It's Time for Metformin :(


One thing about Metformin that you may not be able to avoid. Depends upon your Pharmacy. One of the manufacturers make Metformin pills that smell really, really bad. Almost stomach turningly bad. If you google search Metformin smell you can find out which manufacturer, but as I said your Pharmacy probably uses a particular company for their source.

I have tried leaving the lid off for days and it helps but I wonder if it affects the strength of the part.

Zydus is my latest batch mfg (CVS) and they don’t smell nearly as bad as previous ones (maybe Rite Aid has a different source)?

I will note I have been taking Metformin for 13+ years. Some stomach effects, but not too bad.

One final thing, I stop taking Metformin when I am doing extended fasts since I don’t need them after about 3-4 days.


My fasting BS is between 120 - 140. The rest of the day it’s around 100 - 120. My is A1C is 6.0.


It’s 6.0


I would expect the Metformin to knock you down into the 100-110 range. Maybe more in the beginning. Every drug has a honeymoon period :wink:


Kathleen - you might benefit from the new medical clinic that Phinney and Volek (well known LCHF researchers) are involved in. It would give you medical supervision while you work on reversing you prediabetes markers with diet. They would manage the metformin, if you end up on it, and try to figure out how to get you on the right track to improve your glu with diet. It’s just getting going, but the plan is to have a telemedicine version that people can do remotely.


I save up the little oxygen/moisture-absorbing packets from empty bottles of vitamins and supplements I take and put several of those in with my metformin as soon as I get a new bottle. By the time I need to start on that bottle a few days later, the smell is greatly reduced (or even eliminated).

(jketoscribe) #26

Teva brand doesn’t smell bad and seems to have a low incidence of side effects.

(paddy0761) #27

I use the seeds in a pepper mill and crack tem generously over every meal. I also apply the oil topically as a moisturiser a few times each week. I’ve not controlled the dose at all. Never taken capsules.


One of the few drugs that I haven’t heard bad things about; only positive ones. (I don’t take it; my father does though he has never said anything one way or the other about it).

I remember years ago hearing an interview with Dr. Jonny Bowden and he said he would consider taking it for the health benefits even though he doesn’t have blood sugar issues.

(Richard Morris) #29

Yes Metformin likely lowered my fasting insulin.

(Jamie Hayes) #30

No doubt you’re also doing interval training.

(Steve Stephenson) #31

I’m wondering if I should ask my oncologist for a Metformin Rx because of Cancer in a remission!.

But I’m a little taken aback by this statement

It also decreases the amount of sugar that your liver makes …


I don’t want to mess up feeding my brain the small amount of glucose it needs!

(Richard Morris) #32

I had the same concern. We need glucose when we’re keto.

One of the problems with type 2 diabetes is an over production all the time even when we don’t need any more. Metformin reduces the livers output and that over production by up to 30%. It doesn’t appear to affect release of glucose on demand. I have put my own body under fairly dramatic pressures like fasting 3 days then riding a bike for several hours - and my glucose goes down to 3.5 mmol/l under that load, but in that circumstance I make a lot more ketones and I feel fine. I have never experienced hypoglycemic events on a ketogenic diet and while taking 1000mg/day of metformin.

The last time I did was a decade ago and I was on a Sulfonylurea that promotes additional insulin production. So I am cautiously optimistic that metformin shouldn’t have that kind of effect … but I’d check my glucose regularly for the first couple of weeks just to make sure.

(Brian ) #33

Richard, I totally agree. In my experience, patients don’t get hypoglycemic on Metformin even with a very low carb diet. The Sulfonylureas cause this effect by spiking insulin and causing reactive hypoglycemia…just like when sugar causes insulin spikes and resulting hypoglycemia. I am not a fan of Sulfonylureas because of this and the fact that they burn out the beta cells of the pancreas. Metformin makes our tissues more sensitive to insulin…which is exactly what we are trying to do on a Ketogenic diet. Of course I invoke the Tim Noakes clause that I am not giving specific medical advice!

(betsy.rome) #34

@richard Are there downsides to taking Metformin for a long time, while keto?
I recall my now-retired primary care doc telling me at the time of my T2D diagnosis 12 years ago, that Metformin would only work for 5-10 years. I suppose she was referring to the “progressive” nature of the disease.

Is there a good reason to discontinue Metformin at some point?

(Richard Morris) #35

Yes that is what he is probably thinking - the 30% reduction in glucose production from metformin won’t be enough to get you out of trouble once your disease has progressed 5-10 years.

I have heard that it can cause more creation of lactic acid and if your kidneys are compromised they may not be able to clear it quickly enough and you could become acidotic. It also apparently uses B12 faster so people can become deficient in B12.

(Carolus Holman) #36

I take Metformin, I tested my Blood Sugar before taking my daily dose and it showed 68. I am thinking my BS is too low for Metformin. I only took one pill that day!

(Stephanie Hanson) #37

I chose to go on metformin after 8 months of keto my A1c was 5.7. Anything over 5.5 wasn’t okay with me. I’m now 5.0 with the metformin.

(Consensus is Politics) #38

It really depends how you tested your Blood Sugar. I have two meters that I use everyday. They are never the same. They are sometimes have a 50 point spread. And that’s testing within the same minute.

I did some quick research to find that the US Food and Drug push…Er… Administration say that BG meters can be off by as much as 20%. That’s a huge margin of error in my book. I would think 5% should be the cut off point. But they chose 20%. That like saying a test of 100, could actually be anywhere from 80 to 120. That’s a 40 point spread right there!

So an actual BG level of 80 could be measured as +/- 16. So could show 64 to 96 and be considered just fine.

As for Metformin. I stopped taking mine back in November. Because I had missed a couple of days due to ‘reasons’ and my BG levels improved and leveled out over time. They weren’t as spikey as before.

From what I have learned about Metformin is there is little to worry about it when it comes to lowering BG. As it’s helping the glucose get to where it needs to go. It’s not stopping production of it. I’ve also read some interesting things about how it may also help IR (insulin resistance) heal, or become less resistive.

I would NOT recommend going cold turkey with it though like I did. My doctor said going cold turkey on it WILL CAUSE A MAJOR BG SPIKE. [pinch of salt here].

Check with your Endocrinologist. Always, always check with your doctor before modifying your meds. They might not be telling you something, because, well, you know, we are the peons, they are the high and mighty. But seriously, there could be other reasons to take it. Talk to the doctor, maybe lowering it would be a good idea. Personally I’m thinking of getting my prescription changed from 1,000 mg 2x a day (that I’m no longer taking anyway) to a minimal dosage 1x a day. If the benefits to using it are true.

(betsy.rome) #39

Do y’all take your Metformin on fasting days? I’m on the ER version, supposedly a longer-acting med.