Metformin Dosage 2nd Opinion

[xnikx]

i was told in this forum that each person is beter on a dif dosage of metformin dependin on there body, when i was on the lower dose in jan-june i lost about 10kilos, i hav been on the higher one from june and i hav only lost about 3 in the past 5months, so i sugested to my doc mayb im beter on the lower dose and she said that cant be true cause as im not small in my size i should logicaly be beter on the higher, if any one has any input on this would be much apreciated

[ouzogirl]

Interesting...

I can tell you this...when I was on 500mg at first it didn't bother me at all. I was fine for the week I was on it.

Then I increased to 1000mg and I had the WORST side effects ever. Of course, I thought great when I increase to 1500mg its going to be so much worse.

I was wrong. Once I made it up to 1500mg I was fine. I feel normal, etc. DH suggested to me that MAYBE my body needed the bigger dosage and the 1000mg was too small for me.

I don't think body size should have anything to do with it. I think it has to do with your insulin levels. If you aren't terribly IR or maybe your are more sensitive to the dosage, then yes I could see how a lower dose would benefit you more than say someone like me.

Hope it works out for you!

[xnikx]

thanks for input, am seein the GYN next week will have words :D

[jennlee]

Overall Met is meant to lower your insulin resistance, which doesn’t always have to do with size, part of it is genetics. You could have two woman who both weight 200lbs on Met, and one needs 1500mg and the other woman only needs 500mg. You might be one of the lucky people who responds very well to Met, if so your doctor might want to consider lowering your dose regardless of size.

[xnikx]

wel i askd my doc about maby lowerin it she said as im not exactly small it wouldnt make sense to put me on the lower one again

[ouzogirl]

Can you find a better doctor? Maybe one who specializes in PCOS?

Does being on the higher dosage make you feel crappy or is it just the weight? I don't know how I could gain on met...I feel like the bathroom calls my name somedays...I feel like I could move in there!! But I have noticed that I retain a lot of water lately...do you get that too?

[xnikx]

im big all over hav been for years so duno if i retain water duno how i wud find out. i hav a gp doctor and a GYN i see every 6months wich is totally a waste of time just says keep takin the met and goin gym and come back again in 6months

[camaromom]

I was reading a brochure about PCOS given to me at my dd dr appt monday. It said that often people lose when starting out on Metformin, but that the weight loss effects decrease with time.

[xnikx]

so im screwed then lol i dont get why the GYN wud be keepin me on it then if its not showed any signs of helpin since almost a year ago

[quietone]

xnikx- are you on this to lose weight or to help with insulin resistance?

this is meant to treat IR, and usually when you treat IR you lose weight. Perhaps even though you have some PCOS symptoms (?) your IR is not severe enough so it stabilized quickly and that's why you haven't loss since.

Aside from the weight loss, have you noticed a decrease in cravings...or your fasting glucose not as high? Not as tired after eating carbs?

These would all be signs that your IR has stabilized.

And your info says "whole grain" so I assume your still eating grains? Every day? That could also be part of the problem.

[xnikx]

no by whole grains i mean like wheat cearel rather then sugary ones, and i hav been told i hav pcos, and im on metformin i guess intitaly to help with weight los

i used to eat alot of pasta and yes used to get tired after, but since bein on met hav cut out pasta almost all together and the ocassional once in a blue moon that i mite hav it i dnt feel as tired as i used to

i used to crave carbs but since cutin them out as best i can i dont crave them now

i think i worked out that last year wen i joined gym in april by nov i had only lost a stone surely this is way to slow on met?

[gsddiver]

Hi, I just joined this board but I have been Diagnosed with PCOS since 2000. I am on Met. While it's often helpful in losing weight that is really not what it is made for. If the only reason your Dr. is giving for your dosage is your weight, you may need to find a new Dr. And, if your Dr. told you that she/he was putting you on Met to lose weight and not saying anything about controlling your insulin. Again see a new Dr. because there are much easier ways to lose weight then taking meds. But, I don't think that just because you are not losing weight anymore that it is the wrong dose.

