Conclusion: Metformin does not appear to cause or exacerbate liver injury and, indeed, is often beneficial in patients with nonalcoholic
Metformin doesn't cause kidney damage. The kidneys process and clear the medication out of your system through your urine. If your kidneys don't function properly, there's concern that metformin can build up in your system and cause a condition called lactic acidosis.
Although the incidence may be rare, metformin- induced hepatotoxicity should be considered in patients with diabetes treated with metformin in whom symptoms of liver disease or abnormal levels of liver enzymes develop.
In monotherapy, sulfonylureas were found to have opposite effects. The drug was linked to premature death and an increase in liver decompensation. Statistically, sulfonylureas were associated with a five-fold increase in the risk of death or transplant and twice the risk of liver decompensation.
The human pharmacokinetic data point to the liver, kidney and intestines as the key target organs of metformin and in this review we will primarily focus on the liver and intestines, particularly when referring to the beneficial impact of metformin on metabolism and inflammation.
Long-term side effects
Taking metformin can cause vitamin B12 deficiency if you take it for a long time. This can make you feel very tired, breathless and faint, so your doctor may check the vitamin B12 level in your blood. If your vitamin B12 levels become too low, vitamin B12 supplements will help.
Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear, and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure.
You will have blood tests to check liver function. Liver enzymes will be higher if you have the condition. Your provider will do a physical exam to check for an enlarged liver and abdominal tenderness in the right upper part of the belly area. A rash or fever may be part of some drug reactions that affect the liver.
Lose weight if you need to, and try to stay at a healthy weight. Take steps to reduce high blood pressure. Keep your "bad" cholesterol — also called low-density lipoprotein (LDL) — and blood fat, called triglycerides, within recommended limits. Don't drink too much alcohol.
Five studies showed that metformin treatment for 12 to 24 weeks reduced the body mass index (BMI), liver fat content, liver enzymes, and hemoglobin A1c (HbA1c) and improved insulin resistance in NAFLD patients with type 2 diabetes mellitus (T2DM).
In conclusion, it was shown that 10 weeks metformin treatment in obese rats reduced liver steatosis, but had no effects on the levels of serum markers. It is hypothesized that a longer treatment period may be required for the metformin treatment to exert a significant effect on the levels of liver damage markers.
Metformin, a drug approved by the U.S. Food and Drug Administration (FDA) for use in patients with diabetes, has been shown to improve fatty liver in animals and in a small number of human beings. Other Names: metformin.
In some people, metformin leads to poor absorption of vitamin B12. That can lead to a vitamin B12 deficiency, though this only occurs after long-term medication use. Taking metformin might also lead to loss of appetite, which could cause a small amount of weight loss.
1. How long does it take metformin to work? Metformin is a long-term medication. While not everyone with diabetes needs to take medication forever, many people will continue taking metformin for life.
They noted that in observational studies there was a significant association of exposure to metformin with the risk of cancer death, all malignancies, liver, colorectal, pancreas, stomach, and esophagus.
The liver is part of the body's natural detoxification system, which helps filter out toxins. Foods that support liver health include berries, cruciferous vegetables, beans, whole grains, nuts, and fatty fish. Coffee and green tea contain antioxidants that are helpful for liver health.
Developing non-alcoholic fatty liver disease, or NAFLD, occurs in people with obesity and type 2 diabetes, and can be reversed with weight loss.
Acetaminophen. Taking acetaminophen in excess is the leading cause of drug-induced liver injury. “When you follow recommended acetaminophen doses, the drug is very safe,” said Francisco Durazo, MD, chief of transplant hepatology and transplant medicine at the Froedtert & MCW health network.
How could something natural be bad for your liver? In fact, some common herbs could cause toxic liver disease. Watch out for supplements that contain aloe vera, black cohosh, cascara, chaparral, comfrey, ephedra, or kava.
More serious side effects are rare. They include severe allergic reactions and a condition called lactic acidosis, a buildup of lactic acid in the bloodstream. The risk for this is higher among people with significant kidney disease, so doctors tend to avoid prescribing metformin for them.
Metformin should be avoided in patients with acute or unstable heart failure because of the increased risk of lactic acidosis. It also should be avoided in patients with hepatic impairment, according to the labeling.
Why Shouldn't You Stop Taking Metformin? Metformin works by decreasing the amount of sugar your liver releases into your blood, making your body more sensitive to insulin's effects. If you suddenly discontinue use, it can lead to dangerously high blood sugar levels.