A weekly column looking at common ailments.
Metformin - an anti-diabetic medication
What is it? Metformin, known more commonly as glucophage, is an anti-diabetic drug used to treat mature-onset diabetes (Type II).
What's it good for? It is used for the treatment of Type II diabetes in which some insulin cells are still active in the pancreas. Most recently metformin has found a role in the treatment of insulin resistance, a pre- diabetic state of increasing importance.
How does it work? Metformin lowers blood sugar by reducing the absorption of glucose from the digestive tract into the bloodstream. It also reduces glucose production by cells in the liver and kidneys and increases the sensitivity of cells to insulin so that they take up glucose more effectively from the blood.
Any contraindications? A number of other medications reduce the effectiveness of metformin. These include oestrogen, diuretics and corticosteroids. Beta blockers and drugs known as MAOIs (used in depression) increase its effectiveness. Metformin also increases the effect of the anticoagulant drug warfarin.
Possible side-effects? Minor gastrointestinal problems such as nausea and loss of appetite have been reported but can be reduced by taking the medication with food. Diarrhoea usually settles within a couple of days of continued treatment.
Dr Muiris Houston
Alternative Remedy: Grapefruit Seed Extract
What is it? The seed and peel from fresh ripe grapefruit are one of the most powerful broad-spectrum antibiotics available.
What's it good for? It is excellent for bacterial infections. It can also be used to purify water, as a wash for infected wounds and as a general disinfectant. It can be used to prevent diarrhoea or dysentery when travelling.
How does it work? Grapefruit seed extract (GSE) has been found to be active against a large number of micro-organisms including staphylococcus, helicobacter pylori, campylobacter, dandida albicans, streptococcus, salmonella, herpes simplex 1, influenza A2 and measles. One study showed that a commercial preparation of GSE was effective against over 700 bacterial strains and 90 fungal strains.
Any contraindications? It is difficult to make at home and must either be purchased or made from plants with a limited range of growth. It has an extremely bitter taste even when taken in citrus juice. It should be used with caution during pregnancy.
Possible side-effects? GSE can kill off beneficial intestinal bacteria in much the same way as broad-spectrum antibiotics will, so yogurt and acidophilus are recommended after its use. The undiluted extract can cause skin and mucous membrane irritation and severe eye irritation.
Sylvia Thompson