Alcohol & Metformin: Interactions & Side Effects

Alcohol and Metformin Risks

Additionally, there are dangerous health effects when combining alcohol and Metformin. People with diabetes who drink while using Metformin are at risk of the following conditions:  

Lactic Acidosis: 

Lactic Acidosis is one of the most dangerous conditions when taking Metformin and using alcohol. This dangerous condition occurs when the Ph balance drops and lactic acid levels rise. This increase in acidity can cause a life-threatening reaction. Lactic Acidosis is rare on its own; 1 in 30,000 people develop the condition. However, when combined with alcohol, the risks increase significantly. For this reason, the Food and Drug Administration has issued a black box warning on Metformin about the dangers of Lactic Acidosis and alcohol-use disorder. 

If you have any of these symptoms, call 911 immediately. 

Signs of Lactic Acidosis:

• Stomach cramps.
• Diarrhea.
• Fast, shallow breathing.
• Rapid, irregular heartbeat.
• Muscle seizures.
• Intense weakness.
• Low blood pressure.
• Nausea.
• Vomiting.

Hypoglycemia: 

Drinking alcohol and having diabetes can cause some complications. Alcohol alone can cause blood sugar to drop. Low blood sugar is known as the condition of hypoglycemia. The purpose of Metformin is to lower blood sugars. The combination of alcohol and Metformin can cause dangerously low blood sugar levels. If blood sugars drop too low, it can cause some individuals to pass out or lose consciousness. 

Symptoms of Hypoglycemia: 

• Muscle weakness.
• Sadness.
• Anxiety.
• Extreme fatigue.
• Dizziness.
• Sleep disturbances.
• Headache.
• Pale skin.
• Rapid heartbeat.
• Confusion and disorientation.
• Slowed, shaky movement.
• Blurry vision.
• Cold sweats.
• Poor concentration. 

B12 Deficiency: 

Vitamin B12 is an essential nutrient for cardiovascular and neurological health. Metformin and Alcohol individually block the absorption of B12, which can lead to significant health challenges. If you are experiencing any of the following symptoms, please seek emergency medical services. 

Symptoms of B12 Deficiency:

• Confusion.
• Numbness.
• Tingling of hands/feet.
• Neuropathy.
• Impaired memory.
• Dementia.
• Headache.
• Inability to concentrate.

Treatment may include immediate detox of alcohol and high doses of B12 vitamins injected. The goal is to help reduce damage to the brain from lack of nutrient absorption.

Managing Diabetes While Drinking Alcohol

Should you drink alcohol if you have diabetes? The answer is no; you shouldn’t drink alcohol when you have diabetes when numerous risks are involved, especially excessive drinking. However, if you are going to have a drink, here are some guidelines to follow to help you be as safe as possible. 

1. Talk to your doctor. Ask about any medications you are taking and if there are any adverse side effects from combining alcohol and your prescriptions or if you are at risk for any of the conditions mentioned earlier. It may mean adjusting your meds, knowing what types of drinks you can have, and what time would be best. 
2. Talk to your friends/loved ones. It would be best if you never drank alone when you have diabetes and have a risk of hypoglycemia. Understand what it looks like to be in a hypoglycemic state and how it can imitate intoxication. There is a chance you will not know if you are hypoglycemic, so it is best to rely on a loved one to look for the signs for you. 
3. Don’t drink alcohol on an empty stomach. Eating a meal with complex carbs will help your body manage the alcohol and prevent the risk of hypoglycemia. 
4. Know your alcohol limits. Keep track of how much alcohol you drink, the alcohol content, sugar/carb content, and the times you are consuming alcohol. 
5. Check your sugar levels frequently. Check before, while you are drinking, and after you have had alcohol. Check as soon as you wake up and before you go to bed. Do not drink if your blood sugar is low. 
6. Be prepared. Have ways to check your blood sugar, a snack, water, and people with you.