Can You Take Metformin If You Aren’t Diabetic?

Metformin is one of the most well-known medications to treat diabetes. 

But you may not know that metformin can be used for conditions other than diabetes.

Keep reading to learn metformin’s off-label uses for non-diabetics, the benefits of metformin for non-diabetics, and what happens if you take metformin and don’t need it.

Metformin’s off-label uses for non-diabetics

Metformin also has several off-label uses. “Off-label” means that the FDA has not approved the drug for a specific use. 

Metformin is sometimes used off-label in conditions such as:

1) Gestational diabetes 

Gestational diabetes is diabetes that happens during pregnancy and is linked to babies being born with congenital malformations. 

High levels of blood glucose can impair both the mother’s and fetus’s health. More than 8% of pregnant mothers in America are reported to have gestational diabetes in 2021. 

In gestational diabetes, metformin is widely recommended as an alternative to insulin because it carries fewer risks for adverse effects. 

Metformin works well to decrease blood glucose during pregnancy to prevent complications from gestational diabetes, such as:

• High blood pressure or preeclampsia 
• Preterm delivery
• Birth trauma
• Stillbirth

2) Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome, or PCOS, is one of the most common causes of female infertility. In America, more than 5 million women of reproductive age are affected by PCOS. 

PCOS is associated with insulin resistance, which means that the body is not responding to insulin effectively. 

Hence, people with PCOS have a higher risk of developing diabetes. PCOS also increases your risk of developing other health problems, including heart diseases, high blood pressure, high cholesterol levels, stroke, and mental health illnesses. 

Metformin has been used to treat PCOS as early as 1994. Recent studies showed that metformin works to treat PCOS by: 

• Increasing the body’s sensitivity toward insulin
• Reducing the production of male hormones 
• Increasing the production of female hormones

Metformin can help to normalize your menstrual cycle by regulating your hormone levels. It can also increase the chances of pregnancy in women with PCOS, which helps to treat the infertility aspect of the disease.

3) Prevention of type 2 diabetes 

The risk of developing type 2 diabetes mellitus is linked to several factors, such as:

• Being overweight or obese
• History of gestational diabetes
• Underlying health conditions such as high blood pressure or high blood cholesterol levels
• Family history of diabetes
• Being sedentary or physically inactive

The development of type 2 diabetes can take years. In the meantime, your healthcare provider may pick up certain signs and symptoms during routine health checks and tests. 

If you are at risk of getting type 2 diabetes or if you are prediabetic, your doctor may prescribe metformin to prevent it. 

4) Weight gain or obesity 

Obesity is increasingly common, affecting more than 3 billion people around the world. Roughly 2 out of 3 Americans are considered overweight or obese. 

Obesity is recognized as a chronic disease that requires a long-term and multifaceted approach. 

The management of obesity includes medicine and lifestyle modification. Sometimes, surgical interventions are recommended.

In the U.S., only a handful of drugs are approved by the FDA for the treatment of obesity, such as: 

• Phentermine/topiramate (Qsymia), 
• Lorcaserin (Belviq)
• Naltrexone/bupropion (Contrave)
• Liraglutide (Saxenda)
• Semaglutide (Wegovy)

However, these drugs have not done very well in the U.S. marketplace, likely due to poor acceptance by both patients and doctors. 

Though not approved by the FDA as an obesity medication, metformin has been used as an off-label drug, especially for patients with impaired fasting glucose. 

Metformin has been seen to induce weight loss in overweight patients, even in those without glucose abnormalities.

Metformin can help in weight loss by:

• Increasing insulin sensitivity levels
• Reducing the release of fats into the blood and liver
• Increasing removal of fats in the body
• Regulating appetite
• Increasing caloric expenditure

Obesity is a tricky problem to tackle as it is a multifactorial and complex disease. Everyone’s weight loss journey is different. 

If you have any concerns about losing weight or obesity, you should consult your doctor to learn about metformin and weight loss. 

Some helpful questions to ask your doctor include:

1. Am I overweight?
2. What is my ideal weight, and what is a reasonable weight loss goal for me?
3. What would be the best diet and exercise program to help me lose weight?
4. Could you refer me to a dietitian to help me to lose weight?
5. Do I need medication to help me lose weight?

5) Weight gain caused by antipsychotic medications

Some antipsychotic drugs are known to cause weight gain and other metabolic derangements. 

