Who needs vitamin B-12 shots and why?

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Physiologic glucose levels should be maintained prior to and during pregnancy to decrease the risk of adverse events in the mother and the fetus. Flushed them down the toilet by mistake. You won't be able to lose weight unless all 5 of those areas have been addressed and reversed if necessary. Nearly a billion dollars paid for sirtuins activators, but no drugs on the market. There are a number of different medications used to treat type 2 diabetes. If you experience any of these symptoms you should seek help with your physician immediately. The main concern with metformin over long-term therapy is accumulation of metformin leading to lactic acidosis too much lactic acid in the blood.

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Nicotinamide riboside was actually discovered a long time ago. Among the precursors, NR was said to be the one that causes the most rapid growth of the bacterium 9. That paper was authored by two highly respected big names in the field; Leonard Guarente, Ph. Excerpt from the image caption: These nuclear events might reduce mitochondrial function in old mitochondria.

You can buy other precursors in a plethora of supplements on the market and those are nothing new, but a nicotinamide riboside supplement is new. Those synthesis processes were developed in academia by Cornell, Dartmouth, and Washington University. The company ChromaDex has snapped up that IP in recent years through exclusive licensing agreements with them. In , they began producing and selling NR under the brand name Niagen.

In the same way, ChromaDex licenses their NR to different supplement manufacturers. Some choose to feature the Niagen brand name, while others refer to it as nicotinamide riboside, however both are the same thing.

A few products currently using it include:. As to which is the best nicotinamide riboside supplement on the market to buy, really the decision should be based on price.

This is because any reputable brand such as those listed above and others should be of equal quality, given that they are all using the same source for the active ingredient; ChromaDex.

As far as nicotinamide riboside side effects are concerned, much of the findings are said to be quite positive. The prior animal model studies were analyzed for this review and the authors suggested these claims in their summary:.

Again, we stress these things are about animal studies and only preliminary scientific conclusions. An international peer reviewed journal, Human and Experimental Toxicology HET , published a study in which specifically looked at nicotinamide riboside safety In the study, they used a several methods:. Niagen was not found to be genotoxic. Its toxicity and side effects were found to be similar to regular nicotinamide.

If we had to guess which was affected at that dose, we would presume the liver, since that is by far the most common organ affected from drug toxicity and often, supplement overdosing too. Many of the Niagen supplements on the market are mg per capsule with an instructed serving size of 1 or 2 capsules per day. You would have to be taking approximately 40 times that amount to reach the 20, mg.

There are over articles on PubMed which mention nicotinamide riboside and we are not aware of any that mention serious side effects On a forum, we did read someone claim that if you have a methylation defect , higher NAD may cause neuropathy, fatigue, and pain. One comment we saw was by a person on mg dose of levothyroxine medication for treating hypothyroidism.

He said that after a couple weeks of taking a NR supplement, he experienced peripheral neuropathy, joint and muscle pain. Everyone should talk with their doctor before taking not just a dietary supplement like Niagen, but any supplement.

Even though the ability to isolate and synthesize NR is new, there has already been a great deal of research about it. Much of it within just the past 5 years. David Sinclair is only one of many who are researching this. Keep in mind that most involve animal models. A study conducted at the University of North Carolina and published in a edition of Cell Metabolism claims that nicotinamide activates a SIRT3 pathway that reduces neurite degeneration. This reportedly helps protect against noise-induced hearing loss The study claims that in cultured neurons, axon-protection is seen with it.

There are two studies, one in and the other in , which looked exclusively at the effect NR had on diabetic rodents. The earlier study was conducted by two universities in South Korea. Weight gain and liver function were not affected by the NR, but they do state that the oral glucose tolerance test OGTT and levels of insulin in the blood were improved in the mice receiving the supplement.

In the liver, the total cholesterol concentration was decreased. The study was conducted at the University of Iowa. It looked at prediabetic mice who were on a high fat diet and showing signs of insulin resistance and neuropathy.

The same mice were then also administered an agent to induce full on type 2 diabetes The mice on a high fat diet were found to lose weight and experience better glucose tolerance and protection again neuropathy.

Hepatic steatosis, weight gain, and neuropathy were also said to benefit. A Swiss study which was published in a edition of Cell Metabolism looked at the side effects of nicotinamide riboside on mammalian cells and mouse tissues, which included brain, muscle, and liver.

