Using Metformin Off Label

(KM) #1

I understand, more or less no one here is a doctor qualified to give medical advice, and certainly not to random people not their own patients. I’m just putting this out there as a hypothetical to see what you think.

My husband’s doctor has switched him from Metformin to Ozempic. This means we now have a closet full of Metformin. Does anyone know if it works to reduce blood sugar if taken intermittently?

I’m not talking about suddenly having carte blanche permission to eat chocolate cake and ice cream whenever I want. I KNOW, I’m not supposed to eat that **** at all and for the most part I’m fine and happy with that idea. But occasionally, if I’m out at a restaurant, or I’m at a family function with people who already find me Extra, it would be a heck of a lot easier to pop a Metformin and eat someone’s cookie homebaked with love than stand on my “high horse” - as the only not-overweight person in the room, dietary snowflake doesn’t play well.

ETA - for some reason I’m not allowed to delete this post. I see from more online research asking the right question that it can take 4-5 days for metformin to start having an effect, not really useful for my off-label purpose after all. Too bad.

(Bob M) #2

I don’t know, because some people think it’s a life extension drug. Though I don’t know the dosing or time schedule for that.

The only person I know of who is taking metformin is taking it for PCOS and is quite heavy, primarily due to a very high carb diet.

(GINA ) #3

Like you said, it won’t work the way you originally hoped, but it might do you some good if your fasting insulin is still high.

I have taken it off-label but it didn’t really do anything for me. My a1c is already under 5 and my fasting insulin has been in the single digits for ages.

(Doug) #4

I would think so, but agree that going from none at all to taking it close in time to a high-carb meal may not do much. I’m thinking more of taking it every other day, or every three days - stuff like that. I take it, and have never felt anything, no side effects, and I’ve also never tested blood sugar enough nor stopped Metformin to see what effect it really has on a net basis.

While there are people who have felt negative side effects, overall it seems like a pretty easy drug to be on, without the risk of going too low on blood sugar that many other similarly-targeted drugs have. That said, I always have a gut feeling of *“You don’t get something for nothing,” i.e. there must be some downside to a drug. If nothing else, our livers have to process it…

(Bacon is a many-splendoured thing) #5

The question boils down to what your goals are, and what your problems are. Ketosis is important for a few reasons: first, it shows that insulin is low enough to allow us to be metabolising our body fat, and not have to be metabolising glucose instead. Second, there are epigenetic benefits to having circulating ketones. Third, ketones can pass the blood-brain barrier (fatty acids are too large to do so) and fuel the brain, which can be especially valuable if the brain’s ability to metabolise glucose has been damaged.

On the other hand, while chronically elevated serum glucose and serum insulin are known to damage the body, transient rises are something the body can handle. So if you really can’t escape eating Aunt Millie’s special dessert, you are generally safe eating it, if necessary to keep peace in the family.

The only problem comes when addiction is involved. Recovering alcoholics have to find ways to deal with being urged to take “just one” drink, because any alcohol at all sets up cravings that can result in a return to heavy drinking. In fact, addiction to alcohol is defined as not being able to take “just one” drink and stop. The same is true of sugar addiction. If “just one” slice of cake is going to set you off on a binge of carb-eating, then it’s best to avoid that “one” slice.

What non-addicts often don’t get is this inability to stop. But normal drinkers often don’t drink at all, and when they do drink, they often stop at one drink. The most annoying part of socialising with non-alcoholics, from an alcoholic’s point of view, is watching someone stop halfway through a drink. This is mystifiying to an alcoholic, whether in recovery or still actively drinking. But one strategy a recovering alcoholic can use to get the situation clear in the minds of people is to liken alcoholism to a nut or shellfish allergy: “If I were allergic to nuts, you wouldn’t tell me I can have ‘just one,’ would you?” “If I went into anaphylactic shock from shellfish, you wouldn’t tell me to have ‘just one’ shrimp, now would you?” Then you just explain that sugar, as much as you love it, has a similar deleterious effect on you, and you have found it best to avoid it altogether. That usually mollifies Aunt Millie, and she’ll forgive you for avoiding her special dessert.

The A.A. literature tells the story of a recovering alcoholic who was asked to organise a cocktail party, as a fundraiser for her charitable organisation. She worried about being urged to drink, and she hit on a great solution: for the first half of the party, her response was “Oh, not just yet, thank you,” and for the second half, “Oh, no more, thanks.” No one even noticed she didn’t drink. Something similar can work for sugar/carb addicts. If we just stick to steak and salad, nobody is likely to even notice.


HAH! That depends on your defnition, many here are more qualified on lots of things and a lot more knowledgeable on up to date reseach than many in practice. HOW SAD IT THAT? (for the Docs!)

The nickname the “Sick care system” happened for a reason ya know!

First, he’s gonna love Ozempic, that thing is the closest thing to magic made yet! I prescribed myself that years ago. Didn’t really give it a shot, and about 6mo ago did it again and it’s amazing, only thing that controls my binge eating. Hopfully given you got Ozempic and not Wegovy ins us picking it up for Diabetes and you’re not paying for it, because WOW are some people paying a LOT for Semaglutide these days! Like $1000/mo+

On the Metformin, yes, it works when you take it. You can take it when you know you’re gonna push it a little and it’ll still do it’s thing so you get a little extra help. When my kid wants Pizza,…METFORMIN! Maybe we’re out and the wife and kid conspire against me and now I’m at a place with REAL Ice cream…METFORMIN!

