This Popular Weight-Loss Drug Might Cause Gnarly Stomach Issues

metformin side effects

ICYMI: Medications are weird and kind of complicated. Sometimes, after a drug is created to treat one problem, we discover it can actually be used to treat other conditions as well—#science!

That’s the case with metformin, a medication that was initially developed to treat Type 2 diabetes. Over the years, studies (and real-life stories) have shown that taking metformin can lead to weight loss, even in people who aren’t diabetic.

“Metformin is an insulin sensitizer, which means it helps the insulin, a hormone made by your pancreas, in your body work better,” explains Valentina Rodriguez, M.D., an endocrinologist at NYU Langone Health.

Insulin is the hormone that regulates how the body uses and stores glucose and fat, and it’s how many of your body’s cells convert the glucose in your blood into energy. Steady insulin levels can help to keep blood sugar stable, which prevents hunger and carbs cravings that come with spikes and subsequent drops in blood sugar.

Keep in mind, though, that it’s not a guaranteed weight-loss solution. “The weight loss that is seen is really variable,” says Rodriguez. “Some patients might lose a couple pounds, and some people might actually lose 15 to 20 pounds.”

As with any drug, there are reactions that can vary from person to person—so if you and your doctor decide this is a medication that might help you, here are the side effects you should be aware of.

You’ve got some serious tummy troubles.

Metformin is most notorious for causing a wide array of stomach issues. “It varies from person to person, but up to 40 to 50 percent of people who use classic metformin can develop diarrhea, nausea, vomiting, and/or gassiness,” says Rodriguez.

Why metformin leads to GI distress is unclear, but “because this medication is metabolized by the liver, people who are heavy alcohol drinkers or who already have problems with acid reflux or IBS may be more predisposed to this side effect,” she adds.

Most of the time, your body adjusts after just a couple of days and the symptoms improve; if not, your doctor can adjust the dosage or even take you off the drug.

You’re feeling kind of flu-ish.

One of the rarest side effects is lactic acidosis, a condition in which there’s an imbalance in the acid-base levels in your body. “This can present with muscle aches, pain, fatigue, chills, dizziness, drowsiness; very vague symptoms,” says Rodriguez. The condition can be fast-acting and possibly even fatal.

Super-scary, but remember: It’s rare, and occurs less than 1 percent of the time. Also, if you have it, you’ll know it. “The symptoms of this are very severe, and you’ll want to see a doctor just because you’re feeling so sick, not necessarily because you even remember lactic acidosis being a side effect,” says Rodriguez.

Your mouth tastes like metal.

It’s not uncommon for certain medications to leave you with an unpleasant, metallic taste in your mouth. “I’ve had a few patients tell me this—it’s difficult to explain why this happens, but it can occur,” says Rodriguez.

When you absorb medicine, some of it can leave your body via saliva; that metallic taste could come from the ingredients in the pill, adds Rodriguez. Luckily, this isn’t harmful and mouthwash should take care of it.

Your head is pounding.

Metformin doesn’t typically cause blood pressure to plummet and lead to hypoglycemia, but it can—and that can cause headaches. “Metformin alone should not cause hypoglycemia,” Rodriguez explains. But “when we see headaches, it’s usually in a patient on a combination of medications that can drop blood sugars too low.” If you’re experiencing an abnormal amount of headaches or an abnormal type of headache, talk to your doctor about adjusting your medications.

You’re not really in the mood to eat.

“One of the ways that people hypothesize metformin helps with weight loss is that, in some patients, it can help curb your appetite a little bit,” says Rodriguez. When your body’s insulin doesn’t respond normally, it can lead to cravings. Metformin can help stabilize insulin levels, thereby helping improve or curbing that sensation of extra hunger, she explains.

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