An even more exciting study involved humans. A press release put out at the end of from the National Institutes of Health. The title of it was The lead researcher, Dr. Metformin may have this characteristic from stimulating too much serotonin in the gut. Try eating a Fibertab, or at least a half of one a couple of times a day. However, as wonderful a medication metformin is, if it is affecting your quality of life, you may have to ask your provider to lower your dose.

In addition, you should consider that your digestive system may be more sensitive than you had previously thought, as your physician may have mentioned, the diarrhea should have cleared up by now and it may be preventing you from absorbing certain vitamins and minerals. You may find this article useful as well: Is it true that once you get on metformin, you can never get off it?

This is a difficult question to answer because there are many variables to consider when discussing if you will stay on a medication for the rest of your life. For example, you may be changed to another medication to treat your diabetes. However, if a patient with high sugar levels has been unable to control their sugar with diet and exercise alone, then they likely will be on some type of medication to treat the diabetes for their lifetime.

Attached is a link to additional information provided by Everyday Health regarding diabetes. How soon after one takes metformin does it act on one's blood sugar?

Metformin brand name is Glucophage works within days to exert its effects on blood sugar. The maximum effect may take up to 2 weeks. In another study, Glucophage was reported to start lowering blood sugar within 24 to 48 hours. I have included a couple of links you may find helpful.

I am taking metformin to help in weight loss. Is loose stools a common side effect? Metformin Glucophage, Glumetza is an oral diabetes medication that helps control blood sugar. Diarrhea is listed as a common reaction when taking this medication. However, side effects are patient specific. The following websites will provide additional information about taking metformin: This site is provided for informational and educational purposes only.

You may not rely on this site for professional medical advice, diagnosis or treatment, pharmacist advice or any professional service requiring licensure, registration or certification in any state. Follow the instructions of your health care provider and read carefully all product packaging associated with any medication that is provided to you. Medication information offered on this site is for informational purposes only and is neither independently verified nor endorsed by Everyday Health, Inc.

We cannot offer any assurances that any product is safe, effective or appropriate for you. If you are in need of medical attention, contact your physician or other health care provider or dial if you believe that you are experiencing a medical emergency. Is there a good way to counteract the laxative effect of metformin? I take mg twice a day and after over a year , I still have unpleasant side effects.

According to the package insert for metformin, nausea and upset stomach are side effects of metformin that generally go away after being on the medication for some time. Consult with your health care provider if these symptoms are not going away, appearing later in therapy or affecting your daily life. You may need to lower your dose, or stop the medication for a short period of time, or for good.

It is important to consult with your health care provider before making any changes to your medication. In recent medical literature, it has been shown that patients who were switched from metformin to extended release metformin, had fewer stomach side effects.

Do Pravachol, Tenex, and Paxil interfere with my diabetes medicine? Studies suggest that there are no significant interactions between these medications. It is best to take metformin with food. Pravachol is best taken at bedtime since body makes cholesterol at night. I'm a newly diagnosed diabetic, and I've been talking metformin, 1, mg a day. When will the diarrhea stop? My doctor told me that it might take up to three months. Side effects or common reactions to individual medications such as metformin Glucophage are very patient specific.

Therefore, it is not possible to determine how long your diarrhea may last. Oftentimes, it takes a few weeks for a person. If I'm taking the slow-release version of Glumetza metformin for PCOS, can I also take calcium two hours later, or will it interfere with the absorption and effectiveness? It should be fine for you to take the calcium 2 hours after the Glumetza. The absorption and effectiveness should not be affected.

Of course, it is always good to speak with your doctor before you take any over-the-counter products just to be sure that the product is right for you based on your personal medical history. There are no restrictions to taking metformin with any non-alcoholic beverages. Excessive consumption of alcohol may cause liver damage. Liver damage is one of the contraindications for taking metformin because it may lead to lactic acidosis.

The risk of lactic acidosis, caused by accumulation of metformin, is higher in patients with liver problems. Lactic acidosis is a rare but fatal condition in which the body produces excess lactic acid.

Symptoms of lactic acidosis are muscle pain, difficulty breathing, sleepiness, abdominal pain. If you notice these symptoms, contact your pharmacist or the prescriber immediately. Why doesn't metformin dissolve in my system? Take metformin with a meal, unless your doctor tells you otherwise. Some forms of metformin are taken only once daily with the evening meal.