[xnikx]

iv been told that there is no other way to lose weight with pcos but no carbs diet and lots of exercise wich is exactly wat i was doin, goin gym 4-6 times a week for 3months and only lost 3kilos so something cant be rite

it mite be beter if uk wud alow the highest met dosage to be same as usa here its 1700 and i think in usa its 2000

[camaromom]

Well, first of all Atkins isn't NO CARBS, it is LOW CARB. Bread, pasta, and tropical fruits aren't allowed until way later in the program and that is only if you can tolerate them. The metformin does initially help with weight loss, but the main reason it has been given to you as a previous poster said is to stabilze your insulin. The weight loss effects do decrease with time. If your insulin is under control a higher dose won't help you any. You list that you have PCOS. I have a couple of questions.
1) Were you having menstrual periods before the metformin?
2) If you weren't having them before the met, are you having them down?
3) Do you check your blood sugars? Are they improved with the met?
4) What is your hemoglobin A1c test result? Is it normal now, or decreased from before?
5) Did you have acanthosis negricans before? Is it improving?
6) How are your lipids now compared with before?
7) How about hair growth patterns?

You don't have to answer if you don't want to. I'm simply trying to get you to think about the symptoms of PCOS and whether or not the met is helping.
Good luck.

[xnikx]

alot of them stuff i have never had checked not even by doc

1. i used to have periods once every 4-7months, then almost 2yrs back i went on diannet and had periods, then came off it after a few months, and ever since i have had periods every month for a year 3months and only 11months of that iv been on met
2.not sure if its due to the met or the diannet i was on
3. dont check blood sugars, dont think my doc has either
4. i hav no idea wat that is
5. no idea wat that is never been checked to my knowledge
6. no idea wat it is never been checked to my knowledge
7. not to sure iv always been hairy, i guess its the same as it was

[camaromom]

1) Were you having menstrual periods before the metformin?1. i used to have periods once every 4-7months, then almost 2yrs back i went on diannet and had periods, then came off it after a few months, and ever since i have had periods every month for a year 3months and only 11months of that iv been on met
2) If you weren't having them before the met, are you having them down? 2.not sure if its due to the met or the diannet i was on
3) Do you check your blood sugars? Are they improved with the met? 3. dont check blood sugars, dont think my doc has either
4) What is your hemoglobin A1c test result? Is it normal now, or decreased from before? 4. i hav no idea wat that is
5) Did you have acanthosis negricans before? Is it improving? 5. no idea wat that is never been checked to my knowledge
6) How are your lipids now compared with before? 6. no idea wat it is never been checked to my knowledge
7) How about hair growth patterns? 7. not to sure iv always been hairy, i guess its the same as it was

I'm thinking that you need to do some internet searches or talk with you doctor extensively to understand what PCOS is and what symptoms you can expect to see improved with the metformin.
Women with PCOS often have irregular menstrual periods. Once you improve the underlying insulin resistance often times menses resumes. If you aren't checking your blood sugar surely your doctor has done lab work to check your sugar. A woman with PCOS can have insulin resistance, but have normal blood sugars for a long time as the pancrease overcompensates, which eventually will lead to type II diabetes.
I think I would ask my doctor if (s)he has done a hemoglobin a1c test. That is a measurement of what your blood sugar has been over approximately the last 3 months. With the met you should see an improvement in this number even if you aren't diabetic.
There is an entire thread here on this forum that talks about acanthosis negricans. It is a skin condition caused by insulin resistance. The skin will appear dark and be rough. It often looks as if you haven't washed, as it appears dirty. Many women have it around the neck, elbows, breasts, groin, armpits. It should improve with the met.
Because excess insulin also acts as a fat storage hormone many with PCOS will have elevated blood lipids (cholesterol, triglycerides etc) I would think you doctor would be monitoring these.
Hair growth patterns are affected by PCOS. Many women have excessive facial hair as well as thinning hair, and extra hair on the abdomen. Some women, myself included report that this is improved with the met.

Again, I would educate my self as much as possible. The met, I'm sure wasn't only given to you to lower your weight.
Does anybody else want to help me out here?

[xnikx]

yeh i have a rough idea about pcos but all these regualr tests u say the doc should be givin me seems kinda odd as she has said no such thing neither has the GYN

is it pos that treatment in UK is dif to USA?

[camaromom]

I wouldn't think that the basic treatment would be that different whether you are in the US or the UK.

