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What Is The Link Between Metformin and Diarrhea?

Many diseases are present all over the world. Some of these diseases have a high prevalence rate, but they are not life-threatening, such as the common cold. However, some diseases have increased incidence and can cause several pathologies inside the body. One such disease is Diabetes, with its prevalence rates increasing drastically.

Metformin and Diarrhea

This disease is characterized by high blood sugar, which cannot be converted into other forms by the body. The excess of glucose in the blood results in harming the vascular system, compromising the functioning of the heart and all the associated organs, such as the brain, kidney, eyes, and liver.

The complications that come with diabetes are numerous, and hence it is crucial to maintain normal blood glucose levels to prevent the damage.


Pathophysiology in Diabetes

Type-2 diabetes is more common in the general population, with the defect lying mostly in the beta cells of the pancreas. The main function of these cells is to make sure that the concentration of glucose in the blood is kept in its range. (120 mg/dl). 

Whenever the concentration of glucose exceeds its normal limit, the body sends signals to the beta cells of the pancreas to secrete insulin. This hormone then acts on the liver and helps convert all the excess glucose into glycogen (storage).

Primary defects in the receptors of insulin or its production result in the accumulation of glucose in the blood, which then causes DIabetes type-2. 

As soon as the condition is diagnosed, physicians recommend medicines that can lower the blood glucose uptake or act on the receptors that actively transport glucose.

One of these drugs is Metformin.It is the most common drug prescribed to patients who come with complaints of hyperglycemia. However, with time it has shown a number of side effects despite its excellent role in lowering blood glucose levels.



This drug has been recommended as the first line of therapy for the management of diabetes type-2. 

The main action of this drug is to decrease the production of glucose from the liver. It also works through multiple channels by increasing the absorption of glucose from the gut. It has been shown to decrease the concentration of glucose by 25%. However, there are a number of side-effects coupled with the intake of this drug which make consumers reluctant in its consumption.


Side-effects of Metformin

The use of Metformin has reported several side effects. This glucose-lowering drug mainly acts on most of the gastrointestinal system to exert its effects. This is why most of the drug's side effects are related to the gut.

The effects of this drug are many, and one of them results in the production of serotonin, bile acids, and lactate on the body.

Some of the side-effects due to these products are listed below;

  • Diarrhea
  • Vomiting
  • Nausea
  • Lethargy
  • Muscle Pain
  • Low levels of Vitamin B-12 in the body
  • Abdominal distention
  • Heartburn

Among these many side-effects, diarrhea and abdominal pain have reportedly been the most common. This gravely affects the quality of life of these individuals. Therefore, many of these individuals are more likely to discontinue this medication due to its side effects.

It has also been seen that extreme gastrointestinal intolerance has been seen to develop lactic acidosis. This is a fatal condition and needs immediate attention. Therefore, metformin is contraindicated in individuals with renal impairment. 

According to a study published, it was reported that the side-effects reported by people with diabetes consuming metformin were as follows. [1]

It was seen that 62.1% of the people who suffered from side effects included diarrhea. 52.1% of people reported heartburn. Nausea was reported by 47.4%, whereas abdominal pain was experienced by 35.5% of the people with diabetes. [1]

A clinical trial conducted on mice in 2020 on the effects of Metformin on the gut was done. In this study, mouse models were used who have injected doses of metformin four times a day. 

At the end of this trial, it was seen that metformin did indeed cause diarrhea in all the mice models who were obese and diabetic, whereas normal mice were unaffected by the drug. [2]

This shows the high probability of people with diabetes suffering from diarrhea after the usage of metformin. This can predispose to many other conditions such as electrolyte imbalance and fluid depletion in the body. 


Natural Ways to Regulate High Blood Glucose

Metformin and Diarrhea

Owing to the side effects produced after the consumption of Metformin, many people with diabetes look for alternatives to help them regulate their blood sugar levels.

Nature has a lot in store for us, and these organic natural products are usually the safest when it comes to their consumption. Many herbs have been used in folk medicine for many years.

Many plant species and certain naturally produced compounds can be very beneficial for patients with diabetes. These plants and herbs can not just help maintain blood glucose levels, but they are also primarily free from side effects such as diarrhea or abdominal pain.

Some of these herbs have been discussed below;

1. Ashwagandha

Ashwagandha has long been used in Indian folk medicine with many therapeutic properties. It is also known as Indian ginseng, and it is scientifically proven to help manage diabetes and other chronic illnesses.

The extracts present in the Ashwagandha plant works by helping the body produce insulin on its own. Since the main pathology in diabetes is due to insulin insufficiency and its function, the production of even small amounts of this hormone can bring about significant changes in the blood glucose level in people with diabetes.

It also helps the body get rid of the many metabolic wastes produced in the body. These destructive and toxic metabolites, if not excreted, can cause a lot of damage to the cells of the body. Therefore, this extract helps regulate glucose levels in the blood, but it also works by making the body more healthy. 

A healthy body brings an additive effect in controlling the deranged levels of glucose in the blood. 