Follow your doctor's instructions. It is important to use this medicine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely. Do not crush, chew, or break an extended-release tablet Glucophage XR. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time. To be sure this medication is helping your condition, your blood will need to be tested on a regular basis.

Your kidney function may also need to be tested. It is important that you not miss any scheduled appointments. According to the American Diabetes Association, diabetics should avoid or reduce sugary drinks such as sodas and drink water instead.

Drinks like cola, even diet sodas, can increase your blood sugar levels which in the long run increase your A1c levels. These drinks should be avoided or at a minimum consumed in moderation by diabetics. Are there any issues with sunlight and taking metformin?

A review of the package insert and medical literature did not show reports of sensitivity to sunlight in patients taking metformin. Another type of medication used for type 2 diabetes, called sulfonylureas drug names: There are several prescription drug products that combine metformin with a sulfonylurea, including Glucovance and Metaglip. You are encouraged to report any negative side effects of prescription drugs to your health care practitioner and the Food and Drug Administration FDA by visiting www.

For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action.

Is it safe for a diabetic taking metformin to have an occasional alcoholic drink? Clinical studies have shown the use of alcohol with certain medications such as metformin may increase the risk of lactic acidosis.

For further information, please refer to the following links. Can I take cough medicine if I am taking metformin? Most cough medications are fine and do not interact with metformin Glucophage. The caution is to watch the sugar content of elixirs, syrups and suspensions. Also, cough medications come in a variety of active ingredients and combinations. I have also included a link about metformin Glucophage with some information about drug interactions: When is it best to take metformin, before or after meals?

As always, talk with your health care provider regarding questions you have about your prescription medications. Does metformin cause hives or urticaria-like symptoms after some time of usage? A rash is listed as a common reaction to or side effect from taking metformin Glucophage. Check with your physician to see if an over-the-counter low-strength steroid cream such as hydrocortisone might help alleviate some of the rash or if you need to change drugs.

Click on the following link for additional information: Is Glumetza a form of metformin? I couldn't tolerate metformin in the past. Is this medication like that? Yes, Glumetza is a brand name for metformin. There are a number of oral medications available to treat type 2 diabetes, and each class of drugs works in a different way.

Please contact your health care provider for an appropriate alternative for you. Would a high dose of metformin cause blurry vision? Blurry vision is not listed in the adverse effects section for metformin in Lexi-Comp.

This does not mean that it is not a possibility, but it is not a common adverse side effect. Keep in mind that diabetes itself can affect the eyes. Another thing to consider is if this could be a symptom of changes in blood-sugar levels. Make sure that you are checking your blood-sugar levels. Talk to your health care provider regarding your blurry vision. The following link provides information from Everyday Health regarding diabetes. Is it okay to take my entire daily dosage of metformin at same time instead of spreading it out throughout the day?

Whether you can take the entire 2, mg dose of metformin at one time depends on the dosage form you are prescribed. Generally, the immediate-release formulation is meant to be spread out during the day, in 2 or 3 doses with meals. The sustained-release or XR formulation is designed to be taken once daily with the evening meal.

Consult your health care provider for specific recommendations. I am on metformin. My AIC is 6. I don't feel like taking these anymore -- what are the consequences? I have been a diabetic for almost two years. Can I do it with diet and exercise? It's easy to become overwhelmed by the demands of a daily diabetes management plan. Often the stress can lead to burnout, when you feel that caring for your type 2 diabetes is more than you can or want to handle.

Although it's normal to have these feelings from time to time, don't let them derail your health. You can learn about ways to combat burnout at the following link: Exercise is beneficial for everyone, but it's especially important for people with type 2 diabetes.

In fact, incorporating regular exercise into your daily routine can help you get to or maintain a healthy weight, reduce blood sugar levels, and reduce stress levels. It may even lessen your need for diabetes medications. You can find helpful information about exercise and diabetes at: Your health care provider or diabetes educator is best able to help you with your treatment choices and in developing a plan to meet your needs and goals.

Do not stop or change the amount of medication you take without talking to your health care provider first. Does metformin build up in your system? How long does a dose last? Metformin has a half-life of around seven hours for a single tablet.

