Metform

[Pea-n-Me]

The other big issue with Metformin is that if you have a scan with dye, you can experience a fatal reaction. If you are on Metformin it is imperative that you get a Medical Alert bracelet stating so in case you are ever incapacitated.

It's not so much that you'll have a fatal reaction, but that together, the metformin and dye can be hard on your kidneys. Usually you don't take the dose the day of the procedure utilizing dye, and for two days afterward, that's it. I have scans once a year and have been on metformin for years. I've never had a problem, even at times when I forgot to skip doses around the time of the scans. (I also never had any GI problems from it, probably because my doc/endocrinologist had me start it on a very specific schedule, increasing it over time.)

 

[Darsa]

have you been able to loose any weight one it?

Slowly but surely the weight is coming off. A little easier than before, but still pretty slow. Basically when I remember to take the pills it keeps me from munching between meals. I'm especially thankful for it during the week before Aunt Flo arrives, because I could eat everything in the house and be looking for more...

Now if only I could find a pill that will lessen my cravings for carbs... that would be heavenly!!

 

[Kurby]

thank you everyone for all your great posts. it's funny - my mom thinks these boards are a waste of time. she doesn't get the whole internet thing anyways but when i told her all the great information i was getting she said - hummm you mean "professionals" go on these boards too - meaning lawyers, dr's, nurses, i laughted and said -

ahhh ya - they like to take vacations too ya know - she thinks this is just a "disney" board and was surprised there's more to posts here then about the mouse.

 

[Pea-n-Me]

I still haven't found the article I'm looking for, but think you might find these helpful.

PCOS and Non-Alcoholic Fatty Liver Disease http://pcos.insulitelabs.com/PCOS-and-Liver-Disease.php

"We determined that Insulin Resistance explains the high rate of elevated ALT in women with PCOS, and that these women with PCOS are at increased risk for NAFLD [non-alcoholic fatty liver disease]"

http://www.postandcourier.com/news/2008/jan/28/pcos_more_than_just_fertility_risk28732/

Kurby, I'd suggest that after you do some research, you make another appointment, or call your doctor, to re-discuss all of this since now it will make more sense to you and you will undoubtedly have lots of questions and concerns. I'm glad that you're on your way to better health knowing what you're dealing with.

PS - you have a good doctor. I know many women who had to search and search before getting a diagnosis and/or finding treatment. Hopefully it's becoming better understood.

 

[Keggy]

I just recently started taking Metformin two weeks ago. I have been daignosed with PCOS. I went to an Endocrinologist thinking I was having issue with my thyroid and went through a slew of tests and then subsequently had a Ovary ultrasound and came back with this. I have had a horrible time trying to lose weight. DH and I have not TTC yet, I am turning 32 next week. And now I am starting to think we shouldn't wait any longer since it could take awhile...

I am hoping that this helps with the weight, but she said it would be a minor help...

I was nauseous almost every afternoon for the first week, but I have been fine this week.

 

[Pea-n-Me]

have you been able to loose any weight one it?

Losing weight is not the goal of treatment for metformin. Correcting hormone imbalances, in the setting of the syndrome of PCOS, is.

Weight loss can come, however, from a better awareness of health, and following a recommended diet and exercise program to go along with a diagnosis like this.

If someone's taking metformin thinking it's going to cause them to lose weight, they'll probably be disappointed, though some weight loss can occur in some patients.

 

[mickeyboat]

I just recently started taking Metformin two weeks ago. I have been daignosed with PCOS. I went to an Endocrinologist thinking I was having issue with my thyroid and went through a slew of tests and then subsequently had a Ovary ultrasound and came back with this. I have had a horrible time trying to lose weight. DH and I have not TTC yet, I am turning 32 next week. And now I am starting to think we shouldn't wait any longer since it could take awhile...

I am hoping that this helps with the weight, but she said it would be a minor help...

I was nauseous almost every afternoon for the first week, but I have been fine this week.

I took it when I was TTC for PCOS (apparently I no longer have it, if that's possible), and I lost 13 lbs. in 3 weeks.

 

[Kurby]

well i took it last night at dinner and was up until about 2am - not running to the w/c but i definitely am not constipated lol

had a slightly upset stomach this morning but i can't be sure if that was the meds or just my normal twinges i've been having lately. it's why i've gone through a bunch of the pg tests and all are negative.

we'll see how the next week or so go and if it eases up.

 

[Pea-n-Me]

well i took it last night at dinner and was up until about 2am - not running to the w/c but i definitely am not constipated lol

had a slightly upset stomach this morning but i can't be sure if that was the meds or just my normal twinges i've been having lately. it's why i've gone through a bunch of the pg tests and all are negative.

we'll see how the next week or so go and if it eases up.

