 Hi guys, welcome to Sugar MD. Today we are talking about metformin. Does metformin cause kidney damage? Is metformin bad for your kidneys? Let's talk about it right now. Hi guys, I'm Dr. Ahmet Ergen. I'm an endocrinologist and a diabetes specialist. Today we are talking about the effect of metformin on kidneys. Now we have a lot of videos about metformin like here, like there, like this one, you name it. I have a lot of videos about metformin but specifically, I don't think I've ever answered the question, does metformin kill your kidneys? And I get this question a lot in my clinic and people actually come to me and say that I want to stop my metformin because it kills my kidneys. I'm like, who said that? I don't know, somebody said it, I heard it. Well, we don't go by, she said it, he said it, right? So we go by signs. Now, does metformin really cause kidney damage? It does not directly cause kidney damage. But what happens when you have a kidney failure? Now, most people cannot differentiate the chicken from the egg, right? So is it the chicken or the egg? People's kidney function go down for many reasons, right? And if they are metformin, which I would say 90% of diabetics are almost on metformin, you know, most of the time, at least in the beginning, and they blame metformin for causing the kidney damage. Well, that's not typically the case, but the reason we stop metformin when the kidney function goes below a certain level is because metformin is cleared by the kidneys. Like any drug that is cleared by the kidney, your doctor should adjust the dose or stop the medication depending on the kidney function since it is clear from the kidney. Because in excessive doses, if metformin is not cleared by your body, there's something called lactic acid doses, which can actually kill you. Now, thankfully, it is very, very rare. That's why FDA said, you know what? You know, it's so rare that we will allow metformin to be in use, to be used by the patients until GFR is below 30 kidney function. We call this GFR, glomerular filtration rate. Now, your physician may not be comfortable if your metformin is below, say, 50, you know, 60 sometimes, they will stop the metformin. But what happens when you stop metformin is if you are not doing something else and just stopping just somebody's medication and sending home, they're gonna come back with a very high blood sugar, and most of them will be. So you have to do something differently. You know, you can use another medication, you can use another supplement. Unfortunately, a lot of doctors are not very open minded when it comes to supplements because they don't study supplements at school. So when they don't know it, they say no to it, you know, but you can do your own research. And, you know, if you don't want to take metformin, you can take, you know, berberine, super berberine, dehydra berberine. There's a lot of metformin equivalent, I would say, not necessarily pharmaceutical, but at least efficacy wise, or the end result wise is similar. And you don't necessarily have to use a supplement or a medication that works like metformin, you can use just something else that can get the job done, which is lowering your blood sugar, right? So we have a lot of supplements on our website, you can check that at sugarmds.com or sugarmds.com, which you may find useful. But back to the topic, guys, metformin does not kill your kidneys. But if you're not comfortable with it, because of all the side effects that you're experiencing because of metformin. And again, we talked about metformin side effects, you know, on this video here, make sure you check that video out because it's more comprehensive. But if you're tired of the side effects, or if you don't think it's helping you anymore, it is okay to change it. But don't blame the poor drug for your kidney damage, because then if you don't know what really is causing your kidney damage, and you blame metformin, what if it is something else? What if it is your high block pressure? What if it is your like uncontrolled cholesterol? What if it is some another systemic disorder killing your kidneys? Like, you know, you need to really be open minded and just stop blaming things only one one thing. But I'm okay with stopping or reducing metformin as the kidney function goes down just to protect you from the possible lactic acidosis that happens with metformin. Again, you know, sometimes I just reduce the metformin dose when the GFR goes below 60. And I stopped the metformin if the GFR goes below 30 for sure. But again, you know, we work with the patients, you know, if you don't feel comfortable, it is okay to stop it. It's not like the only medication in the market. There are a lot of ways to do it. And if you are dedicated to change your lifestyle and do some exercise and dieting and change your lifestyle entirely, that is probably the best thing you can do. It may or may not be enough in every case is every case is different. But I think you have options. As long as you know your options and you're educated. And that's why you're watching this channel. I think you have the odds to your favor. Guys, make sure you like this video, share and give a thumbs up and we'll see in the next one. Hey guys, I hope you're enjoying this channel so far. And I hope you subscribed already. If you didn't do it. And if you did, watch this video right there. I think that will help you too.