March 24, 2023

Metformin is often the first treatment option given to type 2 diabetics. While it has many advantages, this prescription medication can also deplete several nutrients that are essential to proper functions within the body.

Welcome to the invite health podcast where our degreed healthcare professionals are excited to offer you the most important health and wellness information you need to make informed choices about your health you can learn more about the products discussed in each of these episodes and all that invid health has to offer at podcast first time

Customers can use promo code podcast at checkout for an additional fifteen percent off your first purchase let’s get started metformin is a very important drug it’s probably the most commonly prescribed drug for type 2 diabetes mellitus it works it has a bunch of advantages it also is useful for some other conditions it does have some drawbacks we’ll discuss that

Too but what we’re going to really go into detail is the nutrients that metformin depletes so hi my name is jerry hickey i’m a nutritional pharmacist i’m also the senior scientific officer over here at invite health well welcome to my episode metformin depletes these important nutrients thanks for tuning in today to the invite health podcast you can find all of our

Episodes for free wherever you listen or just visit forward slash podcast please subscribe and leave us a review you can also follow us on twitter instagram and facebook whatever that’s called today at invite health the information on this episode is linked at the episode description so here is the issue first of all metformin is the original name

For metformin was glucophage but you could get it generically and like i said it’s a first line treatment for type 2 diabetes it’s often the drug that doctors first prescribe to see if it’s enough especially it works well in those who are overweight um interestingly it’s based on an ingredient from a plant that was discovered oh almost a century ago in france

And it was based on constituents in a plant called french lilac so it’s been around for a long time that means doctors know how to use it doctors know what to expect from it doctors know the problems with it doctor no doctors know who to use it in it’s been around in europe since the 1950s in the united states since the 1990s now there are some common side effects

Usually with the digestive tract like gassiness nausea cramping stomach cramps intestinal cramps and diarrhea but these usually disappear within weeks and you can avoid them or try to avoid them if you start off with a lower dose so frequently doctors might uh start a patient on 500 milligrams of metformin once a day and work it up to 500 milligrams twice a day

And slowly but surely work it up to the those that they need which could be a thousand milligrams twice a day so metformin is about by guanide when i went to pharmacy school it wasn’t in the united states yet we were using sulfonylureas and sulfonylureas one of the big problems with them drugs like diabetes and tarbutamide as they caused hypoglycemia it was very

Easy to lower the blood sugar way too much and uh so you had to be really careful with them and then metformin came along and it was less likely to cause hypoglycemia excessively low blood sugar now um there is a little issue with lactic acidosis but i don’t know if it’s real lactic acidosis is also called ketoacidosis it can happen to antibody it’s more common

In diabetics and there are some diabetic medications that are connected with diabetic ketoacidosis or lactic acidosis and it’s dangerous it’s dangerous because your blood is supposed to be a certain ph which is slightly alkaline alkaline is the opposite of acid so your blood is just slightly alkaline slightly not acidic and if it goes towards acidity you can go

Into a coma and your organs like your lungs and your heart and your kidneys can shut down so obviously it’s a dangerous situation but i have to be honest with you with all the reports i’ve read it’s really not common with this particular drug now metformin what it does it suppresses the formation of sugar by the liver so when you uh when you eat food there’s a

Lot of sugar in the blood so the the pancreas it’s involved with digesting food but it’s also involved with regulating sugar the pancreas releases insulin and that stores away the sugar it can store it in your muscles which is good because muscles never let the sugar go they keep they convert into glycogen and they use it when you do some exercise so having more

Muscle makes it easier to control your blood sugar it’s stored in your fat cells but it’s also stored in your liver that’s a major site of sugar storage and when the body wants to release some of that sugar in between meals because you need some energy uh you go through something called gluconeogenesis the alpha cells in the pancreas release glucagon that’s a

Different hormone it’s kind of like the opposite of of insulin and the glucagon causes the liver to release the sugar the stored sugar so what metformin does is it helps slow down gluconeogenesis in between meals you’re releasing less sugar but during a meal metformin helps insulin work better insulin is released from the beta cells in the pancreas glucagon is

Released from the alpha cells in the pancreas so the insulin stores the excess sugar away the problem with diabetics is the insulin can’t cling onto the cells and it doesn’t work so they have insulin resistance and their sugar stays up after a meal metformin besides slowing down the production of sugar and the release of sugar in between meals from the liver also

Improves insulin sensitivity during your meals it also enhances the uptake of sugar into your cells so the cells can use it more efficiently it increases what we call fatty acid oxidation any of those bodybuilding types weight trainers etc they’ll discuss fatty acid oxidation it’s burning energy it’s burning energy and that’s one reason why when you use metformin

You might lose some body fat the other thing that metformin does it it a little bit reduces the absorption of sugar from your intestines so the question is how well does it work it seems to work exceedingly well in fact they found in some studies that overweight people really obese people with heart disease and helps prevent them from having serious complications

In their heart and may even lower the risk of developing heart disease in the in the first place um you can’t use it they don’t use it in people with severe liver disease even though it’s not really excreted by the liver it could be stored in the liver but you have to be careful in people with kidney disease because metformin is a very water soluble it’s

Excreted from the body through the kidneys so if you have a reduced kidney function the level of metformin can go up and it’s easier to have the side effects complications and toxicities such as lactic acidosis now in about 2017 the american college of physicians they updated their guidelines they said hey metformin that’s the drug you go to first for people with

Type 2 diabetes so what else can it do it could do a bunch of things there’s some evidence that metformin can help people with lung cancer and pancreatic cancer there’s more recent research showing that women with diabetes if they’re on metformin they have a much greater chance of surviving their breast cancer now metformin can help these people lose weight

