What To Avoid Eating When Taking Metformin

Many of us would be aware of Metformin as a drug to control blood sugar in the case of Type 2 Diabetes Mellitus. Yet we may have questions regarding its usage. 

Here are some of the questions that we get commonly:

• What to eat on Metformin
• What not to eat on Metformin
• Is Metformin bad for you
• Should Metformin be taken with food
• When is the best time to take Metformin
• What should I avoid while taking Metformin 

In this blog, we endeavour to address as many of those queries as possible. But before we start, it is important for you to know that there are more effective proven methods to reverse diabetes, rather than relying on drugs to control blood sugar.

Let’s know Metformin

Metformin is predominantly the first line drug prescribed for diabetics. It reduces the absorption of glucose in the intestines, lowers liver glucose production, improves insulin sensitivity, and may even help the body make more insulin. 

Simply put, Metformin lowers your blood sugar level by improving the way your body handles insulin. However, it does not cure the disease by any means. It just manages the symptoms.

Apart from Type-2 diabetes, Metformin is also being used in the treatment of gestational diabetes, PCOS, infertility and in reducing the weight gained due to taking antipsychotics drugs, although it is not a sustainable solution.

Understand the importance of diet when taking Metformin

Treatment of diabetes and other chronic ailments have evolved over time. Today, we are able to reverse most chronic diseases with the help of integrative and functional medicine protocols. 

As a result, patients are now able to live a diabetes and medication free life. Under such circumstances, reliance on Metformin alone to control blood sugar is neither the most recommended nor the safest. 

In fact, it can be counter-productive in the long-run. Therefore, Metformin must be accompanied with dietary and holistic lifestyle changes to improve blood sugar regulation and overall metabolic health.

Foods to avoid while taking Metformin

In case you still choose to use Metformin to manage diabetes, you will need to avoid certain foods so that Metformin works more effectively on your body. 

For instance, healthy fats go well with Metformin. But trans fats, saturated fats, simple and refined carbs can be counter-productive. High fiber foods and sodium intake should also be restricted, while alcohol should be completely avoided. 

Let’s discuss the foods to avoid while taking Metformin and Metformin food interactions in more detail:

Alcohol

 If you consume large amounts of alcohol while you’re on Metformin, it will put you at an increased risk of developing lactic acid and low blood glucose levels. The metabolism of alcohol takes place in the liver, so you are also exposed to the risk of developing fatty liver. Moreover, alcohol also impacts the neurons in your brain drastically. Hence, even a drop of alcohol should be considered poison and you should completely avoid it. 

Carbs or foods high in simple sugars 

Simple carbohydrates cause sugar spikes which in turn causes high insulin levels and impacts the overall metabolism of your body. In the long-run, it will lead to insulin resistance. Complex carbs on the other hand, take longer to digest and so they do not spike sugar or insulin levels. Therefore, complex carbs are a more stable source of energy and a healthier alternative. It is important for you to note here, that refined complex carbs (carbs devoid of fiber), behave much in the same way as simple carbs and must be avoided if you are on Metformin diet. Simple sugars that need to be avoided are present in all processed foods such as candies, sugary drinks, syrups, table sugar, fruits juice concentrates and products with added sugar (such as baked goods and cereals). On the other hand, whole fruits contain healthy simple sugars along with vitamins, minerals and other nutrients. Bear in mind that whole fruits are always better than fruit juices because whole fruits contain more dietary fiber.

Trans and saturated fat foods

Polyunsaturated fatty acids (PUFA) found in groundnut oil, bran oil, cotton seed oil, canola, sunflower, safflower etc., trans fat (packaged and fast food) and hydrogenated oils (which are solidified to increase shelf life by adding hydrogen) are all bad for metabolism. These fats can cause chronic inflammation and increase insulin resistance in the liver. Metformin works primarily in the liver where it reduces the output of glucose. Thus, consumption of unhealthy fats impairs the overall effectiveness of Metformin and is among the Metformin foods to avoid. Instead of these, we should consume healthier fat options such as saturated fats found in coconut oil, A2 ghee and butter, avocado, seeds and nuts and monounsaturated fatty acids (MUFA) found in sesame oil.