HTH

GI DISTURBANCE. About one third of women on metformin experience gastrointestinal disturbances, including nausea, occasional vomiting and loose, more frequent bowel movements, or diarrhea. This problem occurs more often after meals rich in fats or sugars. The symptoms lessen over time, so if you can tolerate the GI upset for a few weeks, it may go away. Some women have found it helps to start with a very low dose and gradually increase it. One "benefit" of these unpleasant symptoms is that you find yourself eating less and thus losing some weight.

Benefits of Metformin (Glucophage)
LOWERING OF INSULIN, TESTOSTERONE, AND GLUCOSE LEVELS. Quite a number of studies indicate Glucophage reduces insulin, testosterone and glucose levels -- which reduces acne, hirsutism, abdominal obesity, amenorrhea and other symptoms. In one study conducted at Virginia Commonwealth University, 24 obese PCOS women were given metformin or placebo. The 11 women who received the metformin experienced a reduction in insulin levels, which slowed the activity of an enzyme in the ovaries that stimulates excess production of testosterone. As a result, testosterone levels also dropped.(3)

Glucophage appears to do the same for non-obese PCOS women, according to a study from the University of Medical Sciences in Poznan, Poland. Thirty nine PCOS women were given Glucophage for 12 weeks. They had improvements in insulin, testosterone, hirsutism and acne. (4)

PREVENTION OR DELAY OF ONSET OF DIABETES. Glucophage may help to prevent diabetes, according to a study at George Washington University.(5) In this study, 3,234 non-diabetics with elevated blood glucose were given metformin, placebo, or lifestyle recommendations. The incidence of diabetes in the metformin group was 31% less than in the placebo group.

RESTORATION OF NORMAL MENSTRUAL CYCLE. A number of studies have shown that menstruation can be restored in many women with PCOS. For example, in a study at Jewish Hospital in Cincinnati, 43 women who were not having periods took Glucophage, and 39 of them resumed normal menses.(6) In another study at Jewish Hospital, 11 teenage girls with PCOS were put on metformin and a high-protein, low-carbohydrate diet. Ten of the 11 girls resumed regular periods.(7)

IMPROVED CHANCE OF PREGNANCY. A study of 48 women with PCOS and infertility was conducted at the Baylor College of Medicine. They were first given metformin and 19 of them resumed menstruating and showed indications of ovulation. But 10 required clomiphene (a fertility drug) in addition to metformin in order to show evidence of ovulation. Twenty women of the 48 (42%) became pregnant. However, 7 of the 20 miscarried.(8)

REDUCED RISK OF MISCARRIAGE. Another aspect of PCOS-related infertility is the tendency for repeated miscarriages. A study from the Hospital de Clinicas Caracas in Venezuela looked at 65 women who received Glucophage during their pregnancies vs. 31 who did not. The early pregnancy (first trimester) loss rate in the metformin group was 8.8% as compared to a 41.9% loss in the untreated group. Of those women who previously had miscarried, 11.1% of the metformin group miscarried again, while 58.3% of the untreated group again miscarried. (9)

REDUCED RISK OF GESTATIONAL DIABETES. In another study at Jewish Hospital in Cincinatti, gestational diabetes risk was evaluated in two groups of PCOS women. The first group was 33 non-diabletic women who had conceived while taking metformin or took it during their pregnancy. This group was compared to a group of 39 PCOS women who did not take it. Only 3% of the metformin group developed gestational diabetes as compared to 31% in the non-metformin group.(10)

WEIGHT LOSS AND OTHER BENEFITS. Metformin may contribute to weight loss in some diabetics.(11) However, weight loss does not appear to be one of its primary benefits. Glucophage may also be of some value improving success with in vitro fertilization, lowering cholesterol, and improving energy.

 

[skuttle]

I haven't lost any weight with the metformin. Bummer I didn't get that side effect!

 

[bumbershoot]

Hubby was prescribed metformin. He took it for a week. The side effects were so awful for him that, despite some scary blood sugar numbers and minimal info from the diagnosing docs, he decided to NOT take it anymore. Instead, he changed his diet to a great extent. He's changed it to a bigger extent, when he healed a brain tumor without western medicine's help (all documented by continued MRIs), when he had to go macrobiotic-without-the-fish, but he felt that this time was harder, because he had to lower his intake of so many of his fave foods, and lowering is harder than giving up completely.

