[1] [3] When you skip a week, blood levels begin to decline, which may reduce the medication's appetite-suppressing effects
This is very important if you have health problems or take other medicines
10.1002/mnfr.201800536 172 WhiteA
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Apart from this, metformin can cause changes in the microbial composition of the intestinal tract (Vallianou et al., 2019), increased lactic acid production (Misbin et al., 1998), and increased concentrations of glucagon-like peptide-1 (GLP-1) and bile acids (Mannucci et al., 2004
Avoid eating spicy foods on an empty stomach or immediately before bed, when stomach acid and slower emptying combine to intensify discomfort