Help! Doc just ordered glipizide
JessicaLCHF
Posts: 1,265 Member
Been type 2 several years now. Was doing ok with low carb (around 40-60 net carbs) for a year, but started to get higher numbers in the am blood test. Doc put me on glucophage, but my body will not tolerate it. Without any meds my am sugars are 140-160 and around 200 after meals (soar to 300 if I eat a lot of carbs). I've been reading on this and lots of ppl claim to gain weight on glipizide - which scares me cause it's hard enough to lose weight now! I have a thyroid issue too, and been struggling with the same ten pounds several months now. Anyone on this med? Did you gain weight? How do I avoid it? Also my goal is to get off all diabetic meds! Am I going to be able to if I get on this med?! Also I'm a little worried about low sugars since I don't eat a lot of carbs. Is this a real concern since my natural numbers are already high? She put me on a moderate dose (5) but wants me to double it after a week.
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Oh, boy. That's a tough one! Were you on brand Glucophage (not generic Metformin)?
At the risk that you've already read this in another thread, such as http://community.myfitnesspal.com/en/discussion/comment/39569015#Comment_39569015 ......
Glipizide (IMHO) Is not a good substitute for Metformin!
It does have hypotensive and hypoglycemic tendencies - not good when you're reducing your BG through LCHF - and it also stimulates insulin production. \
If your medical insurance is reasonable, it should allow you to take brand name Glucophage XR with a physician's statement of need.
In my case, it brought a near-total cease-fire after months of heavy lower-GI artillery fire on generic Metformin.
http://community.myfitnesspal.com/en/discussion/10394798/t2d-glucophage-name-brand-metformin-generic
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I seem to tolerate the generic metformin OK. I do wonder if you might have better results with the name brand and the XR version. I was diagnosed T2 last October, and my initial carb goal was 50 a day. On days when I was under, my glucose numbers were better too. I changed my carb goal to 20 net as an experiment, and my numbers fell. I left them at 20.
FWIW, my morning fasting numbers are typically higher than I would like. By that I mean they were 108 today and 117 yesterday. My 30-day average for all my readings is at 111 as of right now.0 -
40-60 net may still be too much. At least for the moment until and if more reversal progress can be made.
Do you incorporate any fasting?
Just throwing out idea...3 -
I asked her about switching to the non generic. I have asked before but she says it won't make a difference. I'll see what she replies.
No, I'm not interested in fasting. I've tried it all and it causes me to overeat at night. I'd rather just eat 3-4 meals and keep my sugars fairly stable all day.
I'm reluctant to start the new meds at all, even on a trial basis if it causes 10-20 pounds of weight gain due to the sugar use alone! I'm reading ppl online who are less and exercised more and the medicine still caused 10-20 pound gains! That would devastate me.0 -
JessicaLCHF wrote: »I asked her about switching to the non generic. I have asked before but she says it won't make a difference. I'll see what she replies.
Ignorant Doc - - > Dumpster?0 -
Sunny_Bunny_ wrote: »40-60 net may still be too much. At least for the moment until and if more reversal progress can be made.
Just throwing out idea...
I am going to suggest - just based on my experience - that you try reducing the carbs as an experiment of your own. If it does not work, you are in the same place you were before. If it helps you may have solved your problem.
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I can absolutely attest to the brand name making universes worth of difference. Metformin made me a full on diarrhea/bile poo factory. Glucophage? Nada unless I eat stupid amounts of sugar or dairy WITH it...and even that is questionable whether it is a result of the glucophage. My ... symptoms have also been more managed after increasing the digestive enzymes I take for my non-gallbladder situation, but I started the Gluco months before I increased the enzymes.
