Metformin and Fasting

#1

Apologies if the answer to my question can be found elsewhere. I’m new to this fasting and ketogenic lifestyle and doing it mostly as a preventative measure. I’ve watched numerous family members succumb to obesity and diabetes and have therefore watched the horrific effects (including loss of limbs and death). My mom was recently diagnosed with diabetes and was placed on Metformin. She is a staunch believer in the CRaP methodology of “healthy eating” and is pretty difficult to convince otherwise. In an effort to try and open her eyes to keto/fasting, I’m trying to get to my personal healthiest version of myself - losing 40 lbs to get to my goal weight and reducing my synthroid dosage as much as possible. I’m not on any other medication and otherwise healthy (blood work/A1c/glucose/etc. are so far just about perfect) so those 2 goals are really my only way of proving the benefits.

My questions are:

  1. Can somebody on Metformin safely fast without needing any medical supervision? I know I’ve read on the IDM site that fasting while on insulin can be dangerous and should be supervised, but can’t seem to find anything about fasting while specifically taking Metformin
  2. Any and all advice on getting a stubborn family member to open her eyes to the life-saving effects of this lifestyle (she’s old-school in that she barely knows what a blog is and doesn’t particularly like podcasts, and this type of forum would be absolutely foreign to her).
(Daniel Crispin) #2

You should consult your doctor about this, but my gut feeling about fasting while using Metformin is that it’s a very bad idea.
I am not certain of the exact way Metformin works, but the result is that it lowers your blood sugar. So if you are not taking in any food, your blood sugar could drop too low and you could end up in Hypoglycemia. So before attempting this, talk to your doctor.

(Karen) #3

I was on 1500 mg Metformin for PCOS and insulin resistance. I had to stop the Metformin after I started Keto eating and IF (18:6). My blood sugar was getting too low.

And I understand your Mom. She sounds a lot like my Mom. She would rather take a pill and do what the allopathic doctor says to do than to change anything about her eating patterns. It’s a challenge to convince another person that there are other options. I think the motivation to change has to be there for the other person.

Yay for you though on doing what you need to do to be your best self! Regardless of what Mom decides to do, I wish you the best with your healthy journey.

(Consensus is Politics) #4

I’ve been doing mini fasts because of this question. I’m on 1,000 mg of metformin 2x a day. I’ve noticed my BG would make its largest dip during this time. The lowest yet has been 92.

My mini fasts have been sometimes just breakfast, or lunch, or dinner. I have been taking my metformin at 8:00 am and at 6:00 pm. If anyone knows of a good strategy on when best to take meds, please let me know. I try my best to time the one meal with the metformin. The lunch only days it just doesnt happen. I think that although its recommend to take the metformin with food, it doesnt seem to matter for me. It was explained by my doctor that it was just to buffer the drug in the stomach to alleviate digestive problems. Those side effects for me have been minimal. So for that reason alone it might not be good to fast with metformin.

I have noticed that even while fasting, and taking metformin, my morning BG reading has been 50 points higher than the average for the rest of the day. I was puzzled by the morning sugar boost that I have been reading about on so many diabetic websites. Funny thing is, this website answered that question my very first day here! Not a single health related website I had visited, including actual medical websites had an answer for morning sugar levels being so high. So I learned here first, that the liver creates sugar. I had never heard that. Something you would think should be known by diabetics. Sugar is the enemy, so you really need to know your body does create its own.

#5

I took metformin for insulin resistance (A1c and fasting glucose were okay) for about 15 years. Then I became diabetic. Then about two years later, I developed neuropathy. STILL took another half a year (and a slow-healing foot injury) before I was sufficiently scared to commit to keto.

After a month, I was no longer diabetic. Foot healed. The neuropathy is going to take a few years, but I’m optimistic.

I still take metformin because my insulin is too high, and that’s very unhealthy. I will probably always take it. I used to take 1000mg three times a day, but when my A1c went down, I cut back to 1000mg of the extended release formula twice a day.

Since starting keto, I’ve always taken my full doses of metformin even when fasting (23-hour almost daily, and occasional two- and three-day fasts). I don’t test my blood sugar, but I’ve never felt hypo. I take all my pills and supplements with two tablespoons of unmodified potato starch dissolved in water (to prevent stomach irritation).

#6

Thanks, this was my initial thought too but figured it couldn’t hurt to see what other people’s experiences were.

#7

Thank you so much! I try to constantly remind myself that the only person who can change my mom’s life is my mom, but it’s still hard to watch her go through trying times knowing there’s another option. Wishing you the best as well!

#8

Too funny that a quick browse over this forum answered your BG question before the doctor! I think there are many people who can relate to that story. I don’t have any advice regarding the timing of your metformin (not sure of my mom’s schedule even) but I bet a quick question posted to the chat section will get you at least a few answers. Thanks for the “mini-fasts” suggestion - I think starting small is the way to go in regards to fasting!

#9

Neuropathy can be so difficult, but don’t give up - it sounds like you are well on your way to a life of health! Have you read through/listened to Dr. Fung’s blog and podcasts? He runs a program called “Intensive Dietary Management” (google search should bring the website up) and has helped hundreds of people get off their diabetic medications forever. They’re now offering the program to everybody (obviously for a cost) but if you’re interested in a more individualized keto/fasting plan, I haven’t found a better place that can offer it! And thanks for the info RE the metformin :slight_smile:

#10

I feel pretty confident that I could stop taking metformin without my blood sugar getting out of hand (as long as I stay keto, which I will), but lowering fasting insulin takes longer. I’m not at all concerned about staying on metformin indefinitely. Getting off it isn’t even a goal for me.