But it worked, along with taking (and eating) cinnamon; his diagnosing number was nearly 500, and he now has a steady rate in the 80s (barely reacts to his normal diet, which is interesting). His endo is finally on board with him not taking it, and is quite impressed.

Anyway, it can be unpleasant.

The other big issue with Metformin is that if you have a scan with dye, you can experience a fatal reaction. If you are on Metformin it is imperative that you get a Medical Alert bracelet stating so in case you are ever incapacitated.

Augh...yeah, like they told hubby that.

It's not so much that you'll have a fatal reaction, but that together, the metformin and dye can be hard on your kidneys.

Am now fainting, b/c prescribing doc (not the diagnosing doc...diagnosing was fairly sure it was type 1 from presentation...next doc refused to hear any of that and said it was type 2 b/c hubby's fat...of course, hubby's skinny mom having type 1 didn't matter to doc, doc assumed hubby was lying about his mom being skinny) never mentioned that, and he KNEW that hubby had had kidney failure before (after a meat binge once he was allowed to come off of the macro diet after his tumor was gone).

Augh.

Losing weight is not the goal of treatment for metformin. Correcting hormone imbalances, in the setting of the syndrome of PCOS, is.

Weight loss can come, however, from a better awareness of health, and following a recommended diet and exercise program to go along with a diagnosis like this.

If someone's taking metformin thinking it's going to cause them to lose weight, they'll probably be disappointed, though some weight loss can occur in some patients.

You might want to read the post that the PP was replying to:

, my doctor decided to put me on Metphormin when I told her I was sick and tired of being fat and was trying to lose weight and having NO luck. I have FANTASTIC numbers (other than the weight), BP, cholesterol, blood sugar, all apparently excellent.

That poster's doctor certainly seems to think it's going to cause weight loss!

Benefits of Metformin (Glucophage)
LOWERING OF INSULIN, TESTOSTERONE, AND GLUCOSE LEVELS.

And I've now had to pick myself up off the floor, because the thing that hubby's diagnosis allowed us to find out (the endo doesn't even care about his blood sugar anymore) is that hubby has a prolactinoma. For diagnosis he had to have TWO MRIs done (first "open" one was useless as it didn't get the pituitary), both with dye, on hubby who had kidney failure once before....and the prolactinoma has reduced hubby's testosterone to near zero. (and this prolactinoma was only diagnosed b/c we insisted on hormone levels being checked, b/c docs had been ignoring a whole important set of symptoms and complaints for 3 years or even more)

If he had been on metformin this whole time (the endo thought he was when he sent him off for the MRIs, by the way, and NEVER mentioned to not take it)....my mind boggles.



Anyway OP, if you're oging to need to change your diet anyway...hubby would say...might as well do that FIRST, make sure you have cinnamon in your diet...give that the old college try, see how that changes your body. If no changes with serious diet changes, then go to the drugs...but if you've been told to change the diet...might as well JUST do that for now. Sure worked for him!

 

[Eeyores Butterfly]

Did you find out your numbers? That is so important.

 

[My2Cinderellas]

i've been on metformin for several years.

Definitely get the XR (extended release) version if you can. Generic metformin XR is available - it is the equivalent of the brand name drug Glucophage XR. Before the generic was available, i tried both the Glucophage XR 500 mg tablets and the 1000 mg tablets. My dose is 1000 mg twice a day. I found the 1000 mg tablets to be huge and hard to swallow, so took 2 500 mg tablets each time.

There is another brand name version of Metformin that is slightly different - called Fortamet XR. The GI side effects are not as severe with Fortamet for some people. the problem is that this is considered a non-formulary drug on many insurance companies lists - meaning the copay is greater if it's even covered at all.

I have never been diagnosed with IBS, but it and Chron's run in the family. Metformin definitely causes GI side effects for me, but switching to the Fortamet helped. I also have found that taking 1 generic Immodium pill with the Fortamet helps. My doctor is not thrilled that i'm doing this, and I have cut back from twice a day to once a day with the Immodium. It doesn't prevent all issues, but helps a lot.

Metformin is considered a weight-neutral drug by my endocrinologist. That in itself is an improvement over other drugs used to treat Type 2 Diabetes. Some drugs actually can cause weight gain - and with so many diabetics fighting weight issues this is a problem.

 

[honugirl]

I keep getting put on metformin by well meaning doctors, but it honestly doesn't really agree with me. The extended release version is much better.

