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J Exp Med 217 (2020)

I was taken off the medication after that

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This mechanism may explain why metformin users are more likely to develop hypomagnesemia over time Bouras2020Chen2024

Early phase reflecting nicotinic stimulation (CNS, Parasympathetic & Sympathetic) (first 15 mins to an hour): nausea & vomiting a result of parasympathetic stimulation of the GI tract, causing increased tone and motility, resulting in nausea, vomiting, diarrhea, and voiding of urine (Vanderah & Pappano, 2021)