Risks: Generally, metformin is well-tolerated. However, there may be unknown risks associated with exposure to a new medication in a clinical population where this specific compound has not been studied extensively. The general and rare side effects are listed below. These risks will be minimized by careful monitoring and higher than standard of care safety evaluations. In addition, an individual's symptoms could potentially remain unchanged or worsen by initiating this medication, or from delaying initiation of a potentially more effective alternative treatment. For these reasons, participation in the study is entirely voluntary and consent may be withdrawn at any time without any repercussions and will result in the patient being immediately discontinued from the study. If at any time the clinician believes that the patient is not benefiting from the study, the study will be discontinued and endpoint measures will be obtained if possible. A risk-benefit analysis, weighing clinical improvement against side effects will be done at each visit and will determine further inclusion in the study.