Will metformin harm the liver and kidneys❓❓❓

Metformin was originally just a blood sugar lowering drug, but it was later
discovered to have many other effects, such as anti-aging, anti-cancer, etc., and it has been widely discussed (the medication should follow the doctor's guidelines and do not use it indiscriminately). Although with the advent of SGLT2 inhibitors, metformin has been replaced by SGLT2 inhibitors to a certain extent, metformin is still the drug of choice for type 2 diabetes in general. The vast majority of drugs will have some damage to the liver or kidneys. Many people would also think that metformin also harms the liver and kidneys. Will metformin harm the liver and kidneys?

Why do many people think that metformin harms the liver and kidneys?

In fact, the doctor prescribes oral hypoglycemic drugs for a newly diagnosed type 2 diabetes patient. According to the guidelines, if there are no contraindications, metformin should be recommended first. At this time, the doctor will ask the patient if he has any problems with the liver and kidney function, and may even check the liver and kidney function. As a result, many patients think that metformin will harm the liver and kidneys, so doctors will ask about their liver and kidney function. Of course, the doctor will explain to the patient that it is not that metformin hurts the liver and kidneys, but that patients with poor liver and kidney function may not be suitable for this medicine. However, doctors often do not have much time to explain the reasons to patients in detail, and most patients often fail to understand this highly specialized content. Therefore, patients will only remember the first impression that metformin may harm liver and kidney function. Then pass on the impression they remembered to others.

Why do doctors ask about liver and kidney function?

In fact, metformin neither hurts the liver nor the kidneys, and even some studies have shown that metformin can improve the liver and kidney function of some patients in some cases. So, why should doctors pay special attention to the patient's liver and kidney function when prescribing metformin? 

• Renal function: Metformin is mainly excreted from urine in its original form and cleared quickly. Therefore, metformin itself does not damage the kidneys. Since the launch of metformin, a large number of clinical and practical data accumulated in the past 100 years have also proved this point. Therefore, metformin does not harm the kidneys. However, in patients with renal insufficiency, the renal clearance of metformin decreases and the elimination half-life is prolonged, which leads to an increase in plasma metformin concentration and an increased risk of lactic acidosis. Therefore, patients with renal insufficiency need to adjust the dosage or discontinue according to the renal function when using metformin.
• Liver function: Metformin is not metabolized by the liver in the body, nor degraded in the body, and does not require liver detoxification, so it will not increase the burden on the liver, and it has no liver toxicity. It will not cause liver damage when used within the recommended dose. Therefore, metformin does not hurt the liver. The reason why doctors ask about liver function before prescribing metformin is that severely impaired liver function will significantly limit the patient's liver's ability to clear lactic acid. Therefore, the guidelines recommend that serum transaminase exceeds 3 times the upper limit of normal or severe liver insufficiency Of patients should avoid the use of metformin. 

Therefore, it is not that metformin harms liver and kidney function, but that the patient's existing liver and kidney function problems may affect the use of metformin.

Can't you take metformin if you have problems with liver and kidney function?

Not all patients with liver and kidney problems cannot use metformin. For example, for patients with type 2 diabetes who have normal renal function but have a small or large amount of albuminuria, metformin is still the first choice. For another example, patients with type 2 diabetes with hepatitis B or cirrhosis can also take metformin if they do not have severe liver insufficiency. However, it needs to be used under the guidance of a doctor, and follow the doctor's advice for regular liver and kidney function monitoring. Metformin has more than 60 years of global clinical application experience and its safety has been fully tested. Years of clinical studies have fully confirmed that metformin has a strong anti-diabetic effect, weight loss, cardiovascular protection, blood lipid improvement, tumor risk reduction, anti-aging, anti-inflammatory, improved intestinal flora, safety and tolerance, and high cost-benefit ratio and other advantages. This also makes metformin widely used by doctors. 

Metformin does not increase the risk of hypoglycemia when used alone, and it does not harm the liver or the kidneys. Long-term use does not increase the risk of hyperlactic acidemia or lactic acidosis. A common side effect of metformin is gastrointestinal discomfort. Metformin sustained-release tablets can solve this problem well.