What this means is that one half of the medication will be metabolized and excreted after seven hours, but the entire one tablet dose will be out of your system in about 35 hours. This does not mean that you can change how you take the medication because most of the active medication is contained in the first 7 to 14 hours; what gets out of your system after that is usually the metabolites or inactive ingredients of that tablet.

For example, the dosing is usually twice a day for the non-extended release form of metformin. By taking the medication every 12 hours you keep a steady level of active medication in your system. For more information on metformin, follow this link: Why do doctors give metformin with insulin? Taking insulin and metformin together works better at controlling blood sugar for people with type 2 diabetes than just taking insulin on its own. If you have type 2 diabetes, your pancreas doesn't make enough insulin, and the insulin your pancreas makes doesn't work properly.

This means you get too much glucose in your blood. Insulin is a hormone that your body uses to keep the amount of glucose sugar in your blood steady. Insulin is made by your pancreas, a gland that sits just behind your stomach. It's used for people who have type 2 diabetes that isn't controlled by drugs. Taking insulin and metformin together aims to combine the benefits of both treatments. Together they give you better control of your blood sugar levels.

The metformin may also mean you don't need to take as much insulin. Or is metformin usage for life in terms of controlling blood sugar? A healthy lifestyle including a healthy diet, daily activity, and exercise can help control diabetes and perhaps lessen the need for medications. Your health care provider or diabetes educator is best able to guide your treatment decisions based on your specific circumstances.

Consult them about developing a plan for lifestyle changes that can help you. Can I eat grapefruit every morning? Major clinical trials have not indicated any effects between grapefruit and metformin, even though grapefruit interact with a whole host of other medications. But there are some animal studies that have shown that the combination can lead to complications such as lactic acidosis.

Please check with your physician before making any new changes in your diet. For more information on metformin, please see: I am on metformin and my doctor is a holistic devotee so he has me take vitamins and supplements.

Do you have any advice about this? The effectiveness of vitamin and mineral supplements are very patient-specific. Why does my metformin have an odor? I never noticed this before. Only recently within the last month or so, have I noticed this. Metformin is used to help control blood sugar levels in patients with type 2 diabetes. A recent report in a medical journal indicates that the pills have an odor to them. Pharmacists and other people who take the drug have reported that metformin smells like dead fish, tires, or smelly sweat socks.

If you have concerns about the smell or it effects your ability to take the medication, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. I take mg of metformin twice a day, and there is this horrible fishy smell from the medication, which makes me wonder what's wrong with it?

The article suggests that manufacturers could add a coating to the pill to prevent the odor. If you have concerns about the smell or it affects your ability to take the medication, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action.

Why does my metformin have a fishy smell? Is it still good? I take 1, mg metformin ER morning and at night. I have noticed an odor. Is it ok to take It? I only smell it if I put my nose to the bottle. Does metformin have a fishy smell, or is it a sign that it's bad and should be thrown out? The metformin I take sometimes when I get it refilled, it smells like fish.

Is it still safe to take and effective? A recent report in a medical journal 1 indicates that the pills have an odor to them. Researchers have recently discovered that the popular Type 2 diabetes drug metformin brand names Glumetza, Riomet, Glucophage, Fortamet, and others has a distinctive scent that, for some people, is enough to cause them to stop taking it. But as the most widely prescribed diabetes drug in the United States, metformin plays an important role in helping people with Type 2 diabetes control their blood glucose levels.

But as the most widely prescribed diabetes drug in the United States, metformin plays an important role in helping people with Type 2 diabetes control their blood glucose levels, and experts have suggested several solutions for dealing with the medicine. Regarding metformin, is it a problem if it smells like fish? Why does metformin have a bad, fishy odor?

Is it safe to continue to take? I have had no problems with the drug besides a slight stomach upset at first. Why does metformin have a bad, fishy odor Does metformin have a suitable relacement that doesn't smell and is as cheap? Some reports indicate that some metformin pills have more odor than others. There are a number of different medications used to treat type 2 diabetes. It works by decreasing the amount of sugar your liver releases and by helping your body to use its own available insulin more efficiently.

Other options include the following: This can lead to low blood sugar levels and weight gain. These drugs can cause upset stomach, gas, and diarrhea.

