Foods To Avoid While Taking Metformin
By Dr. Vishesh Bharucha +2 more
Medically reviewed by Dr. Vishesh Bharucha
Last updated: Jul 8, 2025 Published on: Oct 10, 2023
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By Dr. Vishesh Bharucha +2 more
Table of Contents
Did you know that some foods can mess with your medicines? This can happen even with everyday foods like grapefruit or coffee. It is important to avoid such food-drug interactions to prevent any adverse events and maintain the effectiveness of the medicine1.
In this article, we’ll discuss about the food interactions which can occur with the drug, metformin. Metformin is a common medicine prescribed for the management of Type 2 Diabetes. We’ll talk about Metformin’s intricate relationship with foods, when to take it, and more2.
Did you know?
Metformin is a drug that helps bring down your blood sugar levels. It is mainly used to manage Type 2 diabetes3.
Metformin is available in different doses and forms. These include tablets, oral solutions, and even extended-release tablets. Your doctor will prescribe the right form and dosage based on your health condition and lifestyle.
Mostly, Metformin is stored at room temperature. It should be placed away from moisture or heat. Also, keep it out of reach of children.
Metformin mainly works by reducing glucose production by the liver. By doing so, it helps lower overall blood sugar levels. It also improves the body’s response to insulin and helps cells use insulin better, making it easier for them to take in glucose from the blood4,5. If you have type 2 diabetes, your healthcare provider may prescribe Metformin.
Certain food items and alcohol can affect Metformin’s effects6,7. We will discuss this in detail in the coming sections.
In my experience, I have observed that use of metformin might lead to vitamin B12 deficiency. It is important to be aware of the potential risk and consider regular monitoring of your vitamin B12 levels, as well as discussing the need for supplementation with your healthcare provider13.
Dr. Siddharth Gupta, BAMS, MD (Ayu)
Food choices play a big role in managing type 2 diabetes. While they don’t directly counteract Metformin’s actions, overeating or bad food choices can increase its efforts to control blood sugar.
Certain foods can get in the way of Metformin. These are processed carbohydrates, saturated fats, trans fats, and too much sodium. While not opposing Metformin directly, they can spike up your glucose and insulin levels.
Detailed list of Foods to Avoid
Saturated fats can also make you more insulin resistant, which can make weight loss and blood sugar management more difficult. Fatty foods can delay gastric emptying and contribute to, prolonged postprandial hyperglycaemia (high blood sugar levels after food), which can be problematic over the long term. Sodium does not directly affect blood glucose or Metformin, but it increases cardiovascular risk and blood pressure, which are comorbid concerns in diabetes8. Also, some studies6 have found that a high-fat, high-calorie diet can slow the absorption of metformin.
So, although these foods don’t directly interfere with Metformin’s pharmacologic action, they can oppose its intended effect by raising blood glucose levels, adding to Metformin’s workload.
Some foods can make it hard for Metformin to work. Yet, some others support Metformin’s actions. These are complex carbohydrates, healthy fats, fibre, lean proteins, and select fruits and vegetables9.
Detailed List of Beneficial Foods
Consuming these foods along with Metformin can support your blood sugar balance. Plus, it can help keep your weight in check. But please note that not all fruits are low glycaemic. Portion control and glycaemic index should be considered especially if you are diabetic. Your doctor can guide you best on what type of foods you can eat based on your blood sugar control.
Based on my experience, I have found that metformin typically does not cause low blood sugar (hypoglycaemia) when taken alone. However, it is important to be cautious when combining metformin with other diabetes medications like insulin or gliclazide, as these combinations may increase the risk of hypoglycaemia13.
Dr Rajeev Singh,BAMS
Food choices matter a lot in diabetes, especially if they interact with drugs like Metformin. Here are some specific food items that can affect metformin.
Grapefruits are beneficial but found to interact with many drugs including Metformin. An old study on non-diabetic rats showed grapefruit juice might trigger a potentially fatal condition called lactic acidosis when mixed with Metformin10. Lactic acidosis is a rare but serious side effect of metformin, typically in patients with renal impairment or other risk factors.
