What is metformin?
Metformin is a prescription pill that lowers blood sugar in type 2 diabetes. Doctors also use it for prediabetes and for polycystic ovary syndrome, or PCOS.
Dr. Martin on how common it is:
Dr. Martin, from The Doctor Is In, episode 893One of the most prescribed medications is a medication called Metformin.
In the US it is approved for type 2 diabetes. It is not approved as a bipolar medicine.
What he says it does and does not do:
Dr. Martin, from The Doctor Is In, episode 893So when you give them Metformin, yes, it helps to control blood sugar, but it doesn't fix the problem. It doesn't fix the problem of insulin resistance.
To him, high blood sugar is the late sign and insulin resistance is the problem under it. That is his view, never a reason to change your metformin without your doctor. More on catching it early in prediabetes at 60.
What does the research say about metformin and bipolar disorder?
It is early, and he presented it as news.
How he opened episode 897:
Dr. Martin, from The Doctor Is In, episode 897There seems to be some promise in bipolar condition, mental health condition that is suffered by millions and millions of people. There seems to be some research that is showing that Metformin, the medication, the most popular medication used in diabetes seems to help bipolar.
The trial behind the news was small: it gave metformin or a dummy pill to 45 insulin-resistant adults whose bipolar depression had not lifted with treatment. By week 14, half on metformin were no longer insulin resistant, and their depression improved more than in people who stayed insulin resistant.
What a psychiatrist said, as he tells it:
Dr. Martin, from The Doctor Is In, episode 897And this doctor looking at the studies on Metformin and bipolar said, there's a paradigm shift going on in psychiatry. They're starting to change their thinking.
She was Dr. Claudia Baldassano of the University of Pennsylvania, who was not part of the trial. She called the results intriguing but said they need a larger study.
Why would a diabetes drug matter for the brain?
Because of insulin resistance, he says. The trial's lead researcher, Dr. Cynthia Calkin, said she does not think metformin works as an antidepressant, and she credits reversing the insulin resistance.
His take on what researchers are finding:
Dr. Martin, from The Doctor Is In, episode 897What are they saying? Insulin resistance changes your brain. It changes your brain chemistry. It changes the way your brain operates.
He explains it with fuel. Your brain is small, yet it burns a big share of what you eat.
On why the brain feels it first:
Dr. Martin, from The Doctor Is In, episode 1266The brain is an energy hog. We've taught this many a time. It's only 2% of your body weight and yet it's headquarters. It's the central government, and it needs 25% of your energy.
When cells stop answering insulin, he says, the brain struggles to use that fuel and quietly becomes inflamed.
"Metabolic syndrome has a major, major effect on the brain."
Dr. Martin, from The Doctor Is In, episode 897What is insulin resistance?
It is when your cells stop listening to insulin, so your body has to pour out more and more of it to keep blood sugar in range.
How he describes it:
Dr. Martin, from The Doctor Is In, episode 803When your body is in insulin resistance, meaning your cells at the cellular level are tired of insulin, but insulin's got a job to do.
On how common it is:
Dr. Martin, from The Doctor Is In, episode 803But 88% of the population have trouble with metabolic syndrome, which is insulin resistance. Your cells don't like insulin anymore way before you become a diabetic. Diabetes, guys, is the last thing that happens.
For the signs he looks for, read insulin resistance in women over 60 and what your A1C should be after 60.
Are people with diabetes more likely to have mental health problems?
A study he covered says yes. It tied type 2 diabetes to depression, bipolar disorder and other psychiatric illness.
What the study found:
Dr. Martin, from The Doctor Is In, episode 803Now, they mention diabetes and the reason they mention it is because what they found is that diabetics were much more susceptible to mental health issues, 30, 40% more susceptible than the rest of the population.
He saw it in his office too. Many women he treated for PCOS, a hormone condition tied to insulin, struggled with their mental health.
On what a broken metabolism does:
Dr. Martin, from The Doctor Is In, episode 897We know now it affects your brain. It affects your thinking. It affects your moods.
None of this means diabetes causes bipolar disorder. It means the two often travel together.
Does metformin lower vitamin B12?
Yes, and he calls it the biggest problem with metformin. The drug's own US label says it can lower B12 and that levels should be checked from time to time.
On metformin and B12:
Dr. Martin, from The Doctor Is In, episode 897But the biggest problem with Metformin is it destroys your vitamin B12. It takes it outta your body. It whacks it. If you're taking Metformin, you're going to be low in B12, almost invariably.
B12 feeds your nerves and your brain, so he wants anyone on metformin to know their number.
What he found in older patients:
Dr. Martin, from The Doctor Is In, episode 699Almost every senior that walked into my office, was low in B12. Most of them were on meds.
Your doctor can check your B12 with a simple blood test. More in whether B12 is worth it after 60.
Should you ask your doctor about metformin for bipolar?
Yes, if you have questions. Never start, stop or change metformin, lithium or any other medicine on your own; that decision belongs with your doctor or psychiatrist.
He is not against medicine:
Dr. Martin, from The Doctor Is In, episode 897Big pharma, look, they do wonderful things, okay? I'm not dismissing pharmaceuticals a hundred percent. I won't do that. I'm not gonna do it. Cause they, they can save your life. Certain things save your life.
In the same episode he says he never tells people to come off metformin, a choice that stays between you and your doctor.
Why he talks about it at all:
Dr. Martin, from The Doctor Is In, episode 1266I'm trying to give information, educate people. Education provides a person with power.
If you or someone you love is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline at any hour. If someone is in danger right now, call 911.
Where can you hear him on bipolar and insulin resistance?
In episode 897 he reads the news about the study and explains why he thinks insulin resistance reaches the brain.
Common questions
Is metformin used for bipolar disorder?
Not as a standard bipolar medicine. It is approved for type 2 diabetes, and the study he covered tested it only in people with bipolar depression who were also insulin resistant. Episode 897.
Is there a link between metformin and bipolar disorder?
The link he points to is insulin resistance, not the pill itself. In the news he read out, a psychiatrist said the potential link between insulin resistance and bipolar disorder is causing a paradigm shift in psychiatry. Episode 897.
Did Dr. Martin tell people with bipolar to take metformin?
No. He reported early research and never told anyone to start metformin, which is a decision for you and your doctor or psychiatrist. Episode 897.
Read next: What Is A Normal Blood Sugar For A Woman Over 60?
His plan for healthy blood sugar
The Metabolic Reset is the eating plan Dr. Martin used in his clinic to support healthy blood sugar. It is a book you follow, not a capsule, and it sits beside your doctor's care, never in place of it.
60-day money-back guarantee. Nothing on this page is a treatment for any illness or a reason to start, stop or change a medicine, so talk to your doctor first.