And are other, less odorous options available? Many patients and pharmacists have noticed that metformin glucophage has a fishy odor. An article in a medical journal states that there appears to be no correlation with the odor of fish associated with metformin and the effectiveness of the medication.

It also appears that the fishy odor is seen with the immediate release metformin and not the extended release formulation. If the smell is extremely offensive to you, talk with your physician to see if the extended release tablets would be an appropriate option. Always store your medications as specified by the storage requirements and do not take expired medications. Click here for additional information provided by Everyday Health regarding diabetes.

Why does metformin smell so bad? Does Glucophage smell better? Glucophage is used to help control blood sugar levels in patients with type 2 diabetes. Researchers say the odor varies between generic versions of metformin and seems to be more apparent with the immediate-release form of the drug.

A film-coated, extended-release formulation of metformin may be a good alternative. If you have concerns about the smell or if the odor affects your ability to take the medication, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action.

My doctor has prescribed another medicine to go with it and it has helped a lot, although I am still craving food in the What is another drug that takes the place of metformin and does not make me crave food or sweets? It does not usually cause blood sugar levels to go low called hypoglycemia , but if you take other medications for diabetes, drink large amounts of alcohol, exercise heavily, or do not eat enough calories, hypoglycemia may occur.

To raise your blood sugar, eat a quick source of sugar, such as glucose tablets, table sugar, honey, candy, or fruit juice. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. The reverse effect, high blood sugar levels or hyperglycemia, can also occur with metformin and can have the symptom of frequent urination.

It may mean that your dose needs to be adjusted. There are a number of different types of medication used to treat type 2 diabetes.

Depending on your blood sugar levels, your doctor may prescribe one or more medications to help control your blood sugar. Can you please tell me which brand of generic metformin performs the best? I'm sure there is a big difference in absorbability and performance, and I'm sure there is some kind of rating system. It is available by several manufacturers as a generic drug.

All generic drugs have the same dosage, intended use, effects, side effects, route of administration, and strength as the brand name drug.

Food and Drug Administration requires that generic drugs be as safe and effective as brand name drugs. Generic versions of a drug often look different from the original brand medication. This is because trademark laws in the United States do not allow the generic drugs to look exactly like the brand name product. Importantly, the active ingredients are the same in both preparations to ensure that the effect on the body is the same. Concerns are often raised about the quality of generic drugs because they are often substantially less expensive than the brand name drugs.

Generic drugs are less expensive because the generic manufacturers do not have to spend substantial money on research, development, and marketing of the drug.

My metformin smells like fish. What does this mean? The metformin drug, why does it smell like fish. It didn't smell like that before. Also like everything you put in your body that's strong is going to come through your body, right! Any alternatives for metformin available? Metformin Glucophage is unique in the way it works. Other alternatives exist for metformin, but will not work the same way. Unfortunately, it is the only one in this class.

The way that metformin works is that it decreases the amount of sugars glucose that the body absorbs from food. Other options to metformin include sulfonylureas examples: All of these medications work in different ways and are more appropriate based on individualized needs, the severity of diabetes, side effects and patient response.

Also, various therapies are either less expensive or more expensive than metformin. I have included a few links for more information about diabetes and treatment options. There have been complaints from patients that take metformin Glucophage about an odor that has been described as fishy. The exact reason for this is unknown but is likely due to the products that are in the tablets. Some patients feel that the smell is only in the immediate release metformin and not the extended release formulation.

An article in a medical journal states that there does not seem to be any correlation with the fish smell and how well the medication works. If the smell is extremely unpleasant to you, talk with your physician to determine if changing to the extended release formulation would be an appropriate therapy option for you.

Patients and pharmacists have reported a fishy smell associated with metformin Glucophage. It appears that this is most commonly seen in the immediate release formulation of the medication and not in the extended release tablets.

It is stated in a journal article that the fish smell is not related to the effectiveness of the medication. If the smell is extremely offensive to you, contact your physician to ask if the extended release metformin is an appropriate treatment option for you.

It has not been determined what is the exact cause of the odor of Glucophage metformin. Some generic products do not have the smell as much as others do. It all depends on the different binders that the company decides to use. Binders are found in every tablet and are used to hold the tablet together. While the amount of the medication must remain constant regardless of manufacturer, the binders can vary.

