come into the equation, but my insulin still does. Yes, for some women, the weightloss will result in ovulation being restored without the need for Metformin, but for other women, this is not an option, since they have no weight to lose and yet their insulin is still too high.**END RANT**
    That doesn't help you in your situation though. Are you on a high enough amount of folate? Are you taking any aspirin to help with the clot? (Don't take the aspirin without first talking to your doctor). Folate can sometimes help with reducing clotting, since homocysteine increases clotting and folate can reduce homocysteine levels (and homocysteine is often elevated in women with PCOS). The Elevit tablets contain a good amount.
    Maybe talk to your doctor about taking aspirin, if you are not already taking it. I'm not a doc, but I know some women w/ PCOS take half a tab throughout ttc and pregnancy since it can help some women w/ PCOS to reduce their chances of m/c'ing.
    I'm not an expert... but hope this helps in some way.

  3. butterfly_warrior

    I take metformin for PCOS, have been on it since March, but still not pregnant.
    My gyn told me that if I conceived, I should stay on the metformin through first trimester at least. My GP told me to stop.
    Fortunately, I'm in the situation of having a friend who is nearly finished her studies to become a specialist obs/gyn. It's new research, and not everyone knows about it, especially at the GP level. Metformin is considered fine during pregnancy, and it actually reduces the risk of miscarriage that is associated with PCOS.
    Your new GP may mean well, but they aren't up to date with the PCOS and metformin literature.

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