What is Metformin?
Metformin is a widely used oral antidiabetic medication, often prescribed as the first-line treatment for type 2 diabetes [1]. Metformin mainly works by reducing glucose production in the liver and improving insulin sensitivity in peripheral tissues, thereby countering insulin resistance [2, 3, 4].
Uses of Metformin
As we discussed, Metformin has been used for over 60 years primarily to manage type 2 diabetes due to its ability to decrease plasma glucose levels [5, 6]. However, its uses extend beyond diabetes management.
Treating PCOS
One of the established uses of Metformin is in the treatment of polycystic ovarian syndrome (PCOS). It helps improve insulin sensitivity, often impaired in individuals with PCOS [7].
Gestational diabetes
Metformin is also used in the management of diabetes during pregnancy, known as gestational diabetes. It helps control blood glucose levels, reducing the risk of complications during pregnancy and delivery [7].
Preventing diabetes progression
In the context of prediabetes, Metformin is used to prevent the progression of type 2 diabetes. It helps maintain normal blood glucose levels and improves insulin sensitivity. Metformin is also used as an adjunct therapy in type 1 diabetes, where it may help reduce the required insulin dose [7, 8].
Cancer prevention
Emerging research suggests potential uses of Metformin in the prevention and treatment of various types of cancer, including breast, endometrial, bone, colorectal, and melanoma [5, 9].
Neuroprotective effects
In the realm of neurodegenerative diseases, Metformin shows potential therapeutic benefits for mild cognitive impairment and Alzheimer's disease. It has been shown to improve mental function and reduce the incidence of dementia [10].
Treating various disease
Metformin has also been studied for its potential benefits in cardiovascular, renal, and infectious diseases like tuberculosis (TB) and COVID-19 [10].
However, it's important to note that while these potential uses are promising, more extensive studies are needed to confirm these additional benefits [11].
Metformin for bodybuilding
Based on the available scientific evidence, metformin does not appear to be an effective drug for muscle building or enhancing muscle hypertrophy, especially in healthy individuals. Some studies suggest that metformin may blunt or impair the muscle growth in response to resistance exercise training.
While metformin may help improve insulin sensitivity and glucose uptake in skeletal muscle [12, 13], the evidence does not support using metformin as a muscle-building aid, especially in healthy adults. More research is needed to determine if it could help specific populations like older adults who respond poorly to resistance training alone. But for now, Metformin appears more likely to blunt rather than enhance muscle hypertrophy when combined with resistance exercise.
Side effects of Metformin
Common Side Effects
The most common side effects of Metformin primarily affect the digestive system. These include:
- diarrhoea,
- nausea,
- vomiting,
- gas,
- indigestion, and abdominal discomfort.
Other side effects include heartburn, a metallic taste in the mouth, and headache. These side effects are usually temporary and may disappear over time [14, 15, 16].
Severe Side Effects
Serious side effects of Metformin are less common but require prompt medical attention. These include lactic acidosis, a rare but potentially life-threatening condition characterized by a buildup of lactic acid in the blood. Symptoms of lactic acidosis include muscle pain, trouble breathing, sleepiness, and abdominal pain [15].
Metformin can also cause hypoglycemia (low blood sugar) when used in combination with other diabetes medications. Symptoms of hypoglycemia include dizziness, sweating, increased heart rate, confusion, blurry vision, headache, hunger, and feeling jittery [15].
Long-term use of Metformin can lead to a deficiency in vitamin B12, which can cause symptoms such as low energy, muscle weakness, loss of appetite, and tingling or numbness in the hands or feet [16].
It's important to note that only some who take Metformin will experience these side effects, and they may vary depending on factors such as your age, other health conditions you have, and other medications you may be taking. If you're concerned about the side effects of Metformin, it's best to discuss these concerns with your healthcare provider [15].