That being said, do you feel that your thyroid is optimally managed? Because insulin levels and thyroid levels are such a yin-yang type of balance. Lower insulin tells your body to make less thyroid and less thyroid triggers insulin resistance and about a dozen other things... So it's a horrible cycle if at least one part isn't mostly balanced. Optimal TSH for anyone over 20-25 is supposed to be 0.5-1.5. I know that I've been at a 2 and still felt room for improvement. I recently switched from synthetics to NDT, so I've been catapulted back into not level ThyroidHell....
Sending (HUGS) for all the ups and downs, @JessicaLCHF - make sure you check the warnings on that med. When I was helping my mom check hers, I think that was one that interfered with something else she was on...2 -
Yeah so heard back from my doc and she said no. She thot it would be ineffective and expensive to switch. As far as dumping her, this is a small remote town. There are literally no other doctors here I would go to. I've had her for years and usually agree with her. She had mentioned an injectable that not only lowers blood sugar but can help drop weight but said it was very expensive. We are currently without insurance (thanks Obama) and can't get coverage from anyone in state. We are going through the channels for Obamacare but it's going to be a long difficult haul. So for now we have to pay for everything from meds to dr visits in cash. If is not too awfully expensive tho I'd rather try that than go on something that's almost guaranteed (IMO) to make me put on weight. From what I gather it's due to the forced increase of insulin from the pancreas that uses the blood sugars that usually don't get used, creating more extra fat storage and more "efficiently" using every single calorie you eat. I'll let you know the name of this other medicine (she had only mentioned it and it's side effect in passing) and what she says as well as the (shudder) cost when she replies back to me. Doctors here are so booked it's hard to even get a visit, so I do most "visits" with her via email.1
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Ps as far as my thyroid, same thing. One endocrinologist in town. He's happy with my levels and refuses to adjust them. I've been complaining if being exhausted, no dice. Edit: my extreme exhaustion could be a side effect of the extreme bowel issues from the metformin for months on end which also depleted my magnesium and potassium. I'm just a mess.
I'll post my last levels in a screen shot. I'm on 200mcg synthroid.
Last levels in March: 1.33
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@JessicaLCHF, I had markedly different reactions to different cheap generics of metformin XR (of which there are many). If you have a good pharmacist, you might be able to find one that works... But I wouldn't blame you for not wanting to put yourself through that exercise.
If I might be so nosy, how did you happen to stumble onto LCHF and our LCD group?0 -
@JessicaLCHF, I had markedly different reactions to different cheap generics of metformin XR (of which there are many). If you have a good pharmacist, you might be able to find one that works... But I wouldn't blame you for not wanting to put yourself through that exercise.
If I might be so nosy, how did you happen to stumble onto LCHF and our LCD group?
I have no idea. Been here for years tho. On and off. I can't remember how it started as far as this group. As to LCHF, I have been low carb for several years now and kept thirty pounds off (as much as up to fifty but that all came back over the summer as I went through two extensive painful surgeries). I did old school Atkins and that slowly morphed into LCHF for me through reading the 30 day Diabetes Cure and watching the video Fathead.
I've been stalled with weight loss several months now, but at least I'm not gaining. I have a very painful frozen shoulder and it's practically immobile, chronic constant pain which is a while other issue. It hurts to even walk and I'm not working right now. But I need to get to a point where I can pretty soon. My husband is an RN and nurse educator so we are doing ok financially but it's very very tight. As I'm sure you can figure. I spend me days crying. Lol. Not really but almost. Been through several orthopedic doctors, nine months of physical therapy with no results, and have my third doctor in the next state over appt June 6th which I'm really hoping to have insurance for by then! Cause they ALL want X-rays and MRIs! Ugh.
Edit: I say stalled but not exactly stalled. Just very very slow.
More than you prolly wanted to know.
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Just checked. Said my first visit was January of 2015. I think it's been longer than that. I had a name change tho (I stupidly started with my actual name) and maybe it reset. I believe I found this group pretty much at the very beginning. It's also the only group I ever go on here.0
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I'm sorry to hear of your woes.
You're obviously doing yourself a big favor by being informed - though it probably doesn't seem very obvious when you're not feeling well.
