{"id":630009,"date":"2024-10-07T14:34:16","date_gmt":"2024-10-07T18:34:16","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=630009"},"modified":"2025-08-25T13:00:03","modified_gmt":"2025-08-25T17:00:03","slug":"metformin-and-liver","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/metformin-and-liver\/","title":{"rendered":"Metformin and liver health: Risks, benefits, and safety"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Diabetes is one of the most common diseases in the U.S., and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin\"><span style=\"font-weight: 400;\">metformin<\/span><\/a><span style=\"font-weight: 400;\"> (brand name: Fortamet, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/glumetza\/what-is\"><span style=\"font-weight: 400;\">Glumetza<\/span><\/a><span style=\"font-weight: 400;\">) is the <\/span><span style=\"font-weight: 400;\">most commonly prescribed diabetes medication<\/span><span style=\"font-weight: 400;\">. An estimated <\/span><span style=\"font-weight: 400;\">19 million Americans took it in 2022<\/span><span style=\"font-weight: 400;\"> to help control blood glucose levels. But because it tells the liver to reduce its glucose production, many people wonder if it affects the liver in other ways. While it might cause liver complications in very rare cases and in people with cirrhosis, it can also benefit people with certain liver diseases. We\u2019ve got all the details below.\u00a0<\/span><\/p>\n<h2 id=\"is-metformin-bad-for-your-liver\"><span style=\"font-weight: 400;\">Is metformin bad for your liver?\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Metformin isn\u2019t inherently harmful to the liver, although it does affect liver function. A \u200b\u200bbiguanide drug, it inhibits a process called <\/span><a href=\"https:\/\/www.sciencedirect.com\/topics\/neuroscience\/gluconeogenesis\"><span style=\"font-weight: 400;\">gluconeogenesis<\/span><\/a><span style=\"font-weight: 400;\">, which is how the liver turns things like amino acids and lactate into glucose. This lowers the body\u2019s blood sugar, a key component of treating diabetes mellitus.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Even though it changes how your liver functions, metformin shouldn\u2019t wear the organ down. Most metformin users can take the medication long term without experiencing harmful hepatic effects. But like most drugs, there\u2019s a slight risk of serious side effects\u2014and that includes ones involving the liver.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cMetformin is generally safe for the liver, but in rare cases, it may cause liver problems, especially in people with pre-existing liver disease,\u201d says <\/span><a href=\"https:\/\/www.medicalofficesofmanhattan.com\/our-team\/dr-yoshua-quinones\/\"><span style=\"font-weight: 400;\">Yoshua Quinones, MD<\/span><\/a><span style=\"font-weight: 400;\">, board-certified internist with Medical Offices of Manhattan and contributor to <\/span><a href=\"https:\/\/www.labfinder.com\"><span style=\"font-weight: 400;\">labfinder.com<\/span><\/a><span style=\"font-weight: 400;\">. \u201cIt can sometimes lead to a buildup of lactic acid in the blood, known as lactic acidosis, which can harm the liver.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Additionally, <\/span><a href=\"https:\/\/www.frontiersin.org\/journals\/pharmacology\/articles\/10.3389\/fphar.2022.969505\/full\"><span style=\"font-weight: 400;\">certain case studies<\/span><\/a><span style=\"font-weight: 400;\"> have shown that the use of metformin may cause liver injury (hepatotoxicity). <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S016748891630283X\"><span style=\"font-weight: 400;\">Others have suggested<\/span><\/a><span style=\"font-weight: 400;\"> that it might cause intrahepatic cholestasis\u2014a condition that reduces or blocks bile as it flows out of the liver. These adverse effects of metformin are extremely rare, but if you experience jaundice, fatigue, anorexia, pruritus, and dark urine while taking metformin, seek medical attention.\u00a0<\/span><\/p>\n<h2 id=\"benefits-of-metformin-on-the-liver\"><span style=\"font-weight: 400;\">Benefits of metformin on the liver<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Not only is metformin therapy relatively liver-safe for most people, but it might actually help improve your liver health. Here\u2019s how it might benefit people with certain conditions.