[xnikx]

wel i dont think uk nos anything about pcos doesnt sound like iv had half the treatment im ment to have had

[camaromom]

You may want to look at these sites:
http://www.4woman.gov/faq/pcos.htm

http://familydoctor.org/620.xml

http://www.rtfm.com/lowcarb/lc-pcos.html

I liked this one best
http://www.mja.com.au/public/issues/nov16/kidson/kidson.html#suba0

[xnikx]

oh i no bout hemoglobin cz it was ME mention that to GYN n he sed not to worry bout iron atm.

the other links the info on it i new most already but stil feel lost cz u lots all getin proper treatment n im 21 n dnt seem like my drs are doin much :(

[camaromom]

Hemoglobin A1c does not refer to an iron test. When you make a new hemoglobin molecule it is around for about 90 days. Therefore, when they check a hemoglobin A1c test they look at how much sugar is attached to the hemoglobin molecules. A score from 4.6 to 6 (roughly, depending on your lab) is normal. Anything higher than that means that your hemoglobin molecules have been subjected to increased levels of blood sugar. Did you check out those web sites?

[xnikx]

i did but alot of it i already no, was pretty much the basics about wat is pcos and how its treated etc

[nobimbo]

Weight Loss Benefit of Met In Women With PCOS Depends On Dosage (Study)

This study investigated whether there were signficant differences in the effects of Met on obese women with PCOS between 1500 mg and 2550 mg dosages. This study, published last May, found that there is a significant difference in weight loss for obese women with PCOS between 1500 mg and 2550 mg dosages (there was signficant weight loss with 1500 mg, and even more with 2550 mg). There was no significant difference in weight loss between the dosages for morbidly obese PCOS women (there was similar significant weight loss with both dosages for that group). No differences in reduced cholesterol were found between the dosage levels (Met lowered cholesterol similarly no matter what dosage was used). Ovarian function appeared to show improvement in all subgroups (no difference between the dosages). There were 83 women in the study and it lasted 8 months.

Abstract
Context: metformin treatment of women with polycystic ovary syndrome (PCOS) is widespread, following studies with diverse patient populations. No comparative examination of weight changes or metabolite responses to different doses has been reported.
Objective: to determine whether different doses of metformin (1500 or 2550mg per day) would have different effects upon body weight, circulating hormones, markers of inflammation and lipid profiles.
Design: prospective cohorts randomised to 2 doses of metformin.
Setting: university teaching hospital with patients from gynaecology / endocrinology clinics
Patients: obese (Ob, BMI 30 to <37; n= 42) and morbidly obese (Mob, BMI >37; n=41) women with PCOS.
Intervention: patients were randomised to 2 doses of metformin, and parameters assessed after 4 and 8 months.
Main Outcome Measures: changes in body mass, circulating hormones, markers of inflammation and lipid profiles.
Results. Intention to treat analyses showed significant weight loss in both dose groups. Only the Ob sub-group showed a dose relationship (1.5 Kg and 3.6 Kg in 1500mg and 2550mg groups respectively, P=0.04). The Mob group showed similar reductions (3.9 and 3.8 Kg) in both groups. Suppression of androstenedione was significant with both metformin doses, but with no clear dose relationship. Generally beneficial changes in lipid profiles were not related to dose.
Conclusion. Weight loss is a feature of protracted metformin therapy in obese women with PCOS, with greater weight reduction potentially achievable with higher doses. Further studies are required to determine whether other aspects of the disorder may benefit from the higher dose of metformin.

http://jcem.endojournals.org/cgi/rap...004-2283v1.pdf

[xnikx]

what wud happen if i came off of metformin cz i think i now have to start payin for my prescriptions and if i cant afford it one month will it be so bad comin off it??

[ouzogirl]

You would probably get bad side effects when you start again...

Other than that, I don't know what it would do to your cycles...

[xnikx]

am i write in thinkin that if i ever got preg unplaned not to abort cz could be only chance to have kids with pcos?

