Could the most popular Type 2 diabetes drug lead to cancer?
Metformin is the most prescribed drug for Type 2 diabetes and the 4th most prescribed drug overall in the U.S. It is prescribed to 120 million people worldwide and here in the U.S. to about 21 million. Metformin is the most affordable drug on the market to treat Type 2 diabetes and some patients can even get their pills for free.
Metformin was first used in clinical practice in France in 1957 but was only introduced to American patients in 1995. Metformin works by decreasing the amount of sugar (glucose) made by the liver. It also helps your body to better respond to insulin so that cells like your muscle absorbs and uses sugar more efficiently.
In early December, Singapore’s Health Sciences Authority recalled three out of the 46 locally marketed metformin products after they were found to contain high levels of a cancer-causing chemical called N-nitrosodimethylamine (NDMA). NDMA is a common contaminant found in water and foods such as cured and grilled meats, some dairy products and vegetables. In low amounts, NDMA is harmless but can lead to cancer in higher amounts and with long term exposure.
NDMA is made as an unintentional byproduct of chemical reactions at industrial sites and can find its way into drugs during the manufacturing process or through storage or the packing process.
The director of the FDA’s Center for Drug Evaluation and Research, Janet Woodcock, MD, said: “The FDA is investigating whether metformin in the U.S. market contains NDMA and whether it is above the acceptable daily intake limit of 96 nanograms.”
She also made it clear that “Patients should continue taking metformin to keep their diabetes under control. It could be dangerous for patients with this serious condition to stop taking their medication without first talking to their healthcare professional.”
The FDA also recommends that physicians continue to use metformin while the investigation is underway as there are no alternative therapies to treat the disease in the same way.
NMDA has been found in popular heartburn medications. The FDA asked the manufacturers to recall ranitidine (Zantac) and nizatidine (Axid) due to NDMA levels which were above the acceptable levels.
Last year, NMDA was also discovered in some blood pressure medications called angiotensin receptor blockers used to treat high blood pressure and heart failure. Throughout 2019, recalls for valsartan as well as losartan, irbesartan and combination medications have been ongoing.
As of now, metformin has not been recalled in the U.S. The FDA is currently working with companies to test samples of metformin sold in the U.S. for NDMA and they will be pulled if high levels are found. Patients on metformin should, therefore, continue their medication.
Through a multi-dimensional platform that addresses the mind, body, and spirit, Dr. Kelly lives out her passion to help others achieve total wellness and lead a balanced life. She makes expert health and wellness advice accessible to all through speaking engagements, media appearances, her Facebook show, and personal blog (drkellywoodmd.com).
Beyond the stethoscope, Dr. Kelly is recognized as “The Bounce Back Coach,” helping high-performing women to bounce back from failed relationships rebuild their self-esteem and reclaim their identity. Her debut book, “Bounce Back to Better: Recovering from the Disappointment of a Failed Relationship,” walks readers through her personal journey of reconstructing her life after her engagement ended.
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