Foods with excess Sodium

Before the introduction of refrigeration systems, salt was widely used as a preservative for food. Yet, the prevalence of hypertension was much lower than it is today. The reason for this is not salt, but insulin resistance. If you are insulin sensitive, your body can easily eliminate the excess sodium from food intake. But if you suffer from insulin resistance, high insulin in your blood causes excess retention of sodium and water. In turn, this will expand your circulatory volume and blood pressure. So, merely reducing salt consumption will not help. The focus should be on reducing insulin resistance as well. It is also advisable that you should avoid ultra-processed foods because they have high sodium content.  There are a couple of factors other than the food type that need to be considered when taking Metformin, as they also have a bearing on sugar levels and the effectiveness of the drug. They are discussed below:

Large portions and overeating

 When we eat ultra-processed food, we tend to eat more than we should. Due to the low protein, low fiber content of the food, our brain is not able to receive a signal from the gut and we don’t feel satiety. Overeating increases the GI and GL and thus, reduces the effectiveness of Metformin. To avoid overeating, we should chew our food adequately (about 25 times per bite). This will provide optimal feedback to the brain resulting in satiety. Moreover, meal sequencing (eating fibers first, then proteins and fats, and carbs last) can also reduce the glycaemic index and glycaemic load, thus enhancing satiety.

Meal timings

Many of us want to know if Metformin can be taken without food. Yes, it can be taken while fasting. But we have to make sure that the blood sugar level is stable and the dose of Metformin is adjusted according to the sugar level. However, it is best to take Metformin along with meals or just after having the meals to offset potential side-effects like nausea, vomiting, diarrhoea, stomach ache, loss of appetite and metallic taste in the mouth. 

Conclusion

Metformin is a cheap drug for symptomatic relief and is therefore touted to be a wonder drug for diabetes. However, if your objective is to reverse the disease completely, you shouldn’t rely on Metformin or any other drug for sustainable results. 

Dietary and lifestyle changes along with Metformin can give us better results in improving our blood sugar regulation and overall metabolic health. Interestingly, studies have reported that supplemental berberine, supplemental folate, B12 and alpha lipoic acid are relatively more beneficial alternatives to Metformin.

However, if you are still on Metformin, it works better when Metformin interactions with food are understood and food habits are followed accordingly. A balanced diet with an appropriate amount of micronutrients (minerals, vitamins, antioxidants) and the right macronutrient ratio reduces insulin resistance and ensures overall health. 

Sleep, stress, natural forms of movement, Circadian rhythm, gut mitochondrial health and avoiding environmental toxins should also be emphasized.

You would’ve found answers to most of your basic questions around Metformin in this article. If you still have further queries or need professional help, you can always contact us at Wellfinity.in. We are an inter-disciplinary team of healthcare professionals and functional medicine doctors who decode the root cause of disease and its pathology. We provide simple and sustainable solutions through a holistic and systems approach, using food and lifestyle as medicine.

Frequently Asked Questions

Below, is a rundown of some common queries along with answers regarding food and their interaction with Metformin..

Can I eat sugar while taking Metformin?

Natural form of sugars can be taken as a condiment or a flavour enhancer but should be restricted to a maximum of 6 tsp in a day. It is also advisable to use natural sugars (like palm jaggery) instead of refined sugars, as refined sugar have a higher GI. However, it is best to avoid all kinds of sugars and sweeteners.

Is chocolate among the foods to avoid while taking Metformin for PCOS?

Again, it is best to avoid. But if you have a sweet tooth and cannot resist, you can eat 90% dark chocolate, but in moderation. 

Can I eat Metformin and eggs together?

Yes, eggs could be eaten safely while the dose could be reduced overtime by monitoring the blood sugar levels.

Can you eat bananas with Metformin?

Metformin and bananas do not go well together. In fact, bananas are generally not recommended as healthy diabetic food. However, raw banana would be a better alternative.

What is the interaction between Metformin and diet soda?

Diet soda doesn’t contain sugar but artificial sweeteners like saccharin & aspartame. These artificial sweeteners impact the gut micro-biome and eventually increase insulin resistance, resulting in rise of blood glucose levels.

Can you drink milk while taking Metformin?

If the objective is to reverse diabetes permanently, then milk should be avoided. One can consume A2 ghee and buttermilk instead.

Can I drink lemon juice while I’m on Metformin?

Yes. Lemon juice with a little Himalayan rock salt can be consumed while on Metformin.

Can I drink coffee with Metformin?

No. When taken along with Metformin, the side effects of caffeine can be enhanced as Metformin impacts its absorption.

Can I go on a Keto diet while I’m on Metformin?

Yes, you can practice Keto diet safely but at small intervals and with frequent monitoring of blood sugar. The dose of Metformin will need to be adjusted as low carb diet improves insulin sensitivity. However, a low to zero carb diet is not necessary for diabetes. The emphasis should be on consuming complex carbs rich in fiber, rather than simple carbs that have high GI. Keto diet is effective when only for a limited period of time and in cases where the insulin production is limited or negligible as in the case of Type 1 and Type 1.5 diabetes mellitus.