If the odor is causing you to not take your medication, you may want to consider trying a different pharmacy to see if they carry a manufacturer with tablets that do not have an odor.

Thank you for submitting your question to Everyday Health. Metformin Glucophage is often described as having an unpleasant, fishy odor but does that mean its spoiled or unsafe? This odor does not affect the effectiveness of the product. Metformin Glucophage is used to help control blood sugar levels in patients with type 2 diabetes. There are also reports of smelly urine in patients who take metformin. My mom's metformin has a fishy foul odor. The pharmacist and doctor says it's okay.

My mom said it never smelled until months ago. Her doctor said to take one instead of two pills. The pills are mg. Metformin Glucophage has been reported to have a fishy smell by both patients and pharmacists.

According to a clinical journal article, there are no correlations between the smell of the medication and how well the medication works. It has also been reported that the smell seems to be most commonly seen with the immediate release metformin and not the extended release metformin tablets. Your mom may want to consult with her physician to determine if the extended release formulation would be an appropriate treatment option for her. Pain in the muscles and dizziness has also been reported in patients.

Please have your mom talk to her physician for further guidance regarding the possible side effects she is experiencing. Dosing of metformin should be done based on her blood sugar levels. Her physician can provide further information about the decision to lower her dosage of the medication. Why does my diabetes drug smell? Is it spoiled or unsafe? One of the diabetes medications that is notorious of having the foul odor is metformin. Metformin is an oral diabetes medicine that helps control blood sugar levels.

There can be a smell with some forms of metformin that is often described as a fishy odor or a locker room odor. This smell is an unpleasant quality of the drug itself and does not affect how it works. The smell varies among generic products, so it may be more noticeable with some generics than others.

It seems to be less noticeable with the extended-release formulations. Most patients are able to tolerate the odor. However, if it is extremely bothersome to you, talk to your doctor or pharmacist. It may simply be a matter of finding a different generic product and your pharmacist can help you with that. If you find that none of the generics are acceptable to you, consult your doctor to see if an extended-release product may be appropriate for you. Do not stop taking your medication without talking to your doctor first.

Your health care provider is best able to guide your treatment decisions based on your specific circumstances. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications. I'm on metformin mg twice a day but right after I take it, I get so sleepy that my brain shuts down. This is not a normal side effect of this medication, according to the prescribing information.

This is a symptom that you should report to your physician to be sure that there is no underlying health condition that is causing the issue. This could be a sign of blood sugar level issues, or a rare side effect known as lactic acidosis. Symptoms of lactic acidosis include: Feeling extremely tired or weak; Muscle pain; Trouble breathing; Abdominal pain or stomach pain ; Feeling cold cold or blue hands and feet ; Dizziness or lightheadedness; A slow or irregular heartbeat; Persistent nausea, vomiting, and abdominal pain; Shortness of breath.

If you are experiencing any of these side effects it should be reported to your physician as soon as possible. I have been told I am a type 2 diabetic and have been taking metformin mg three time a day. Is the medication helping to increase or lower my blood sugar levels? If you have diabetes, your body has problems producing or utilizing insulin. Insulin is a hormone that is produced by your pancreas. Your body breaks down the food you eat into a form of sugar known as glucose.

Insulin is required to convert this glucose into the energy your body needs to grow and perform the activities of daily life. Diabetes is diagnosed with a simple blood test that measures the level of glucose in your blood, either while you are fasting using the fasting plasma glucose test, or FPG or two hours after drinking a sugary drink using the oral glucose tolerance test, or OGTT.

Type 2 diabetes accounts for 90 to 95 percent of all diabetes cases. In type 2 diabetes, the body uses insulin ineffectively, which is called insulin resistance. Over time, insulin resistance causes a decrease in insulin production, which leads to a build-up of glucose in the blood.

When is the best time to take mg of metformin ER, morning or evening? Metformin ER is a prescription medication used to treat type 2 diabetes. It works by decreasing the amount of sugar the liver makes, as well as decreasing the amount of sugar absorbed by the body from the food you eat.

However, as long as the medication is taken at the same time everyday, you can usually choose when you would like that to be based on when you will remember to take it and where it fits into your daily schedule.

For more information on metformin ER glucophage XL , click on this link: When should metformin be stopped during pregnancy? I'm presently on 3 metformin daily. Adverse events have not been observed in animal studies; therefore, metformin is classified as pregnancy category B. Pharmacokinetic studies suggest that clearance of metformin may be increased during pregnancy and dosing may need adjusted in some women when used during the third trimester. Available information suggests that metformin use during pregnancy may be safe as long as good glycemic control is maintained; however, many studies used metformin during the second or third trimester only.

Maternal hyperglycemia can be associated with adverse effects in the fetus, including macrosomia, neonatal hyperglycemia, and hyperbilirubinemia; the risk of congenital malformations is increased when the Hb A1c is above the normal range.

Diabetes can also be associated with adverse effects in the mother. Poorly-treated diabetes may cause end-organ damage that may negatively affect obstetric outcomes. Physiologic glucose levels should be maintained prior to and during pregnancy to decrease the risk of adverse events in the mother and the fetus. Until additional safety and efficacy data are obtained, the use of oral agents is generally not recommended as routine management of gestational diabetes mellitus GDM or type 2 diabetes mellitus during pregnancy.

Insulin is the drug of choice for the control of diabetes mellitus during pregnancy. For more detailed information, consult with your physician or pharmacist for guidance based on your specific condition and current medications, particularly before taking any action.

I was recently diagnosed with type 2 diabetes and I am taking metformin. My right leg has been killing me at night time early morning. What over the counter medications can I use? I thought maybe an iron defficiency could be the problem. What is a good vitamin supplement. My doctor doesn't want to give me anything but narcotics or other prescription medication. I don't want either. Muscle pain can be a sign of a serious side effect of metformin called lactic acidosis.

Muscle pain, while on metformin, should be evaluated by a medical provider. What will happen if I drink alcohol when taking metformin? Alcohol should be avoided when taking metformin because alcohol lowers the blood sugar and may increase the risk of lactic acidosis. Lactic acidosis occurs when there is low pH more acidic in the tissues and blood caused by a buildup of lactic acid. This is a rare but deadly condition that is known to be caused by metformin.

Your doctor should be able to determine if it is okay for you to drink alcohol and in what quantity while on metformin therapy. Does metformin go through the kidney or the liver? Metformin is eliminated from your body primarily through the kidneys. Furthermore, lower levels of stomach acid can encourage the growth of certain bacteria in the gut that use B, reducing the amount of the vitamin available to the body.

The Institute of Medicine recommend that adults over 50 meet their vitamin B needs with fortified foods, B shots, or other supplements, as these man-made forms appear to be more readily absorbed than naturally occurring B As vitamin B is found mainly in fish, meat, eggs, and dairy, people who do not consume these foods are at risk of B deficiency and may benefit from regular B shots or other supplements. Research published in the European Journal of Clinical Nutrition indicates that vegans and some strict vegetarians have low levels of vitamin B Of vegans studied, over half were classed as being deficient in vitamin B The deficiency was observed in just 7 percent of the vegetarians studied, and in only one of the omnivores.

Vegetarian or vegan women who are pregnant will need to be especially careful about supplementing or consuming fortified foods, as vitamin B transfers to the baby via the placenta and breast milk.

Infants who have vitamin B deficiency can experience permanent and severe neurological issues. The most obvious benefit of receiving vitamin B shots is treating a vitamin B deficiency and avoiding its associated symptoms.

In addition, B shots reduce the risk of some serious complications associated with vitamin B deficiency including:. Therefore, they are a better option than oral supplements for those who have gastrointestinal issues, including older adults who have low levels of stomach acid or intrinsic factor. There is no upper limit for the intake of vitamin B because the risk of toxicity or overdose is extremely low. Mild side effects and potential risks, which should be referred to a doctor if they persist or worsen, include:.

Vitamin B may interact with certain medications. People must always inform their doctor about all prescription and over-the-counter drugs they are taking before receiving a B shot. Those who have allergies or medical conditions should always inform their doctor before receiving a B shot. Article last reviewed by Tue 4 July All references are available in the References tab. Serum concentrations of vitamin B12 and folate in British male omnivores, vegetarians and vegans: European Journal of Clinical Nutrition , 64 9 , The BMJ , , Dietary supplement fact sheet.

Vitamin B12 deficiency in the elderly: Is it worth screening? Hong Kong Medical Journal , 21 2 , MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

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