What Are Semaglutide and Metformin?
Metformin
Metformin belongs to a small class of medications called biguanides, which are used to treat type 2 diabetes. These drugs work by lowering how much sugar your liver makes and helping your body use insulin more effectively.
Today, metformin is the only biguanide that is still commonly used and is often the first medicine doctors prescribe for type 2 diabetes. Along with improving blood sugar control, it can lead to mild weight loss or help prevent weight gain and is also sometimes used to manage conditions like insulin resistance and PCOS.
Semaglutide
Semaglutide is part of a class of drugs called GLP‑1 receptor agonists (glucagon‑like peptide‑1). These drugs mimic natural hormones that are produced by your body when you eat and are responsible for helping your metabolism work more efficiently. It is one of the newer drugs in the GLP‑1 receptor agonist family, and is marketed under the brand names Ozempic and Wegovy. It has been used to help individuals with type 2 diabetes regulate their blood sugar since 2017 and was more recently approved for weight management in 2021.
Semaglutide acts like the natural hormones that influence many of the areas of your digestive process, like telling your brain that you feel full, controlling food cravings, slowing down how fast your stomach empties, which helps you stay satisfied longer, and helping your body release more insulin when your blood sugar is high while signaling your liver to release less sugar into your bloodstream.
Can You Use Semaglutide and Metformin Together?
Yes, you can. In fact, it can offer significant benefits for some individuals.
The results of a 2024 peer‑reviewed meta‑analysis combined data from 10 randomized controlled trials consisting of 962 patients in China and found that combining semaglutide with metformin significantly improved the participants’ results.
Some of the noteworthy findings include:
- It lowered fasting blood sugar, post-meal blood sugar, HbA1c, and the participants’ BMI.
- It improved the participants’ insulin resistance scores and cholesterol levels.
- There were no significant increases in side effects such as low blood sugar, nausea, headache, or dizziness.
The SUSTAIN program (Phase 3 Add‑On to Metformin Trials) showed that when semaglutide was added to the metformin program of people with type 2 diabetes, they experienced greater reductions in their HbA1c and greater weight loss.
What Are the Benefits of Using Them Together?
These prescription drugs work in different ways, but studies show they complement each other: metformin improves insulin sensitivity and lowers sugar production, and semaglutide reduces hunger and slows digestion. The combination of these medications offers benefits, including:
Metabolic and Weight Loss Benefits
The combination offers greater weight loss potential than either drug on its own. Semaglutide reduces your appetite so you eat less, and metformin helps with insulin sensitivity, so together they can lead to more effective and sustainable weight loss.
- Improved insulin sensitivity: Metformin directly improves how your cells respond to insulin, and semaglutide assists indirectly by promoting weight loss and gradually reducing fat cells, which also helps lower insulin resistance.
- Better blood sugar control: This combination lowers your fasting glucose levels, post-meal glucose, and HbA1c more effectively than metformin alone. It helps keep your blood sugar levels steady throughout the day so you avoid spikes and crashes.
- Reduced liver glucose production: Metformin slows down how much sugar the liver releases into your bloodstream, and semaglutide reduces the amount of glucagon (which triggers the liver to release more sugar).
Hormonal and Reproductive Benefits for PCOS
Studies show that combining semaglutide with metformin improves menstrual regularity and cycle patterns better than metformin alone in women with PCOS.
- Better hormone balance: The combination of these drugs can help with PCOS because it reduces your testosterone levels and helps balance other hormones that reduce acne and excess hair growth, and alleviate other PCOS symptoms.
- Can help with fertility: Women who participated in clinical studies saw higher rates of ovulation and spontaneous pregnancy when using metformin and semaglutide, likely due to better hormone balance and insulin sensitivity.
Cardiometabolic Health Improvements
- Lowers cholesterol and triglyceride levels: Both medicines work together to help improve your cholesterol levels. Semaglutide lowers the bad cholesterol, and metformin helps to improve the good cholesterol.
- Reduces inflammation: The combination of metformin and semaglutide has been linked to lower levels of inflammatory markers like CRP, which are often elevated in individuals with insulin resistance and PCOS.
- Lowers blood pressure and risk of cardiovascular issues: Losing weight leads to better blood sugar control and insulin resistance and helps to reduce your risk of experiencing heart disease and stroke.
Other Benefits
- Improves energy levels: As your blood sugar stabilizes and you lose weight, you will have more energy and fewer sugar crashes.
- Reduces cravings and binge eating: The medication’s effect on your hunger signals can help reduce emotional or compulsive eating, which is common in PCOS and insulin resistance.
- Assists your pancreas: Using both medicines together might help protect the cells in your pancreas that make insulin. This could help slow down the progress of type 2 diabetes and insulin resistance.
Is It Safe to Combine Semaglutide and Metformin Together for Weight Loss?
Yes, semaglutide and metformin can safely be used together under a doctor’s supervision, and the combination offers better weight loss and blood sugar control than either medicine alone for many people. Both of these prescription medications are FDA-approved and commonly prescribed to help treat type 2 diabetes, and semaglutide is also approved for the treatment of overweight or obesity.
As with any type of medication, these medications can cause side effects. The most commonly experienced side effects include nausea, diarrhea, bloating, or indigestion, which normally improve as your body gets used to the medication.
Serious side effects are rare, but they can happen. Metformin may cause a serious condition called lactic acidosis in people with kidney or liver problems, and semaglutide may cause pancreatitis and has a possible link to thyroid cancer.
Want to Know More About Using Semaglutide and Metformin Together for Weight Loss?
Dr. Angelina Postoev and her experienced team at MySlimMed understand that losing weight is challenging and that everyone’s situation is different. They take the time to understand your health history, past struggles with weight loss, and your personal health and weight loss goals.
If you are considering using prescription weight loss injections like semaglutide and are already using metformin, they can clearly explain how these two treatments work together, who they are best for, and how to use them safely.
Dr. Postoev’s team can build a plan that fits your needs, circumstances, and lifestyle, so set up your consultation today to get expert guidance and the support you need to successfully achieve real results.