Antipsychotic drugs, such as olanzapine and clozapine, may affect weight more than other drugs. This is due to the way they affect your appetite control and metabolism. 

Weight gain associated with antipsychotic medications is more prominent during the initial phase of therapy. 

Studies have shown that metformin can help to counter weight gain and impairment in blood glucose regulation associated with antipsychotic drugs. 

Other methods to reduce weight gain caused by antipsychotic medications include diet modification, exercise programs, and cognitive and behavioral strategies. 

Is metformin safe for non-diabetics?

Yes, as long as your doctor sees an indication and has examined you for any contraindications such as liver diseases, kidney problems, heart problems, or a history of lactic acidosis, metformin is generally safe to use. 

You would still require a prescription from your healthcare provider to take metformin. While on metformin, your doctor may monitor certain blood parameters, such as your kidney function and serum vitamin B12 levels. 

If you have any concerns about taking metformin, you should consult your healthcare provider. 

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Will doctors prescribe metformin if you are not diabetic?

Doctors may prescribe metformin even if you do not have diabetes as long as there is an indication for it. 

They may also take a history and run some routine tests on you to ensure that there is no contraindication for you to take metformin. 

If you have any concerns about taking metformin, you should consult your healthcare provider.

What are the benefits of metformin for non-diabetics?

Some of the benefits of metformin for non-diabetics include:

• Prevention of cardiovascular disease
• Weight loss
• Decreased blood pressure
• Decreased male hormone levels in women with PCOS
• Regulation of menses in women with PCOS
• Increase the potential for pregnancy in women with PCOS

What happens if you take metformin and do not need it?

Metformin is a fairly safe and well-tolerated drug. However, you should not take any medications if you do not need them. 

Taking metformin when you do not need it may cause a waste of supply and money. 

One of the rare but serious adverse effects of metformin use is lactic acidosis, a condition where lactic acid builds up in your blood. 

Hence, metformin should not be prescribed to people with a history or high risk of developing lactic acidosis.

Another side effect of metformin use includes vitamin B12 deficiency, especially with long-term use. 

Some of the signs of vitamin B12 deficiency include fatigue, numbness and weakness in your limbs, mouth ulcers, visual disturbances, and cognitive impairment. 

In a nutshell, if you do not need metformin, you should not take it. If you have any qualms about taking metformin, you should consult your healthcare provider.

Does metformin affect your blood sugar if you are not diabetic?

Metformin alone generally does not cause low blood sugar or hypoglycemia. However, the risk of developing hypoglycemia is increased if metformin is combined with other drugs such as: 

• Antihypertensives like angiotensin-converting enzyme inhibitors (Lotensin, Captopril, Vasotec)
• Other antidiabetic medications such as GLP-1 receptor agonists (Ozempic), sulfonylureas (Micronase, Amaryl, Diamicron), and insulin 
• Salicylates such as aspirin

The above list is non-exhaustive. If you have any questions about what other drugs can affect your blood sugar when taken with metformin, you should consult your doctor or pharmacist. 

Potential future uses of metformin

Metformin has been studied by scientists and doctors around the world for its potential in other uses, such as neuroprotection. 

Though the following properties of metformin require more extensive research, here are some interesting potential uses of metformin:

• Reducing the risk of dementia and improving cognitive function – metformin has been found to reduce the risk of cognitive decline and prevention of dementia in patients with diabetes mellitus
• As an anti-cancer agent – metformin has been studied for its anti-cancer properties, especially in cases of pancreatic and colorectal cancers. 
• As an anti-aging agent – there is a potential for metformin to be used as an anti-aging agent though more extensive research is required.

Conclusion

Although metformin is approved by the FDA to treat type 2 diabetes along with diet and exercise, it is often used off-label to treat other conditions. 

In non-diabetic patients, metformin is sometimes prescribed to treat PCOS, obesity, and weight gain caused by antipsychotic medications. It is also used in the prevention of diabetes. 

Some of metformin’s benefits include cardioprotection and neuroprotection. There is ongoing research to investigate metformin’s potential as an anti-aging and anti-cancer agent. 

Metformin is a generally safe and cheap drug, making it very desirable. However, it is important to note that metformin alone is not as effective in treating the indicated conditions. 

It should be used along with diet modification and physical exercise to achieve its desired outcomes. 

If you have any questions regarding the use of metformin and whether it is suitable for you, you should consult your healthcare providers.

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