#11

Sorry to wake up an old thread. Could you kindly share more info in your foot injury?

I’ve had creeping higher blood sugar for the last 5-7 years. On my most recent physical my A1c came in at 6.3 ( they just started measuring this a couple of years ago, I was at 5.7 before). I’ve had a foot injury for the past 1.5 years, was told that it was a flexor plate injury (deadlifts at CrossFit) and my PCP at annual said it’s neuropathy.

So I took my first metaformin pill last evening. I’m on 500mg 2x (since I just started it’s 1x for this week).

I’ve done keto before, as well as IF; and sadly my annual physical is usually around April or May. So with the new year I’ve usually started off good, and I’m sure some of this has given false positives where the need to control sugar has been getting away for many years.

Sorry for going on - was just curious what the foot injury was…

#12

A wheeled trash bin fell on my big toe. My whole toe swelled up so much, I couldn’t bend it that night. The swelling was down the next day, but the whole nail turned purple from blood underneath it. Three months later, it still looked exactly the same. I did have a doctor to look at it, and when she said, “Oh, I’m so sorry…I think you’re going to lose it,” I thought for a moment she meant my TOE. The nail never came off, but it did separate from the nail bed. After a couple more months, I saw a sliver of new nail at the base. A year and a half later, it still hasn’t completely grown out new (almost, though). I know toenails grow slowly under the best of conditions, but this is taking even longer than typical, so clearly the cellular metabolism is stunted there. I’m not sure that low-carbing/fasting has done anything to help with my neuropathy (yet, anyway; if the nerves regrow, it takes years), but it was the one incident that really terrified me into being good.

#13

Have you tried adding biotin supplement to your diet?

(Consensus is Politics) #14

Biotin should help it grow in stronger. If you want it to grow faster, you want vitamin D3.

I’ve been supplanting Vitamin D3 for 10 years. About 20,000 iu a day. I know that number seems large. I based it on how much my body should make in full sunlight. That works out to be 30,000 to 40,000 a day. That’s the point the generation hits diminishing returns on time spent in the sun, and takes 20 to 40 minutes.

I noticed a few changes within a month of taking D3. First, my seasonal allergies. Gone. With exception of the super heavy pollen days when we get pollen drifts on the front porch and our white car turns very yellow. Those days used to give me horrible problems from non stop sneezing, as I’m unable to catch my breath non stop, to bronchitis, asthma, and swollen shut eyes. But those days are gone now. At worst I might sneeze a few times, and need to blow my nose. Along with that I haven’t had the flu for the past 10 years either. I might get the sniffles when everyone else around me is being ravaged by the flu. I can’t remember the last time I even had a simple cold.

As for my nail growth, I need to clip my finger nails twice a week. Toenails, they seem to last a lot longer. I might need to cut them once a month. For whatever reason they are also very, very strong. Not weak and brittle like my fingernails.

#15

I have been on Metformin since 2008. IMO, it does not lower blood sugar per se, the way insulin does. What is does do is suppress the release of glucose from your liver, and promote the use of blood sugar in the muscles, both of which result in lower blood sugar. It should never take your blood sugar to a dangerous low.

Fasting while taking Metformin depends on how your body handles it. It should be taken “with food” to avoid digestive problems, but if you do not get digestive problems from taking it, it is safe to take it without food. YMMV

#16

Thought I’d wait a bit before I got back here / so I’ve now been on met for 1.5 mo. Usually when I stop eating carbs and sugar I naturally stay in mid 90’s - having natural sugar from fruits puts me at 105, eating processed carbs puts me st 115. So this is how my body has worked without met… since starting met / nothing has changed.

I’m not in the 80’s or 70’s - the jump by 10 still happens… I’ve had zero digestive issues / I’ve also not dropped insane amount of weight. I did drop my usuall 5 lbs by carb and sugar reduction.

I’m mostly having a hard time entering ketosis. I’ll eat proper for 2 days but then mess up on the 3rd day, neutralizing the whole effort.

Anyhow / I plan to run a 4 day modified fast starting tomorrow AM, will do approx:
750 total cals
70 grams of fat
25 g protein
5 g sugar

BCAA + electrolytes several times over the day
90-100 oz of water

I plan to take my morning dose of met (500 mg er) monitor glucose and keytone 4 times per day, depending on readings - I might skip the second dose and just stick with 500, if I drop into 70’s will drop the first dose as well.

Breakfast is usually around 9/10 and it’s a black coffee with a scoop of protein powder and 2 tbs of coconut oil, this right here hits the protein and sugar goal, 1/3 of the fat goal : good time to take met.

#17

Day 1 is over. I’m still alive.

Glucose and ketone readings
Wake up
102
0.1 keystone
Took met

Midday
88
Low (no significant reading detected)

Evening (took 2 reads)
92/83
0.3 keystones

Because of the 83 read / skipping 2nd dose of met

72g fat
25g protein
3g carbs (2 sugar)

100+ oz water, bcaa, electrolytes