Because it increases fatty acid oxidation and uh it seems to be safer than a lot of other diabetes drugs commonly it’s it’s prescribed along with other diabetes drugs in fact there are certain pills where they combine metformin with other drugs now a common use of metformin would be polycystic ovarian syndrome in polycystic ovarian syndrome women young women

Get cysts on their ovaries if it’s really severe they can even get these cysts on their kidneys which can be um potentially dangerous but because they’re developing cysts on their ovaries it affects all kinds of hormones sex hormones etc so that blood sugar goes up so when you give them metformin it helps with the blood sugar their cholesterol levels go up they

Develop piercings like a mustache they lose their hair on their scalp so they go bald a little bit they get very big the metformin can help with some of these but i tell you something if you add to the metformin in women with polycystic ovarian syndrome a couple of supplements it’ll work a lot better we’ve done a podcast episode on that but if for a young woman

With polycystic ovarian syndrome yes to metformin but add a supplement called nac and acetylcysteine add a supplement called resveratrol and especially a supplement called inositol which is a type of b vitamin it’ll really help now let’s talk about the nutrient depletions because that’s really important metformin commonly reduces your blood level of b12 so you

Could become fatigued for a number of reasons b12 uh blood levels drop part of this is thought that you’re absorbing less b12 from the digestive tract so one thing you could wind up with is a type of anemia that has nothing to do with iron it’s called megaloblastic anemia where your red blood cells get very big and it’s hard for them to carry oxygen so you get

Fatigued but you also need b12 so you need b12 to make your red blood cells you need b12 for the myelin sheath on your nerves and your brain cells so the myelin sheath transfers messages from the body to the brain faster so if you lack b12 you can wind up with nerve damage but also you need b12 to lower a molecule and a body called homocysteine homocysteine is

An intermediary in protein metabolism and there’s three b vitamins involved with its with its degradation into healthy things one of them is vitamin b6 you only need a level a little one of them is folate and the other one is b12 so if you lack b12 because you’re on metformin your homocysteine levels could go high and that’s really bad because if you have

Other risk factors for your heart which diabetics commonly do plus the homocysteine is elevated it becomes very dangerous for the heart so homocysteine on its own when it’s elevated may or may not be terrible for the heart it’s hard to tell but if there’s other things elevated like blood pressure like cholesterol like uric acid like triglycerides like your blood

Sugar then it becomes more dangerous so homocysteine is bad for the heart uh homocysteine is bad for the brain it’s terrible for the brain in the brain homocysteine inflames the brain homocysteine once again is an intermediary in protein metabolism it’s not what the body’s trying to make it’s kind of like the halfway point to what the body’s trying to convert it

Into but if you lack b12 it stays as homocysteine and if it’s elevated in the brain it’s involved with depression it depresses the brain it inflames the brain and causes depression it just screws up all the workings of the brain brain metabolism but also if you have elevated homocysteine in the brain it literally strongly increases your risk of alzheimer’s disease

Now the other thing is if you’re low in b12 it’s not just bad for your brain and your heart and your red blood cells it’s bad for your bones lacking b12 is connected with bone loss hollowing out of the bones but also brain shrinkage there’s a number of studies if you lack b12 your brain shrinks now it seems to be tied into low levels of fish oils and low levels

Of vitamin d but that it’s not unusual to have all three in a diabetic low b12 low low fish oils and low vitamin d so you know nutrition is very important for diabetics in fact i did an episode on nutrients that are clearly incredibly beneficial and important for diabetics because diabetics do not use them efficiently so they need a little bit more or diabetics

Lose them in their urine so they need a little bit more it’s just very important now besides b12 metformin lowers your folate level well that can happen because you’re lacking b12 if you lack b12 you can’t activate folate once again if you lack b12 it leads to low folate people on metformin are commonly low in their blood on folate so once again homocysteine can

Go up which is bad for your bones bad for your brain and bad for your heart we just explained it with the b12 also just like b12 if you lack folate you develop megaloblastic anemia your red blood cells are too big they don’t carry oxygen well and you get all kinds of symptoms including fatigue if you lack folate which is a b vitamin and sometimes called vitamin b9

There’s terrible birth defects of the brain and the spine and the face and the heart but also if you lack folate it can lead to cancer folate attaches to the genes in your chromosomes and prevents things like radiation and viruses and toxins and and pesticides and other pollutants from damaging them so if you lack folate it’s easier to go through the initiation

And progression phases that lead to cancer so if you’re on metformin you really need to get a good b12 and a good folate i recommend the active forms a b12 would be methylcobalamin and folate would be methyl tetrahydrofolate that’s the active form but there’s also some evidence that metformin depletes your ubiquinol which is the active version of coenzyme q10

I’ve done a podcast episodes on that also but it doesn’t matter if it depletes ubiquinol because all diabetics should be on ubiquinol anyway all diabetics should be on ubiquinol anyway they cannot convert coq10 into ubiquinol effectively and this leads to some of the problems you see in diabetics like they have a higher risk of kidney damage nerve damage fatigue

Heart problems brain fatigue etc if they lack ubiquinol so when i see diabetics these are just some of the supplements they need and commonly i could group these together they don’t have to take like a million different supplements but they need b12 they need folate and they really should be on ubiquinol if they’re under drug metformin so thank you for uh joining

In today for the invite health podcast you can find all of our episodes for free any place you listen to podcast or just visit invite health dot com forward slash podcast please subscribe and leave us a review you can also follow us on metaverse twitter and instagram at invite health hope to see you next time on another episode of the advent health podcast thank

You so much for listening jerry hickey signing off have a great day you

Transcribed from video
Metformin Used for Diabetes Depletes These Important Nutrients By InVite Health