Sort of OT, but I feel it's important to get out there. Please do not just blindly accept the PCOS diagnosis. PCOS is a disease of exclusion. That means they should rule out Cushing's Syndrome and any other endocrine disorder first. Most doctors do not because slapping the PCOS label on you is the easy way out. Cushing's Syndrome imitates PCOS symptoms plus a whole lot more. They are also told that Cushing's is so rare they probably will never see a case of it. This is false. I'm living proof of that. For years they tried to pin the PCOS label on me along with about 15 other diagnoses including but not limited to: depression, bipolar, ADD, IBS, pre-diabetes/insulin resistance, high cholesterol, etc. I told them they were wrong. I fought for the proper testing and lo and behold I was correct.

Even though it's called Polycystic Ovarian Syndrome, you don't have to have cysts on your ovaries, nor does cysts on your ovaries prove you have it. There's a certain hormone profile you have to fit. Has to do with your testosterone to estrogen/progesterone ratios.

You can have PCOS and Cushings or PCOS and other endocrine disorders combined.

I wasted a good portion of my 20's because of wrong diagnoses. I'm hoping that my 30's are better...

Oh and I wanted to add that I routinely get scans with and without contrast dye and have never had an adverse reaction while on the metformin. I've used both the CT dye and the MRI contrast.

 

[Kurby]

Did you find out your numbers? That is so important.

couldn't get through yesterday - i'll try again today but my mom said the numbers we get are different from americans.

ie she does her blood every day and is between 2 and 7 - 7 is high and she knows before taking it that it's high.

someone mentioned here 140 - 200 for their count so i'm not sure if our numbers would make any difference but i will call when they open to find out.

 

[Kurby]

I keep getting put on metformin by well meaning doctors, but it honestly doesn't really agree with me. The extended release version is much better.

Sort of OT, but I feel it's important to get out there. Please do not just blindly accept the PCOS diagnosis. PCOS is a disease of exclusion. That means they should rule out Cushing's Syndrome and any other endocrine disorder first. Most doctors do not because slapping the PCOS label on you is the easy way out. Cushing's Syndrome imitates PCOS symptoms plus a whole lot more. They are also told that Cushing's is so rare they probably will never see a case of it. This is false. I'm living proof of that. For years they tried to pin the PCOS label on me along with about 15 other diagnoses including but not limited to: depression, bipolar, ADD, IBS, pre-diabetes/insulin resistance, high cholesterol, etc. I told them they were wrong. I fought for the proper testing and lo and behold I was correct.

Even though it's called Polycystic Ovarian Syndrome, you don't have to have cysts on your ovaries, nor does cysts on your ovaries prove you have it. There's a certain hormone profile you have to fit. Has to do with your testosterone to estrogen/progesterone ratios.

You can have PCOS and Cushings or PCOS and other endocrine disorders combined.

I wasted a good portion of my 20's because of wrong diagnoses. I'm hoping that my 30's are better...

Oh and I wanted to add that I routinely get scans with and without contrast dye and have never had an adverse reaction while on the metformin. I've used both the CT dye and the MRI contrast.

that's interesting about the cushings. i was told at 25 that i have PCOS and would never have a child or at the very least would have to spend thousands in fertility treatments (i hate that dr who did that to me) - within months i had spun into a deep depression, gained so much weight, lost all my energy and frankly i blame that dr. all i ever wanted was to become a mom and she ripped that away from me.

10 years later (11 months before our wedding) i was in serious pain and passed something i called the worst period in the world. turned out i had miscarried and had been about 8 -10 weeks pg.

i was in complete shock. i had believed what the dr said and here i got pg without even knowing it.

a 18 months later we did go to a fertility dr since i was now 36 and hadn't gotten pg again and we were now married. the dr did some test (forget the name) where she pushes fluid through my tubes to see if they are clear. well - i hit the roof it was so painful. but a month later i was pg and 9 months later Cassandra was born.

turned out my tubes were 99% blocked. she likened it to having a cold all winter and never being able to blow your nose.

i did mention the pcos to her but being a fertility dr she just said that she had lots of patients who had it and were now mothers so she doesn't take that much stock in that diagnosis. and that some did have to go through extensive fertility treatments but others didn't - i didn't.

i did however take the progesterone incerts for about 12 weeks to make sure i wouldn't miscarry.

 

[Pea-n-Me]

Great posts, My2Cinderellas and honugirl.

I was going to mention the ovary thing but figured I'd said enough.

The name for the syndrome could have been better, as yes, you don't have to have cysts on your ovaries to have PCOS. As a matter of fact, no two cases will be exactly alike - everyone has unique features from a list of many symptoms that go along with the syndrome, so a skilled physician can determine the diagnosis based on having a few or many from the list.

