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  • Writer's pictureDr. Brian Lum

Natural Alternatives To Metformin

Updated: Jun 7, 2023

Whether your goal is to get off pharmaceutical medications or you are alarmed at the FDA recall of metformin[1] or the study that warns of a 40% increase in birth defects when men take metformin shortly before conception, [2] many are looking for natural, effective alternatives.

Fortunately, there are ways that some patients can safely transition to natural, high-grade supplements with similar benefits of metformin without the side effects.

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What Does Metformin Do?

Metformin is currently the first-line therapy for type 2 diabetes and is the most prescribed blood sugar lowering medicine in the world.

It was first prescribed in Europe in the 1920s for the treatment of type 2 diabetes but it was discontinued because of its risk of causing life-threatening lactic acidosis.

Metformin has been used since the 90s in the United States for a wide spectrum of blood sugar related and insulin resistance disorders as well as for off-label uses like polycystic ovary syndrome (PCOS), fertility problems, longevity and diabetes prevention.

Metformin works by decreasing the liver's ability to produce glucose (blood sugar), which decreases the intestinal absorption of glucose and increases insulin sensitivity.

Side Effects Of Metformin

Metformin has a black box warning for lactic acidosis.  This is where lactic acid accumulates in the muscles and liver and can be life-threatening.  Diabetes itself is also a risk factor for developing lactic acidosis [3]

Though this scenario is rare, it can happen, especially in those with kidney, liver, or heart diseases. [3]

Taking metformin can cause B12 deficiency. [4]

B12 deficiency can contribute to many conditions including memory problems and several studies show that long-term use increases the risk of Alzheimer’s disease and dementia. [4, 5, 6]

For those patients who have neuropathy, anemia, chronic pain syndrome, or MTHFR genetic variants (which cause chronic B12 deficiency), it can be disastrous.

A long-term severe B12 deficiency has been linked with an increased risk of cancer [7], heart disease, and can contribute to severe detoxification problems.

Metformin can hinder the benefits of progressive resistance training including muscle hypertrophy. [8]

Lifestyle Changes To Improve Blood Sugar

Rather than swapping metformin for another pill, you can introduce lifestyle changes to drastically improve your blood sugar regulation and overall metabolic health.

These changes can be verified using simple blood tests. It is important to work with your doctor to monitor your progress.

I am also accepting patients worldwide via phone and video consultation.

Incorporating just a few changes along with adding some nutritional support can make a world of difference and reduce your risk of developing additional chronic conditions.

Alternatives To Metformin 

N-Acetyl Cysteine (NAC) 

NAC is considered a semi-essential amino acid, which means that it can be made in your body from other amino acids.

It is crucial for the production of glutathione which is a powerful detoxifier and antioxidant.

In women with Polycystic Ovary Syndrome (PCOS), a condition where insulin resistance is the primary contributor to the disease, NAC was shown to be superior to metformin in improving cholesterol levels, fasting blood sugar, and fasting insulin levels. [9, 10]

NAC has been shown to have potent antioxidant and anti-inflammatory properties that improve insulin sensitivity.

It also protects the body from cellular damage, promotes optimal liver detoxification, can protect the lungs, and thin mucous for those with allergies or respiratory congestion. [11]


Berberine is a plant derived chemical that is found in plants like goldenseal, goldenthread and oregon grape.

Berberine protects against atherosclerosis and has potent anti-inflammatory properties.

Its properties can reduce heart failure pathology, reduce insulin resistance, and has been shown to reduce fat mass in those with diabetes while improving cholesterol levels.[12]

Berberine has also been shown to produce changes good bacteria in favor of better blood sugar control[13]

Berberine had comparable benefits to that of metformin and rosiglitazone, a diabetes drug). [14, 15]

Functional Medicine For Blood Sugar Regulation

It is not enough to swap out metformin for one of the supplements above.

The right dose, the right type, and the right time are all crucial in administering high-quality, pharmaceutical-grade supplementation.

It is also imperative to check your progress to make sure your blood sugar regulation has regained equilibrium.

Functional medicine uses the latest in diagnostic testing with scientifically proven supplementation.

Read more about Functional Medicine

If your medication is not adequate in reducing your blood sugar levels, you want more natural forms of treatment, you have a poor quality of life, other health conditions, or other symptoms then I may be able to help.

Rather than prescribe a drug as the first step of treatment, I investigate why you are having blood sugar regulation problems and in most cases, we can relieve symptoms naturally and restore long-lasting health.

Dr. Brian Lum at an online functional medicine consultation

During your hour-long new patient appointment, we go over your entire medical history, family history, medical history, previous testing, and current symptoms and goals.

Based on what we find, I can order the specific testing to confirm your diagnosis and evaluate your physiology from a holistic perspective.

Begin Here

I offer Telehealth services including online functional medicine consultations

I personalize treatment and even can work with your primary care physician and can order testing if you are out of state or outside of the country.

If you would like to speak with me directly you can schedule a Free 15 Minute Consultation here or call my office directly at 913-728-5291.


If you think that you may have a medical emergency, call your doctor or 911 immediately.  No action or inaction should be taken based solely on the contents of this information. Nor should you ever delay seeking medical advice or treatment due to the information contained on this Website.


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