so my gyn started me on regular metformin 500mg twice a day after my HOMA-IR came back at 3.4 last month. by day 3 i was doing math on which meals were close enough to a bathroom. day 4 i just quietly stopped the evening dose without telling anyone, which i know is not the move. called and asked if there’s a real difference between regular and the extended release version.
she said ER releases slower so it doesn’t hit the gut all at once, switched me last week. week one comparison, same person, different formulation:
- regular: nausea within 45 min of dosing, cramping mid afternoon, two days i skipped lunch on purpose because i knew what was coming
- ER: nausea maybe once in 7 days, no cramping i’ve noticed, only downside is it costs more and my pharmacy had to special order it only other variable is i now take ER with dinner instead of an empty stomach in the morning, so i can’t fully separate formulation from timing. logging both in careclinic actually helped here, i log the dose time then flag GI symptoms after so i can see the actual gap instead of just remembering “that one day was bad.” still not sure if the ER is doing anything for the insulin resistance itself yet, too early for another fasting insulin check. but my gut is functioning like a normal person again which counts for something.
anyone start on regular and get bumped to ER, how long before things settled for you. and did your doctor start you low on ER or jump straight to a higher dose? mine has me at 500mg ER once daily which feels low next to the twice daily regular, but maybe that’s the whole point of the slower release.