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Metformin Effects on the Liver

by
author image Janet Renee, MS, RD
Janet Renee is a clinical dietitian with a special interest in weight management, sports dietetics, medical nutrition therapy and diet trends. She earned her Master of Science in nutrition from the University of Chicago and has contributed to health and wellness magazines, including Prevention, Self, Shape and Cooking Light.
Metformin Effects on the Liver
Businessman sitting at his desk with medicine and a glass of water Photo Credit Stockbyte/Stockbyte/Getty Images

Physicians commonly prescribe Metformin if you have Type 2 diabetes and need help controlling your blood sugar. It reduces how much glucose you absorb from food and the amount your liver produces. On rare occasions, however, Metformin causes liver dysfunction and a serious metabolic condition involving the liver. For this reason, physicians exercise caution when prescribing Metformin to patients with liver disease.

Liver Signaling

In healthy individuals, the liver produces glucose to keep blood sugar stable when you haven't eaten for several hours. Uncontrolled glucose production in the liver may cause high blood sugar in individuals with Type 2 diabetes. Researchers discovered that Metformin blocks critical enzymes involved in signaling the liver to produce glucose, thereby decreasing blood sugar levels. Their work was reported in the February 2013 edition of the journal "Nature."

Lactic Acid Production

Your muscles, brain, skin and other tissues produce a substance called lactic acid. Under normal circumstances, your liver and kidneys remove lactic acid from the blood and convert some of it to glucose. If a life-threatening metabolic condition known as lactic acidosis occurs, lactic acid levels increase faster than the liver can keep up with. Though its mechanism is unclear, Metformin causes lactic acidosis in a small segment -- up to 1 percent -- of patients, according to NYU Langone Medical Center. Almost all reported cases occurred in patients with underlying metabolic issues, such as liver or kidney disease.

Mild Liver Dysfunction

According to LiverTox, a publication of the U.S. National Library of Science drug database, Metformin may occasionally cause mild liver toxicity, characterized by minor elevations in liver enzymes. It occurs in less than 1 percent of the patients taking Metformin and usually appears within the first one to eight weeks of treatment, according to LiverTox. Liver problems usually resolve quickly once you stop taking the Metformin, according to LiverTox.

Knowing the Signs

Your liver is a critical organ that is responsible for detoxifying your blood. While Metformin influences the liver in some positive ways that result in decreased glucose output, it's capable, under rare circumstances, of negatively affecting liver function. Seek immediate medical attention if you notice signs of liver toxicity, which include weakness, fatigue or jaundice.

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