\u00a0<\/span><\/p>\n<h3 id=\"non-alcoholic-fatty-liver-disease-nafld\"><span style=\"font-weight: 400;\">Non-alcoholic fatty liver disease (NAFLD)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">\u201cMetformin helps reduce fat accumulation in the liver by improving insulin sensitivity,\u201d according to Dr. David Garcia, DO, founder of <\/span><a href=\"https:\/\/polarisrejuvenation.com\/\"><span style=\"font-weight: 400;\">Polaris Rejuvenation<\/span><\/a><span style=\"font-weight: 400;\">. \u201cThis is beneficial in conditions like non-alcoholic fatty liver disease, where excess fat builds up in liver cells.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As the name suggests, non-alcoholic fatty liver disease is a condition that causes lipid accumulation in the liver, unrelated to alcohol consumption. It\u2019s the most common chronic liver disease, and certain recent studies\u2014like <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2405580821002624\"><span style=\"font-weight: 400;\">this one from 2021 <\/span><\/a><span style=\"font-weight: 400;\">and <\/span><a href=\"https:\/\/journals.lww.com\/md-journal\/fulltext\/2022\/10280\/effect_of_metformin_on_nonalcoholic_fatty_liver.17.aspx\"><span style=\"font-weight: 400;\">this one from 2022<\/span><\/a><span style=\"font-weight: 400;\">\u2014demonstrate the efficacy of metformin for the treatment of NAFLD.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cPeople with fatty liver disease often have elevated liver enzymes, indicating liver stress or damage. Metformin has been shown to help normalize these enzyme levels,\u201d Dr. Garcia says. <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3135003\/\"><span style=\"font-weight: 400;\">Some research<\/span><\/a><span style=\"font-weight: 400;\"> has associated the medication with lower levels of alanine aminotransferase (ALT).\u00a0<\/span><\/p>\n<h3 id=\"hepatitis-c\"><span style=\"font-weight: 400;\">Hepatitis C<\/span><\/h3>\n<p><a href=\"https:\/\/www.cdc.gov\/hepatitis-c\/about\/index.html\"><span style=\"font-weight: 400;\">Hepatitis C<\/span><\/a><span style=\"font-weight: 400;\"> is an inflammatory condition of the liver caused by the Hepatitis C virus (HCV). It can be a short-term or chronic illness, and when left untreated, it can cause serious liver damage, liver failure, or liver cancer.\u00a0<\/span><\/p>\n<h3 id=\"cirrhosis\"><span style=\"font-weight: 400;\">Cirrhosis<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">This is when scar tissue in the liver\u2014from hepatitis, alcoholism, or other liver diseases\u2014prevents it from functioning properly. In some cases, metformin may <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38477839\/#:~:text=Conclusion%3A%20Metformin%20use%20is%20associated,with%20diabetes%20with%20compensated%20cirrhosis\"><span style=\"font-weight: 400;\">improve the rates of mortality<\/span><\/a><span style=\"font-weight: 400;\"> and hepatic complications. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24798175\/\"><span style=\"font-weight: 400;\">One study even found<\/span><\/a><span style=\"font-weight: 400;\"> that it reduced the risk of death in patients with diabetes and cirrhosis by 57%. Per Dr. Garcia, \u201cIn some studies, metformin has been suggested to slow or prevent the progression of fibrosis (scarring) in the liver, which can lead to cirrhosis if left untreated.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But doctors are careful in prescribing it to patients with cirrhosis since it can cause some serious issues in patients with reduced liver function (see below).\u00a0<\/span><\/p>\n<h3 id=\"liver-cancer\"><span style=\"font-weight: 400;\">Liver Cancer<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Research suggests that long-term metformin use might reduce the risk of liver cancer in people with Type 2 diabetes and chronic liver diseases. For example, results from <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6108939\/\"><span style=\"font-weight: 400;\">a 2018 study<\/span><\/a><span style=\"font-weight: 400;\"> demonstrated \u201ca strong inverse association between metformin and liver cancer,\u201d and<\/span> <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5323227\/\"><span style=\"font-weight: 400;\">a systematic review and meta-analysis from 2016 <\/span><\/a><span style=\"font-weight: 400;\">found a significant improvement in survival rates for diabetic liver cancer patients.\u00a0<\/span><\/p>\n<h2 id=\"safety-and-risks-of-metformin-on-the-liver\"><span style=\"font-weight: 400;\">Safety and risks of metformin on the liver<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">For diabetic patients with otherwise healthy livers, metformin shouldn\u2019t present any serious issues. But as Dr. Quinones mentions, it\u2019s been linked to lactic acidosis in patients with pre-existing liver or kidney impairment.