Underlying Mechanisms of Metformin-associated Lactic Acidosis, Visceral Fat, and GERD Progression: A Case Study

Abstract

Abstract Background: Metformin is a routinely prescribed medication for diabetes. Recently, physicians started to prescribe it for a variety of conditions, including polycystic ovarian syndrome (PCOS). It has adverse effects, just like any other medication; lactic acidosis is an uncommon but lethal side effect. The goal of this study was to illustrate the mechanisms of action of metformin in inducing lactic acidosis as well as two undetermined effects, including visceral obesity and the progression of gastroesophageal reflux disease (GERD). Methods: We present a case of a 23-year-old female with GERD who was treated with metformin for PCOS. We observed the emergence of lactic acidosis symptoms, as well as some unexpected symptoms such as visceral fat, and the advancement of GERD from equilibrium to acute, which lasted for up to a year after stopping metformin. Results: We found that metformin advanced GERD from an equilibrium to an acute condition in the presence of stress and a history of GERD. Furthermore, gastrointestinal issues have persisted even after a year of discontinuing metformin. Conclusion: We demonstrated that, despite metformin's powerful effects on the gastrointestinal system, it cannot primarily cause lactic acidosis. Lactic acidosis had developed as a result of metformin interacting with other factors, such as stress and a history of GERD. Our work is the first to capture metformin's connection with GERD; more research is needed to investigate that association and identify the long-term mechanism of metformin, particularly in individuals who have experienced lactic acidosis.