Grapefruit inhibits CYP3A4 enzymes, affecting drugs metabolized by this pathway (e.g., statins, calcium channel blockers). However, Metformin is not significantly metabolised by CYP enzymes, including CYP3A4. So, this seems to be an overemphasised claim. Yet, we don’t have any human case studies indicating a similar reaction with Metformin and grapefruit so far. More research is needed here.
Alcohol consumption may also interact with Metformin’s action. Taking alcohol and Metformin together may cause lactic acidosis, a rare but serious condition7. Still, this could happen only if you drink alcohol heavily and regularly. It can also swing your blood glucose levels both ways – high (hyperglycaemia) and low (hypoglycaemia). Moderate drinking usually isn’t problematic unless you have kidney or liver issues. (Note that moderation as per guidelines is termed as no more than one drink per day, for women, and for men, a moderate amount is no more than two drinks per day.)
Drinking alcohol regularly can also exacerbate kidney and liver issues, so talk with your doctor if you suffer from non-alcoholic liver disease or kidney disease before consuming alcohol with Metformin.
Wondering how to take metformin the right way? Let’s see how and when to take Metformin for best results.
When taking Metformin, timing is important for minimizing side effects (like GI upset) and optimizing blood glucose control. Normally, immediate-release tabs are taken twice a day while extended-release tabs are taken once daily. Keeping to this schedule helps manage diabetes effectively.
Taking Metformin with meals can cut down its side effects like gas, bloating, nausea, and diarrhoea. Extended-release Metformin is usually taken with the evening meal to reduce gastrointestinal side effects and enhance overnight control.
Metformin, a widely prescribed medication for managing Type 2 diabetes, offers significant benefits, but users should be aware of potential side effects. Commonly reported metformin side effects include gastrointestinal symptoms like nausea, diarrhoea, and abdominal discomfort, although these often subside with continued use.
Continued use often leads to a gradual diminishment of these symptoms.
Metformin Side Effects in Females:
Metformin Side Effects in Males:
If your health changes or you spot signs like muscle pain, feeling tired, abdominal complaints, uneven heartbeats, or problems in breathing, get immediate medical help. These could be early signs of lactic acidosis. It’s a serious but rare side effect of Metformin.
When taking metformin for PCOS, it’s advisable to be mindful of certain foods. Limiting high-carbohydrate and sugary foods can enhance its effectiveness. Avoid excessive alcohol consumption and consider reducing intake of processed foods. Incorporating a balanced diet with whole grains, fruits, and vegetables is beneficial. Consulting with a healthcare professional for personalized dietary recommendations is essential for optimal PCOS management with metformin.
Another interesting aspect of Metformin is its effect on body weight. Over time, people using Metformin have reported a slight weight loss. But remember, this isn’t guaranteed for all users.
Researchers have noticed a link between Metformin and weight loss, which might be due to reduced hunger cues12. However, metformin’s weight loss effect is thought to be multifactorial, including improved insulin sensitivity, decreased hepatic glucose production, possible mild appetite suppression, and effects on gut hormones like GLP-1. But keep in mind, weight management isn’t only about medicine. It’s also about eating healthy and exercising regularly.
Long-term weight loss linked with Metformin varies from person to person and may not be as much as you’d want. An average drop of around six pounds after a year of treatment is seen. To kickstart and keep up the weight loss, diet tweaks and exercise are crucial elements as well.
Simply put, no. Metformin is specially made for patients with Type 2 diabetes. Though it has shown results in helping non-diabetic obese patients lose weight, this is an ‘off-label’ use and not approved by the FDA for non-diabetics. However, metformin is sometimes used off-label in PCOS and prediabetes with some evidence of benefit.
Dealing with food-drug interactions can be hard. However, understanding your body’s specific reactions can help keep good health and make your medication work best.