Stuff great. Also no shortage of people that use it for anti-aging benefits. But using it that way (not that it matters), wouldn’t be off label use, that’s literally what it’s for. Using it for anti-aging when you have no glucose control issues would be off label, for now.

When you finally run out, Dihydroberberine will do the same thing. Only negative I’ve seen people complain of long term is Metformin screwing up their teeth. That, and the slow release stuff destroys my joints, yet the fast stuff doesn’t, weird.

(Bob M) #7

You are likely not “insulin resistant” by any measure now. Probably no reason to take Metformin.


This made me think of a close friend in college who was allergic to shellfish but loved shrimp. He experimented until he knew how many shrimp he could eat before his eyes swelled up too much to find his way home. He became a physician. We remain friends, and he eventually became desensitized.

(Bacon is a many-splendoured thing) #9

My mother had desensitising treatments and became able to eat small quantities of the foods to which she was allergic and which were her favourites (the allergist explained that food allergies often meant cravings for those foods). It took years of treatments, but she was very grateful.

Of course, anaphylactic shock was not a risk for any of her allergies, lol!


How did Metformin screw up peoples’ teeth? I’ve never seen that as a potential side effect before. I’m currently taking it for prediabetes, and have been wondering if I will want to stop taking it once I get my A1C back in the normal range. (A1C was 5.7 last time and I’ll be testing again in a month.)

(KM) #11

Ya, you get why I want to take it. Let me have my damn Birthday brownie and be in ketosis again tomorrow morning, please!

And yes, thankfully insurance covers it. I’m still not thrilled with the big pharma slope I see in the future, but so far not a bank breaker. And maybe the teensiest bit jealous he’s got a magic bullet.

(Bob M) #12

Do you exercise? Exercise the day/morning of you Birthday brownie, and I’ll bet money you’ll be in ketosis. (I’ve eaten 100g carbs my first meal after exercise, was still producing ketones by blood test later that day.)

In fact, I’d bet you could be in ketosis the next day even without exercise, but this is more complex and likely depends on many factors.

And even if you get “kicked out” of ketosis, it’s not a big deal.

The bigger deal is you: can you eat a Birthday brownie and avoid a complete plunge back into carb binging? If so, enjoy the brownie. If not, rethink this.

(Frank) #13

Take it…
It helps.

(Bob M) #14

Berberine supposedly does act in a similar way to metformin, at least for part of the way metformin acts.

I’ve tried it 3 times though, and gave up each time. I can’t remember why, but I didn’t like it and never finished the bottles.

Other people rave about it, though.

(Frank) #15

It’s helped me.
I’ll continue it along with my new found keto diet.
My BGL is finally stable and acting the way it should.

(Kirk Wolak) #16

Real Ice Cream.

Try this test. Buy some Breyers Ice Cream. Open the container remove the seal across the top.
And leave it out for 1-2 days on the table.

Then scoop out a scoop ful. When you realize it still looks the SAME as Ice Cream, without even being cold, ask yourself why it did not turn into a simple liquid?

Well, it’s because one of the sugars they learned to Man-Make… It helps hold it’s consistency, and allows for a huge range in working temperatures, which lowers costs.

Side note. Trehalose leads to C. Difficile outbreaks. Killing elderly people. This pathogenic gut bug normally doesn’t get enough food… And when it gets a food that the other bugs cannot eat, it has zero competition for resources… And problems ensue.

I did this test. Lost ALL taste for Ice Cream after that.

(KM) #17

I have actually noticed this effect with some frozen dessert bars that should be melting wildly, but don’t. No longer eat them, here’s another reason not to.


Yup, I’m familiar with it, but that’s more the gums than the sugars. It’s true that a lot of the alternative sweeteners lower the freeze point of ice cream, but the gums do more for the not melting “normally” and required in low fat ice creams which breyers is known for. I use an ice cream stabilizer in my protein ice creams as it makes it a much better consistency as well as protecting from freezer burns and crystalizing.

I haven’t looked into Trehalose deeply, but it was brought up on another forum a while back and from what little I saw it seems it’s naturally occurring in plants, not as sweet as table sugar and probably on there for the lowered freeze temps. The cancer claim was brought up, but reading it didn’t make it look any more cancer food than any other real sugar.

Also, the alternative sweeteners are typically more expensive than sugar, even common ones, they use them to keep sugar content down. indefinitely wouldn’t lose the taste of ice cream over it, just buy a cleaner ice cream (or make it). My protein ice cream tastes nearly identical to traditional ice cream, and my daily 2 bowls of it gives me almost 50g of protein.

(Kirk Wolak) #19

THanks, I appreciate the difference now. Regardless. C. Difficile is nasty and it tends to kill the elderly in nursing homes.

Are you willing to share your protein ice cream? I am curious. I’ve added collagen to my HWC based ice cream to get a less rock hard result…


Oh that helps? I never was very motivated as I have zero problem with hard ice cream, I melt it for a while and all is well (but I don’t want ice cream, only make it when I need to use up a lot of yolks). Or I pour hot coffee on it but I am a savage like that…
But I still like to have options if it isn’t too much effort.

My ice cream isn’t even remotely similar to “normal” ice cream and I am quite happy with this. I don’t suppose I could enjoy any commercial ice cream even without the insane amount of sugar in it. The macros are very off for me, I like my desserts fatty and very, very eggy :wink: