Foods That Cause Diarrhea With Metformin
Metformin usually causes temporary gastrointestinal side effects that usually disappear as soon as your body adjusts to taking it, however some individuals experience chronic diarrhea lasting more than four weeks at a time.
These patients may find relief by switching to extended-release metformin tablets, which will spread its absorption throughout their gut and decrease symptoms such as diarrhea.
Furthermore, by taking metformin alongside foods that typically cause it, patients can avoid foods which might otherwise trigger diarrhea episodes.
1. High-Fructose Foods
Fructose, a simple sugar found primarily in fruits and some vegetables, can overload the intestines when consumed in large amounts, leading to symptoms like gas, bloating, nausea and diarrhea.
This effect is compounded when fruit juices or high fructose beverages instead of whole, unprocessed fruits are consumed.
Fructose malabsorption may be caused by hereditary fructose intolerance (HFI) or dietary fructose intolerance (DFI); both types can be treated using low FODMAP diets or diagnosed via hydrogen breath testing.
Milk, butter and ice cream contain lactose — the main sugar found in dairy products — as their primary sugar. As people get older they often lose the ability to digest lactose properly due to lactase non-persistence; this leads to lactose intolerance which, when taken together with metformin can cause diarrhea symptoms.
Other sources of high-fructose foods are sweetened yogurt, some frozen desserts, ketchup and other condiments as well as energy drinks. If in doubt about whether something contains high fructose levels, check the ingredient list or contact the manufacturer.
2. Caffeine
Foods containing caffeine (such as coffee and tea) or sugar substitutes like aspartame may lead to diarrhea when taken in combination with metformin.
Caffeine acts as a gut stimulant that speeds up digestion by contracting more of your gastrointestinal muscle groups causing rapid digestion that expedites food elimination from your system more quickly, so it is wise to avoid caffeine-containing products while on metformin therapy.
To minimize risks of diarrhea related to metformin therapy it is wise to refrain from eating caffeine-rich products with metformin therapy.
Metformin may cause diarrhea for various reasons; researchers believe that its exact causes remain unknown; however, one possible theory holds that metformin disrupts bacteria and viruses in your gut, leading to loose stools. Or maybe the drug interferes with certain hormones which regulate how your digestive tract operates causing problems in its function.
Diarrhea is a common side effect of metformin, but while not usually serious it can still be inconvenient and uncomfortable. To help avoid diarrhea it’s best to eat a balanced diet and drink enough fluids — especially water and juice — throughout the day, while practicing proper hand hygiene by washing your hands after preparing food, using the bathroom, touching surfaces etc.
If diarrhea persists, speak to your physician about adjusting your dose or changing medications. They may recommend switching to an extended-release version of metformin which is less likely to cause problems, or suggesting another oral diabetes drug that more closely matches with your system.
3. High-Fiber Foods
Metformin can cause diarrhea in those consuming high-fiber foods, often subsiding once their diet has been adjusted; however, chronic diarrhea is less commonly known but nonetheless a serious side effect that should be managed effectively with healthcare team support. It’s crucial to discuss ways in which to address it effectively in order to keep yourself as comfortable as possible while on metformin therapy.
Diarrhea may also be caused by diabetic neuropathy, which damages nerves in the digestive tract and slows down movement through your intestines, slowing it down enough for diarrhea to occur.
Fiber can help with both diarrhea and constipation associated with metformin. High-fiber foods include whole grains, fruits, vegetables, beans and nuts; to increase fiber intake further simply consume more vegetables, fruit and whole grains while decreasing sugary fruits and snacks in your diet.
Along with increasing the fiber intake in your diet, consider drinking more water and cutting out drinks containing caffeine or alcohol. Also avoid meals high in FODMAP foods such as dairy products, fruit, coffee and spicy foods that could potentially contribute to diarrheal episodes.
If diarrhea from metformin is negatively impacting your quality of life, talk to your doctor about lowering or discontinuing its use altogether.
There may also be FDA-approved alternatives like sodium-glucose co-transporter 2 inhibitors like canagliflozin (Invokana) and dapagliflozin (Farxiga), which work by decreasing glucose levels via urine instead of in the intestinal tract.
4. Meat
People taking metformin to treat Type 2 diabetes and manage their weight can benefit from eating healthily; however, certain foods can trigger diarrhea when taken together with metformin. There are ways around this side effect by avoiding certain foods altogether and opting for other nutritious meals that won’t trigger diarrhea symptoms.
Foods high in fructose may contribute to diarrhea, especially fruits and beverages with fructose-sweetened drinks such as fruit juice. This is because these types of foods encourage your body to pull fluid into your intestines which in turn leads to diarrhea.
Common sources include high-fructose fruits such as apricots, pears, peaches and soda as well as fruit juice as sources of high fructose foods that could trigger it with metformin therapy.
Fatty foods can also lead to diarrhea when taking metformin, as fat takes more time for your body to process than carbohydrates and proteins. To minimize this side effect, only consume fatty foods in moderation when taking metformin — opt for lean cuts of meats, low-fat yogurt and skim milk instead of full-fat versions when possible.
While diarrhea may be an adverse side effect of metformin, it’s important to remember that it will likely go away as your body adjusts.
If it persists, speak to your physician about alternative forms of managing type 2 diabetes management such as an insulin pump or sodium-glucose cotransporter 2 inhibitors such as canagliflozin (Invokana) and dapagliflozin (Farxiga).
You could also consider switching to extended release metformin which has reduced gastrointestinal side effects.