One of the distinguishing features is a high insulin level, ie hyperinsulinemia. This is the indication for insulin resistance (ie the body is making more in an effort to compensate for insulin cells that don't work right - insulin carries sugar out of the blood stream into the liver for storage). High triglycerides is another, and there are many more (see links). Both of those things, over time, can be catstrophic if not treated, as they lead to diabetes, coronary heart disease, and more.

If anyone is reading this thread and interested in learning more, please do your research. If you think this might be something you have, it behooves you to talk to your doctor about it. Ask for a referral to an endocrinologist if you have to. As I mentioned before, I know many women who had to seek help for it on their own. It may not necessarily be something that jumps off the page otherwise. (I wish I could find that article which sums the whole thing up nicely, but I still can't.)

 

[Keggy]

I keep getting put on metformin by well meaning doctors, but it honestly doesn't really agree with me. The extended release version is much better.

Sort of OT, but I feel it's important to get out there. Please do not just blindly accept the PCOS diagnosis. PCOS is a disease of exclusion. That means they should rule out Cushing's Syndrome and any other endocrine disorder first. Most doctors do not because slapping the PCOS label on you is the easy way out. Cushing's Syndrome imitates PCOS symptoms plus a whole lot more. They are also told that Cushing's is so rare they probably will never see a case of it. This is false. I'm living proof of that. For years they tried to pin the PCOS label on me along with about 15 other diagnoses including but not limited to: depression, bipolar, ADD, IBS, pre-diabetes/insulin resistance, high cholesterol, etc. I told them they were wrong. I fought for the proper testing and lo and behold I was correct.

Even though it's called Polycystic Ovarian Syndrome, you don't have to have cysts on your ovaries, nor does cysts on your ovaries prove you have it. There's a certain hormone profile you have to fit. Has to do with your testosterone to estrogen/progesterone ratios.

You can have PCOS and Cushings or PCOS and other endocrine disorders combined.

I wasted a good portion of my 20's because of wrong diagnoses. I'm hoping that my 30's are better...

Oh and I wanted to add that I routinely get scans with and without contrast dye and have never had an adverse reaction while on the metformin. I've used both the CT dye and the MRI contrast.

I was tested for Cushings and those tests came back negative. They tested me for Cushings before the PCOS...

 

[themarquis]

Great timing of this thread, because at this very moment, I have a big, unopened bottle of Metaformin with my name on it sitting in the medicine cabinet

Anyway, it has been a long road to getting a definite PCOS/IR diagnosis. I started skipping periods about three years ago, and my nurse practitioner was really low-key about it ... sort of like 'oh, it's not a big deal --- I wouldn't worry about it'.

They sent me to a gyno at some point who was beyond uninterested and kept pushing birth control (which I don't need and wouldn't treat the PCOS in any way ) I had some other health problems at that point that they wanted to take care of first, as well.

But after all those things were taken care of and I was still missing periods (probably having like 3-4 periods a year) and a couple of numbers on bloodwork started coming up high (my blood sugar was alwyas good but my fasting insulin was coming up slightly elevated) they sent me to an endocrinologist.

The endo was great!! I really recommend going to one! She put me thru all the tests to rule out anything else like Cushings. I got a ton of blood tests and had to pee in a jar for 24 hours ... fun! Everything came back okay, but fasting insulin at the very high end of normal.

She has explained to me that PCOS is a diagnosis of exclusion. That means that there isn't really a test for it. They determine you have it if you're having certain symptoms and there's nothing else ehtat can explain why.

That's why a lot of people get kind of jerked around with PCOS -- some drs will say you have it evne though they haven't done all the other tests just because it's such a hassle and they don't want to deal with it. And then other people can't get a diagnosis at all!

I even had a dr. look at an ultrasound of my ovaries and say "there are cysts there, therefore by definition you have PCOS". This was nonsense because cysts CAN happen in PCOS but they're not the defining feature and they can also happen in women without PCOS :headache. Also it turned out that I didn't have any cysts at all ... lol ... she had misread the ultrasound . So yeah, there a re a lot of medical professionals out there who know jack about it -- just something to be aware of!

Anyway, I have a big ol bottle of metformin and I keep looking at it and saying ... maybe tomorrow ... lol. I'm so afraid of the side effects!!!!!!!!!!!!!!!!

 

[Eeyores Butterfly]

couldn't get through yesterday - i'll try again today but my mom said the numbers we get are different from americans.

ie she does her blood every day and is between 2 and 7 - 7 is high and she knows before taking it that it's high.

someone mentioned here 140 - 200 for their count so i'm not sure if our numbers would make any difference but i will call when they open to find out.

I'm used to dealing with American numbers, but can easily convert the numbers you post and let you know what they mean.