 2. Saffron Extracts

Metformin and Diarrhea

Saffron is extracted from a plant named Crocus Sativus. This extracted compound has shown through many studies that it has beneficial effects on patients with diabetes. It has been used previously in many remedies, which include decreasing the effects of inflammation.

The main characteristic of this plant extract is its antioxidant property. This anti-oxidant activity helps neutralize the many toxic free radicals and oxygen species formed inside the body.

One of the causes of diabetes is also due to increased wear and tear in the body. This damage often reaches the beta cells of the pancreas, harming them and costing their ability to secrete insulin. 

Saffron tends to alter the enzyme functions that are linked to diabetes through its antioxidant property. Moreover, all the effects produced due to diabetes, such as retinal issues, kidney problems, and heart conditions, can be prevented. This is due to the hypoglycemic and hypolipidemic effects of saffron on the body. 

Therefore, this not just helps prevent diabetes who are predisposed to it but also improves the body's mechanism.

 3. Ceylon Cinnamon

Cinnamon is also one of the important ingredients that can help lower down blood glucose levels. This herb which is famous and common in many Asian households, has a lot of therapeutic importance.

The way cinnamon and its extracts work are by mimicking the role of insulin in the body. This not just improves insulin sensitivity but also helps the body store glucose correctly.

It has not only been associated with decreasing fasting blood glucose levels but is also very effective in reducing them after a meal. Therefore, without any side effects, this herb can be used by people with diabetes to keep their blood sugar in range.

Ceylon cinnamon is also a very potent antioxidant. It does not just work by maintaining blood glucose levels but also improves heart health. This particular compound is a lot safer and is free from side effects.

Clinical Study

A study was conducted on seven men who took cinnamon. It was seen that they had decreased levels of glucose in their blood 12 hours after its consumption. 

This shows the fast action of this compound and its long therapeutic role if taken regularly.

4. Mushrooms Complex

Metformin and Diarrhea

Many different types of mushroom species have been linked with the control of blood glucose levels. Many immunity-boosting mushrooms such as; Cordyceps, Reishi, Lions Mane, Shiitake, and many other such species.

The complex compounds present in these species have not just managed high blood glucose levels but have also improved cognitive and memory. 

Long been in use in Chinese medicine, mushrooms have also been studied scientifically for their role in diabetes. Through many clinical studies, it has been observed that mushrooms contain a hypoglycemic effect in the body after their consumption. This is what helps people with diabetes get rid of the excess glucose in their blood.

With improved immunity, the cells of the body function better and fight off invaders. With all the harm caused due to the high levels of glucose in the blood, these compounds make the body strong. The number of free radicals that cause a lot of internal damage is therefore neutralized. Improvements in the brain and cognitive functions, these mushrooms also help with the constant control of diabetes without causing any side effects.

5. Tribulus Terrestris

Tribulus Terrestris has been studied for its pharmacological properties for quite some time. This plant has been researched to have many cardioprotective, hepatoprotective, as well as anti-tumor properties. Along with these characteristics, it has also been shown to decrease blood glucose levels in people with diabetes. Through its antioxidant and anti-inflammatory properties, it not just helps repair the damage caused by diabetes, but it also works by walling off the effect.

Clinical Study

A study was published in 2016 to study the effects of Tribulus Terrestris on diabetes. Eighty-nine diabetic women were randomly selected and then given the extract of Tribulus Terrestris (1000mg/day) for three months. The rest of them were given the placebo. These patients were then tested for their fasting blood glucose; it was seen that there was a significant improvement in glucose levels in those who consumed the extract than the placebo.

Another significant finding that came out of this experiment was that these women also showed decreased lipids in their blood. [3]

6. Magnesium Glycinate

Magnesium is one of the important micronutrients required for the normal functioning of the body. However, the chemical composition of magnesium glycinate is what is considered therapeutic in cases of diabetes. 

It has been seen that magnesium deficiency people are more likely to get diabetes than those who aren't. Insulin sensitivity or resistance is greatly related to the levels of magnesium in the body.

This nutrient is very helpful in controlling blood glucose levels. Decreased levels of magnesium have been linked with the development of insulin resistance over time. 

This is why diabetics and prediabetics need to consume forms of magnesium that are quickly absorbed into the body. One such compound is magnesium glycinate. It does not contain any laxative effects and nourishes the cells of the body with magnesium. 

It does not only help lower down the concentration of glucose in the blood, but it also works by improving mental health, heart health, and brain function.



  1. Fatima M, Sadeeqa S, Nazir SU. Metformin and its gastrointestinal problems: A review.
  2. Takemori H, Hamamoto A, Isogawa K, Ito M, Takagi M, Morino H, Miura T, Oshida K, Shibata T. Mouse model of metformin-induced diarrhea. BMJ Open Diabetes Research and Care. 2020 Mar 1;8(1):e000898.
  3. Samani NB, Jokar A, Soveid M, Heydari M, Mosavat SH. Efficacy of Tribulus Terrestris extracts on the serum glucose and lipids of women with diabetes mellitus. Iranian journal of medical sciences. 2016 May;41(3 Suppl): S5.