It’s estimated that 3–6% of the world’s population suffers from fibromyalgia – a painful and sometimes debilitating condition that has no known cure.
As the disease impacts so many lives, the scientific community is striving to find effective treatments that can help patients lead a better quality of life. One particular drug called metformin – which is currently used for treating diabetes – has demonstrated the potential to alleviate many of fibromyalgia’s unpleasant symptoms. Some scientists also believe it could even halt the condition’s progress if prescribed early enough.
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What is metformin?
Metformin helps lower blood sugar levels and is usually used to treat gestational diabetes, or treat and prevent type 2 diabetes. It can also be used for other medical conditions if approved by a healthcare provider.
The drug contains guanidine, as does another diabetes medication called phenformin which was withdrawn from the US market in 1977 due to its serious side effects. This, along with the discovery of insulin, saw the medication’s vast decline in popularity.
However, metformin was rediscovered several decades later in Europe and was approved for use in the US in 1995. It has since become the most commonly used medication for people with diabetes who are unable to control their blood sugar through diet and exercise.
How does metformin work?
Metformin prevents the glucose (sugar) levels in your blood from getting too high by decreasing the amount your liver can produce or absorb from food and drink. It also helps your body’s own insulin work better – a hormone that helps you use glucose as a source of energy. It can be taken in tablet or liquid form, or as a powder sachet that dissolves in a drink.
In addition, metformin is sometimes used to manage the symptoms of polycystic ovary syndrome (PCOS) by improving ovulation and encouraging regular periods. It also has its cardiovascular benefits, decreasing the number of deaths caused by cardiovascular disease.
What are the side effects of metformin?
Metformin is regarded as being safe, although it can cause mild side effects including nausea and diarrhea. More severe side effects are rare but include allergic reactions and lactic acidosis, which is a build-up of lactic acid in the bloodstream. The risk is greater for people with kidney disease, so they’re unlikely to be prescribed metformin.
Are you taking metformin for high blood sugar but not seeing the results you need? Discover the key signs that metformin may not be working for you and what you can do about it in our comprehensive guide.
What is fibromyalgia?
Around 10 million adults in the US have fibromyalgia (also called fibromyalgia syndrome) — a potentially debilitating condition that causes chronic pain throughout the body. It’s usually defined as pain affecting 11 or more of 18 specific tender points, and that lasts for more than three months.
What are the symptoms of fibromyalgia?
As well as pain, other symptoms of fibromyalgia include headaches, diarrhea, constipation, IBS, dizziness, poor concentration or memory, allergies, and sensitivity to light or heat. It can also result in feelings of worry, frustration, and low moods. The symptoms can fluctuate and improve or worsen over time.
What causes fibromyalgia?
Although the exact cause is unknown, fibromyalgia is believed to relate to abnormal levels of certain chemicals in the brain, which changes how the central nervous system processes pain messages. Some people may also be predisposed to developing it due to genetic factors.
The condition is often triggered by physical or emotional trauma, such as an infection, injury, or severe stress.
What treatments are currently used for fibromyalgia?
Whilst there isn’t a cure for fibromyalgia, medical treatments such as pain relievers, anti-seizure drugs, and antidepressants can help sufferers manage their symptoms.
They’re particularly effective if combined with lifestyle changes such as exercise and therapies, including talking therapies, cognitive behavioral therapy (CBT), and acceptance and commitment therapy (ACT).
Does metformin help fibromyalgia?
Past clinical trials suggest that insulin resistance has an impact on the nervous system and pain – which could in turn play a role in conditions such as fibromyalgia. Conversely, fibromyalgia might contribute to insulin resistance.
A 2003 study about fibromyalgia and diabetes, for example, found that fibromyalgia is commonly found in diabetes sufferers. As such, because metformin treats diabetes, it could therefore be linked with alleviating fibromyalgia.
In addition, several other studies on metformin for fibromyalgia and chronic pain demonstrate its effectiveness in alleviating painful symptoms. Other research about metformin for the consequences of pain suggests that it can reverse the consequences of pathological pain in rodents, such as cognitive impairment, anxiety, and depression.
Ongoing clinical trials for metformin and fibromyalgia
Clinical trials are currently being undertaken to determine exactly how effective metformin is for fibromyalgia. One of the better-known and interesting studies is the University of Utah’s INFORM trial which is currently in phase 2.
The study aims to assess how safe and effective low doses of metformin are for improving fibromyalgia symptoms through modulating neuroinflammatory pathways. In scientific terms, the hypothesis suggests that the drug will decrease the transcription of mTORC1, NLRP3 inflammasome, and nociceptive cytokines interleukin 1beta and interleukin 18, and increase phosphorylated AMPK in patients’ peripheral immune cells.
What is the recommended metformin dosage for fibromyalgia?
As it’s currently undergoing clinical research, metformin isn’t yet available for fibromyalgia patients, and as such, there isn’t a recommended dosage. However, a proof-of-concept pilot trial for metformin and fibromyalgia in six women showed that a low dose of 200 mg per day resulted in substantial improvements in pain, fatigue, stiffness, morning tiredness, depression, and anxiety.
What are the benefits of using metformin for fibromyalgia?
As already discussed, metformin could relieve fibromyalgia symptoms such as pain, stiffness, depression, fatigue, and disturbed sleep. It might also reduce inflammation and the necessity for strong painkillers such as opioids, which could in turn lead to fewer side-effects and reduced prescription costs.
Scientists are also investigating the potential of metformin to:
- help with cholesterol levels, weight loss, and the risk of heart disease
- decrease the risk of some cancers in type 2 diabetes patients
- lower risks of stroke and dementia
- slow the aging process, increase lifespans, and prevent age-related diseases
In addition to these potential benefits, metformin is usually well tolerated and it’s not expensive to manufacture.
How does metformin compare to other fibromyalgia treatments?
Medical experts are currently unable to determine how metformin compares with other treatments for fibromyalgia. However, metformin could offer a more cost-effective alternative that presents fewer complications.
It’s estimated that fibromyalgia costs the American healthcare budget $100 billion a year. Some of this is due to a lack of understanding about the condition, which results in patients receiving expensive but ineffective treatments.
A doctor who doesn't specialize in fibromyalgia, for example, might recommend costly surgery at the source of the pain, which often doesn’t solve the problem and can result in other ramifications. They might also prescribe strong painkillers such as opiates, which can have significant side effects and increase costs.
Some scientists also believe that by finding out more about fibromyalgia so we can diagnose and treat it early (with a drug such as metformin), the disease could potentially be halted or reversed. This is just one of the reasons why clinical studies into fibromyalgia are so vital.
Should you take part in a clinical trial for fibromyalgia?
If you suffer from fibromyalgia, by taking part in a fibromyalgia clinical trial, you could access potential new treatments and advance medical knowledge and interventions. This could help change the futures of millions of other sufferers and significantly improve their quality of life.
Conclusion
Clinical trials have already demonstrated that there’s a link between metformin and fibromyalgia. In addition, promising new studies are hoping to prove that it can significantly reduce the unpleasant symptoms – and even stop them if the condition is diagnosed and treated early enough.
These trials play a hugely significant role in advancing our knowledge of metformin and how it can help fibromyalgia sufferers worldwide. If you’d like to contribute to this important scientific research and try metformin for yourself, you could consider signing up for the INFORM trial.