Beer And Metformin: Is One Drink Okay?

Metformin is a medication used to treat Type 2 diabetes and occasionally prediabetes. It is one of the most commonly prescribed medications in the US, with nearly 20 million Americans taking it in 2021 alone. The drug works by helping the body control its blood sugar levels, also known as blood glucose levels. While it is generally okay to drink in moderation while taking metformin, excessive alcohol use can increase the risk of several serious side effects, including lactic acidosis and hypoglycaemia, both of which can be life-threatening.

Metformin and alcohol can cause hypoglycaemia

Metformin is a medication that helps people manage type 2 diabetes and occasionally prediabetes. It is one of the most commonly prescribed medications in the US, with nearly 20 million Americans taking it in 2021 alone.

Metformin helps the body control its blood sugar levels, or blood glucose levels. This is important for those with type 2 diabetes because they experience insulin resistance, where the body's cells don't respond well to insulin. Insulin is a hormone that controls blood glucose levels. Metformin helps prevent insulin resistance by stopping the liver from producing as much glucose and improving the body's insulin sensitivity.

While it is generally okay to drink in moderation while taking metformin, excessive alcohol consumption can increase the risk of several serious side effects, including hypoglycaemia, or low blood sugar. This is because alcohol puts a lot of stress on the liver and can interfere with its ability to release glucose. Metformin also slows down the liver's ability to release glucose, so alcohol and metformin can be a dangerous combination.

Symptoms of hypoglycaemia include shaking, sweating, a fast heartbeat, dizziness, hunger, headaches, and irritability. It can be a medical emergency and requires urgent treatment. If you are experiencing any of these symptoms, seek medical attention immediately.

It is important to be aware of how alcohol interacts with your medication. If you are taking metformin, speak with your doctor about how much alcohol is safe to drink.

Lactic acidosis is a rare but serious side effect

Lactic acidosis occurs when the body switches to anaerobic, or oxygen-lacking, processes to produce energy during strenuous or prolonged activity. This type of glucose breakdown produces lactic acid, which further breaks down into lactate. The liver then processes this lactate into glucose. However, if lactate does not clear from the bloodstream quickly enough, it can build up, leading to increased blood and muscle acidity, and in turn, lactic acidosis.

The risk of developing lactic acidosis from taking metformin alone is quite rare. However, when combined with alcohol consumption, the chances of this occurring increase significantly. The U.S. Food and Drug Administration (FDA) has issued a black box warning—the most severe warning—on metformin packaging about the risk of lactic acidosis, with alcohol use disorder listed as a risk factor.

The symptoms of lactic acidosis can be subtle and nonspecific, such as gut pain and sleepiness, and may be mistaken for signs of alcohol consumption. However, severe lactic acidosis presents with more intense symptoms that appear quickly. These can include unusual muscle pain, stomach discomfort, nausea, cramping, and sharp pains. If left untreated, lactic acidosis can lead to organ failure and death. Therefore, it is crucial to seek immediate medical attention if you experience any of these symptoms while taking metformin and drinking alcohol.

Alcohol can worsen vitamin B12 deficiency

While it is generally okay to drink in moderation while taking metformin, excessive alcohol consumption can have serious health consequences, including worsening vitamin B12 deficiency. Vitamin B12 is an essential nutrient that plays a key role in maintaining cardiovascular and neurological health, as well as the production of healthy red blood cells. Alcohol consumption, even in moderate amounts, can affect the absorption of vitamin B12 in the body.

Alcohol irritates the mucosal linings in the stomach and intestines, leading to a condition called gastritis, which further reduces the absorption of vitamin B12. Additionally, alcohol prevents the body from fully utilizing absorbed nutrients by altering their transport and storage. Gastritis also reduces the production of hydrochloric acid, leading to the growth of intestinal bacteria that consume vitamin B12, resulting in even lower levels available for the body's use.

Chronic alcohol consumption can also lead to liver damage, compromising the organ's ability to store and release vitamin B12 efficiently. This deficiency can increase the risk of liver disease and inflammation, also known as cirrhosis. Vitamin B12 is primarily stored in the liver, and its deficiency can have far-reaching health implications.

The symptoms of vitamin B12 deficiency can be subtle and slow to progress, but they can lead to serious health risks over time. These symptoms include numbness or tingling in the hands and feet, inability to concentrate, pale or yellow-tinged skin, weakness and fatigue, blurred or disturbed vision, and mood changes.

If you suspect that you may have a vitamin B12 deficiency, it is important to consult a healthcare professional for proper diagnosis and treatment. Treatment options typically include dietary changes, vitamin B12 supplements, or injections to correct the deficiency and restore normal levels.

Gastrointestinal issues are common side effects

Alcohol can worsen these gastrointestinal issues. Alcohol itself can cause nausea, vomiting, and diarrhea, and when combined with metformin, these feelings can be intensified.

The extent of alcohol's influence on the side effects of metformin depends on the amount of alcohol consumed and individual health factors. Generally, the more alcohol consumed and the faster the ingestion, the greater the risk of interactions becomes.

It is important to note that metformin is a medication that helps manage type 2 diabetes. It works by improving insulin sensitivity and reducing sugar levels in the bloodstream. Metformin helps prevent high blood sugar levels, which can cause health complications such as nerve damage and blood vessel damage.

While it is generally okay to drink in moderate amounts while taking metformin, excessive alcohol use can increase the risk of several serious side effects. This includes conditions like lactic acidosis and hypoglycemia, which can be life-threatening and require immediate medical attention.

Metformin is not recommended for heavy drinkers

Metformin is a medication used to help people manage type 2 diabetes and, occasionally, prediabetes. It is one of the most commonly prescribed medications in the US, with nearly 20 million Americans taking it in 2021 alone. Metformin is also prescribed off-label for weight loss in those with type 2 diabetes or prediabetes, and to treat insulin resistance related to PCOS.

Metformin and alcohol can interact with each other and cause harmful, and sometimes life-threatening, effects. Therefore, it is not recommended for people taking metformin to engage in heavy drinking. Heavy drinking is defined as eight or more drinks per week for women and fifteen or more for men, or binge drinking, which is four or more drinks on a single occasion for women and five or more for men.

When a person drinks alcohol, their liver has to work hard to process it, which can lead to the liver becoming tired and releasing less glucose. Long-term alcohol use can also make cells less sensitive to insulin, leading to increased blood sugar levels. Alcohol consumption can also damage the liver, especially when consumed in excess, reducing the liver's ability to produce and regulate glucose.

When metformin is introduced, it also affects the liver by reducing the amount of glucose it produces. This means that when metformin and alcohol are mixed, there is a greater risk of harmful effects, such as hypoglycaemia (low blood sugar) and lactic acidosis (a build-up of lactic acid in the body). These conditions can be life-threatening and require immediate medical attention.

In addition, both metformin and alcohol can contribute to a decrease in vitamin B12 levels, which can lead to health problems over time. Alcohol can also exacerbate gastrointestinal side effects of metformin, such as nausea, vomiting, and abdominal discomfort.

Therefore, it is important for anyone taking metformin to talk to their doctor about alcohol consumption and to avoid heavy drinking.

Frequently asked questions