June 4, 2023

metformin, lactic acidosis, prevention

I’m ducked about practicing endocrinologists today we are going to talk about the most dangerous side effect of taking meat forming lactic acidosis and how to prevent it luckily lactic acidosis is very rare based on multiple studies the instance is around four cases in a hundred thousand patient years what is lactic acidosis anyway lactic acidosis is the

Accumulation of two high lactic acid in blood which cause too much acid and causes organ failure how does our body produce lactic acid lactic acid is a normal product of glycolysis glycolysis is the process of breakdown of sugar to provide energy for our body quickly for example when you are involving in a very strenuous exercise your muscle needs a lot of energy

And need them quickly at this time your muscle produces a lot of lactic acid the production of lactic acid increases one or body suddenly need a lot of energy or our body does not have energy oxygen or tissue organ does not have enough blood supply let us also quickly review how this midforming work if you have not watched my previous video how does my forming

Work please go back to watch it here let us review the exact of mechanism homemade forming work is still an intensive investigation now most scientists agree that metformin increases the production of lactic acid in the liver gastrointestinal kidney and other tissues the use of lactic acid for making new sugar is also reduced in metaforming treated patients as

A result and a summary metaforming increases the production of lactic acid and reduces the usage of lactic acid two organs are very important in getting rid of lactic acid one is a liver which converts lactic acid back to sugar called gluconeogenesis the other is the kidney which is great lactic acid and also convert it into sugar again the gluconeogenesis liver

Is important but the kidney is more or equally important since metaforming is not metabolized in the body but is excreted from the kidney and unchanged if the following situation occurred i might recommend to hold or stop mid-forming again for your specific situation you need to talk to your health provider and you might need to go to the er the severe high sugar

And low sugar can be deadly situation 1 if you have severe nausea especially you have hard time in keeping water down situation 2 if you have vomiting for any reason situation 3 moderate to severe diarrhea from any reason situation 4 acute or chronic abdominal pain situation 5 shortness of breathe from any reason especially acute or worsening situation 6 suspect

Developing yellow skin or yellow urine usually indicating liver failure or dysfunction situation 7 chest pain especially if you suspect that you might have angina or heart attack situation 8 you have reduced urine output situation 9 if you develop fever especially greater than 104 degree fahrenheit situation 10 if you are scheduled to have a iv contrast to the ct

Or cardiac procedure situation 11 if you have to be fasting more than eight hours you can consider to take the last dose before fasting with the meal but in order to take afterwards you might have to be fasting for outpatient surgery or colonoscopy you might think take your last time you were fasting nothing happened this is true most time if you take it nothing

Happens but you want it to be precautious situation 12 if you are drunk not to take it alcohol can cause sugar up and down alcohol can cause its vomiting alcohol can also inhibit the sugar metabolism and may reduce the liver to get rid of acid and might increase the production of lactic acid situation 13 acetaminophen can also damage the liver especially if you

Consume alcohol never drink and take acetaminophen together never take acetaminophen over 4 grams if you think you might have taken over 4 grams in 24 hours inform your doctor and not to take midform situation 14 if are diagnosed acute or chronic hepatitis for any causes situation 15 if you diagnose cancer which needs chemotherapy now we have lots different

Cancers which do not need chemotherapy you might be okay to continue to take metformin and you don’t need to stop it situation 16 if you’re going to run marathon you should consider not to take the day before marathon can produce a lot of lactic acid and also cause dehydration situation 17 if we are started medications like topramat which can cause acidosis

You need to be cautious again metaforming is a safe medication i let my patients take both if they have perfect kidney and liver function if you want to learn more information like this and would like to have a book in hand please check out my books on amazon.com you

Transcribed from video
How to prevent dangerous side effect of metformin lactic acidosis By Diabetes University