[gsddiver]

PCOS affects differant women in differant ways. Some women have no problem concieving with PCOS. Others can do it easily with the help of fert. meds. And some can't even with fert meds. Although, most women do find it hard to concieve with PCOS. My Dr. said that a lot of women with PCOS have a higher chance of miscarrage but he never showed me any statistics to support that. (Although he has been wonderful so I have no reason to doubt him) I personally don't belive in abortion, and not just because you may not concieve again. But that's a decision you have to make. If you concieve easily without planning it. Chances are you will be able to concieve again. But that is by no means a guarentee. So, you really have to decide what's right for you when the situation happens.

[xnikx]

i realy do think i wudnt b able to get preg easy, as a teen have to admit i wasnt exactly careful and never ever got preg, so i guess i was actualy quite lucky, but surely that wud sugest that im not all that fertile

[Shandybob]

Nicola I know exactly what you're going through - I haven't a clue what tests my doc is doing but he's doing a blood work every time I go down - problem is he's reading a 6 month old blood work when I do!

I don't feel better on the meds, am not losing weight as I expected, and feel very lousy and no support either.

I agree with you it seems much better in the USA after reading this forum for many months, and so frustrating that nobody understands the condition well enough :( I feel for you.

[xnikx]

ditto

glad to know im not on my own lol

where abouts are u from?

my docs not done one single blood test since i went on metformin last one was to test my hormone level to diagnose pcos

but my weight did go down a bit with help goin to the gym but then it stopped and i got down about it and havent really been back properly since, i was goin 4-6 times a week for 3months and only lost 3kilos

i have maintainted 18stone since and am thinkin of goin back again once i can get up at normal hours atm im wakin around 730pm lol i stil beleive pcos and sleep are stil related in some way but not enough research

i wish i was in usa cause then i could take higher dose of metformin and maybe lost 3more stone :(

[Shandybob]

I'm from Manchester ish! My GP is helpful to me, but doesn't understand it - I've explained better in my post tonight http://forum.lowcarber.org/showthread.php?t=290532

I'm an insomniac - hence i'm posting this at 1.45am!

My biggest problem is I'm disabled - and not at all mobile - I get a hell of a lot of inflammation and just found that on this link I just got from the forum explaining PCOS suffers get this. I couldn't believe that - there's not been an explanation for the pain I get - found one!!!!! Lol. I'll be printing that for my orthopaedic consultant for certain!!!

I've been researching on the gluten intolerence since I had a dietitian suggest I start having wholegrain bread. I'm starting to think that may be a contributing factor to myself but need to test it - especially after what has been said on this thread about it!

[xnikx]

i did try the south beach diet, but as i dont like many foods on it i wasnt eatin enough callories and thats prob why i lost the few pounds i did lol

but i def hav trouble getin to sleep at night and it has got worse over the years, i had sleep probs from todler years but through teens til now im 21 and still cant get to sleep of a nite, def a link there i think

iv read that pcos makes the amount of the sleep hormone melatonin increase so we should feel sleepy but im not :-s

[Shandybob]

Me either :( Pain keeps me up sometimes but it's not all that - it has to be PCOS. It's amazing how many problems this condition can cause :(

[xnikx]

and yet wen i use pcos as a excuse for everything my dad and fam just say im only sayin it cause im playin on it

[Shandybob]

I feel like my GP feels that way with me sometimes - or I wouldn't be self diagnosing!!! She's a real sweetie, but you know the look you get when they don't quite think you're all there?

[xnikx]

oh i know that look lol i love that look, it intimedates ppl to leave u be lol

[Shandybob]

Hah - yeah but it doesn't work on me - I mither her to death until she doesn't something! Lol.

[Jetlagjen]

I just wanted to say that I think this thread has been hugely helpful.
I've always suspected I had PCOS. (hello, I have more hair on my body than my husband) Last year my periods went wonky and so last week I broke down and went and got a blood test done. My doctor called me the other day and confirmed that ''I had a percentage of symtoms'' which I'll be grilling him about in detail next week when we meet to talk about everything. I'll be taking notes from this thread and I'll ask every question I have until I'm satisfied I know what he's talking about.
I swear to God though, he better be busting out the drugs that make me lose body hair (but not my real hair!) sharpish like!

[xnikx]

even if u didnt have PCOS and just was realy hairy, there must be something that they can give you for reducing the appearence of hair so even if it turns out u dont have it still ask about what u can do for the hair anyway