In short, matching wise food habits with Metformin can boost its effects in controlling Type 2 diabetes while making the wrong choices can increase its workload. Often, it’s about learning the potential interactions and making small food swaps in our daily meals. If you have diabetes, it’s best to discuss with your doctor and design the best diet plan that is suitable for your condition and does not impact your medications.
Moreover, simple things like watching your salt intake, staying hydrated, and exercising regularly can have a beneficial impact on your overall health. Remember, tiny tweaks in your diet and lifestyle can yield big health gains over time!
As of now, there’s not enough proof to say coffee messes up Metformin. But remember, too much of caffeinated drinks might cause hydration issues. So, drink moderately.
Metformin may cause nausea, and if you also take insulin, Metformin can cause low blood sugar levels. This can be dangerous if you’re unable to keep liquids down, so call your doctor immediately if this is the case and you’re having trouble treating low blood sugars.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. However, studies have shown that Metformin passes into breast milk in very low amounts but is generally considered compatible with breastfeeding. The American Academy of Paediatrics (AAP) and other authorities regard Metformin as usually safe during lactation. However, consult a doctor who will weigh the potential benefits against the potential risks before prescribing this medication while breastfeeding.
You may notice improvement in your blood glucose control in 1 to 2 weeks, but the full effect of blood glucose control may take up to 2 to 3 months. Ask your doctor if you have any questions about this.
Health pros suggest a low-carb, high-protein breakfast might work well with Metformin. Think eggs, lean meats, whole grains, and fresh fruits. It gives you main nutrients, lowers glycaemic spikes, and keeps you full till lunchtime.
Metformin-induced diarrhoea is thought to result from its impact on the gastrointestinal tract, causing increased fluid secretion and alterations in gut motility. Metformin increases intestinal glucose and bile acid concentrations, which can cause osmotic effects leading to increased fluid retention in the bowel. It may also alter gut microbiota and serotonin pathways affecting motility. Consultation with a healthcare professional is recommended for those experiencing persistent or severe diarrhoea while using metformin.
Metformin typically does not cause hypoglycaemia (low blood sugar) when used as a monotherapy. However, in combination with other diabetes medications that can lower blood sugar, there may be a higher risk of hypoglycaemia. It’s essential to follow healthcare provider guidance and monitor blood sugar levels regularly.
Metformin is occasionally prescribed during pregnancy for gestational diabetes but should only be used under the guidance of a healthcare professional. Individual health considerations and potential risks to the mother and foetus need to be carefully evaluated before making any decisions about medication during pregnancy.
While metformin is generally considered safe for the kidneys, there’s a rare risk of lactic acidosis, a serious condition. It’s crucial for individuals with kidney issues to consult with a healthcare professional to determine the appropriateness of metformin and to monitor kidney function regularly.
Yes, metformin is known to reduce insulin resistance, a key factor in type 2 diabetes. It improves insulin sensitivity, allowing cells to better respond to insulin and promoting better regulation of blood sugar levels.
No, metformin is not habit-forming. It is an oral medication commonly prescribed to manage type 2 diabetes and does not possess addictive properties. Always follow your healthcare professional’s guidance on medication use.
Metformin for prediabetes can be effective in slowing or preventing the progression from prediabetes to diabetes. However, individual responses vary, and it’s essential to consult with a healthcare professional for personalized advice on its use and to incorporate lifestyle changes for comprehensive prediabetes management.
Stopping metformin suddenly can mess with your blood sugar. Always talk to your doctor before making any changes to your medication, so they can help you do it the right way.
Metformin is generally considered safe for the liver, but in rare cases, it may cause an increase in liver enzymes. Regular monitoring and consultation with a healthcare professional are recommended to ensure the medication’s safety and address any potential concerns.
Signs that metformin is working include stable blood sugar levels, better insulin sensitivity, and reduced symptoms related to the medical condition. Regular check-ups with a healthcare professional help track and confirm its effectiveness for each individual.
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
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