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This is when lactic acid builds up in the bloodstream because your kidneys and liver can\u2019t eliminate it fast enough. In mild cases (like those caused by strenuous exercise), but when lactic acid continues accumulating because of liver or kidney impairment, it can lead to organ failure and even death. It\u2019s rare, but serious enough that the FDA has included a warning on the label for people who have reduced kidney or liver function.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The typical <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin\/dosage\"><span style=\"font-weight: 400;\">metformin dosage <\/span><\/a><span style=\"font-weight: 400;\">to treat Type 2 diabetes in adults is 500\u20131000 mg twice per day. The daily dosage shouldn\u2019t exceed 2550 mg. People with renal or hepatic impairment should generally avoid metformin altogether, although <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5367241\/\"><span style=\"font-weight: 400;\">one study suggests<\/span><\/a><span style=\"font-weight: 400;\"> that doctors might reduce the daily maximum dose to 1500 mg, and potentially further.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cPatients with pre-existing liver conditions who are using metformin should take precautions, such as regularly monitoring liver function through blood tests and watching for symptoms like fatigue or jaundice\u2014a condition in which the skin, the whites of the eyes, and mucous membranes turn yellow,\u201d Dr. Quinones says. \u201cIt\u2019s also important to avoid alcohol, as it can increase the risk of liver damage and lactic acidosis.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">He continues: \u201cPatients taking metformin usually do not need regular liver function tests unless they have existing liver conditions. For those with a history of liver disease, testing is typically recommended every three to six months.\u201d It all depends on your specific condition and circumstances.\u00a0<\/span><\/p>\n<h2 id=\"the-bottom-line\"><span style=\"font-weight: 400;\">The bottom line<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Most of the time, metformin is a liver-friendly medication. There\u2019s a slim chance that it may cause liver damage, but these cases are the exception, not the rule. Even so, it\u2019s crucial to consult your doctor before taking <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/metformin\/what-is\"><span style=\"font-weight: 400;\">metformin<\/span><\/a><span style=\"font-weight: 400;\">, and be open with them about your health history, lifestyle, and preferences. That way, they can tailor your metformin treatment to your specific condition. If you have existing liver issues, your healthcare provider may steer clear of metformin and recommend another drug instead. If not, they may say you and your liver are good to go.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Diabetes is one of the most common diseases in the U.S., and metformin (brand name: Fortamet, Glumetza) is the most commonly prescribed diabetes medication. An estimated 19 million Americans took it in 2022 to help control blood glucose levels. But because it tells the liver to reduce its glucose production, many people wonder if it [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":630010,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[10298,814,12752],"coauthors":[8861],"class_list":["post-630009","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-diabetes","tag-drug-interactions","tag-medication-side-effects","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.0 (Yoast SEO v27.0) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Is metformin bad for your liver? Risks and benefits explained<\/title>\n<meta name=\"description\" content=\"While metformin is generally safe for the liver, rare complications may arise, particularly in people with existing liver conditions. Learn about the drug\u2019s risks, benefits, and how it can help with liver diseases like NAFLD and cirrhosis.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.singlecare.com\/blog\/metformin-and-liver\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Metformin and liver health: Risks, benefits, and safety\" \/>\n<meta property=\"og:description\" content=\"While metformin is generally safe for the liver, rare complications may arise, particularly in people with existing liver conditions. 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