Can Metformin Cause A Gout Attack?


There is this portion of our society that discards the unconventional medication. This is mainly due to the fact that most of them are not that much understood yet. However, what we know less is that even the widely accepted medications aren’t that clarified as of the moment. For example, metformin, a medicine used to treat diabetes still cause scientists to get confused. In the actual fact, the released medicines are even withdrawn some time in 1978. This is due to the fact that it cause lactic acidosis.

Because of the fact that it isn’t wholly understood, metformin has already gotten the attention and has loads of questions. Not just from the experts, but for the common people too. One particular question is, “Can metformin cause a gout attack?”

The connection between Metformin and Gout

It’s really hard to think that as you take medicines for your illness, you kindle the waning of the other one. Just like in the case of metformin, which helps in treating diabetes, but having a trouble with gout.

Given the right situation, there’s a probability that the metformin may cause gout attacks. In the actual fact, if you don’t have gout yet, it may cause you to have one. How does this thing happen? Well, first, we should understand what really causes the condition.

What is Gout?

Gout is a condition that is caused by the crystallization of the uric acid in the joints. The body distinguishes the crystal as a foreign entity and then launch a blockade thru sending in the neutrophils. Regrettably, for you, the neutrophils may not be of a great help against the uric acid crystal yet suppurate and ask for help, sending the pain and inflammation signals.

Actually, this is what causes the appearance of the lump, in addition to the burning sensation.  Over the course of time, the uric acid crystal will settle and then the pain will wane. If left uninterrupted, gout may become dormant for a period of time. However, if it awakens, just as by adding more uric acid into the crystal, it’ll wrath once more.

The more uric acid there is in the body, the greater the chance of having gout. This is because as the uric acid fill the bloodstream, the body will be enforced to put the uric acid away temporarily to be able to reduce the acidity of the blood. One of the ways that the body does this is by sending the uric acid into the tissue spaces and sooner or later into the synovial joints.

Metformin and Uric Acid

Metformin doesn’t upsurge the levels of uric acid. However, it helps in reducing the output of the uric acid. This just means that it helps the uric acid in accumulating in the body.

Thought to be, the liver, as well as the kidneys may flush all of that uric acid out. Nevertheless, if there are several tasks, those organs will not be capable of functioning the way they should be.

Moreover, metformin adds to those additional tasks. As the metformin is a biguanide, it may hasten the conversion of the pyruvate into lactate. Biguanide specially does this by inhibiting the pyruvate dehydrogenase. This is an enzyme that’s responsible for the feeding of the acetyl Coenzyme A into Kreb’s Cycle. If there is no CoA supplying the Kreb’s Cycle, the fermentation of the lactic acid will accelerate.

The cells have two combinations of respiration: the aerobic and anaerobic. The aerobic respiration stores more energy, yet requires oxygen. The metformin may cause a lack of fuel supply thus increasing the anaerobic respiration. The anaerobic respiration comes at a cost: lactate is manufactured.

With excessive levels of lactate, the liver and the kidneys attention are divided into the excretion of the uric acid, as well as the lactic acid. Therefore, this reduces the uric acid output rate that will then increase the volume of the uric acid in the bloodstream. This is now where gout may come to attack.


There is a possibility that the metformin may cause gout attacks. Even though this may not seem to be a problem to those who don’t suffer from gout, metformin may cause hyperuricemia and gout so it may be your entry ticket to the perturbing world of inflammation, pain, and torment.


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