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I'm sorry to hear of your woes.
You're obviously doing yourself a big favor by being informed - though it probably doesn't seem very obvious when you're not feeling well.
Thanks
I'm really hoping things level out soon. My daughter does similar but she's KETO and dairy and sweetener free and also does intermittent fasting. She tries to convince me to try it all the time, but it's not for me. She's lost over 60 pounds tho and just got into onederland. I'm really excited and happy for her. She had two babies in two years but she's young and I'm glad she's taking control of her health at her age. 1 -
The med she's talking about is Byetta, twice a day. I'm going to price it out and see if it's doable. She mentioned two others in today's email that I can also look into: Januvia and Trajenta. I'm going to research them all a bit.
Byetta, Januvia, Trajenta - I'm starting a new thread on these.0 -
I fear I can't offer you any help on this one.
FWIW, my personal take is that Glucophage is the only relatively safe (no hypos) and effective med (other than the honorary meds, exercise and diet, of course).
If you haven't watched Dr. Bernstein's great Diabetes University vids on YouTube or read his book, Diabetes Solution, now might be a good time!0 -
Update: um, yeah, the CHEAPEST is $276 a month. No thanks! I sent another request to my doc asking for third time if she will let me try the Glucophage which will be $76 out of pocket (no insurance). We'll see what she says. I told her at least if I tried it I can say I tried everything before giving up on metformin. The stomach issues I had with it were severe.0
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JessicaLCHF wrote: »Update: um, yeah, the CHEAPEST is $276 a month. No thanks! I sent another request to my doc asking for third time if she will let me try the Glucophage which will be $76 out of pocket (no insurance). We'll see what she says. I told her at least if I tried it I can say I tried everything before giving up on metformin. The stomach issues I had with it were severe.
I had full-blown GI warfare
on one of the generics, but no reaction to Glucophage. 
$76 for 2000-2500mg/day seems reasonable, though barely.
To be honest, the internal combustion era was before (and the main reason) I went seriously LC. I had experienced years of digestive woes, but it is all, um, behind me now.
I think to give even generic Metformin a fair shake, it's best to get rid of those *kitten* carbs.0 -
@cstehansen - What was your research on using Berberine (?) in place of Metformin/Glucophage? I seem to remember decent results.0
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JessicaLCHF wrote: »Update: um, yeah, the CHEAPEST is $276 a month. No thanks! I sent another request to my doc asking for third time if she will let me try the Glucophage which will be $76 out of pocket (no insurance). We'll see what she says. I told her at least if I tried it I can say I tried everything before giving up on metformin. The stomach issues I had with it were severe.
I had full-blown GI warfare on one of the generics, but no reaction to Glucophage.
$76 for 2000-2500mg/day seems reasonable, though barely.
To be honest, the internal combustion era was before (and the main reason) I went seriously LC. I had experienced years of digestive woes, but it is all, um, behind me now.
I think to give even generic Metformin a fair shake, it's best to get rid of those *kitten* carbs.
I tried. Cut dairy. Did even a stool test. It's the metformin. Stopped immediately with it. On/off trials brought it right back.1 -
@JessicaLCHF - You seem to be fairly well managed as far as TSH, the pituitary hormone that stimulates thyroid function release. I personally would request the testing for Total/Free T4 and Free and Reverse T3. I think @GaleHawkins or @RalfLott had links to where you could test it yourself, out of pocket (not too expensive, as I recall...maybe through lifeextension?) if your doc still refuses. You can have the TSH managed, but still need to add a T3 med. I convinced my Endo to test it, and the RT3 test got left off accidentally, so my PCP ran it for me, and the Endo added the med T3 only. We went on with that for a while, and this last time, I finally convinced him to put me on NDT (I'd tried it once before, in the middle of QC issues, and never adjusted the dosage to symptoms). It's been a painful adjustment, and in fact may be why I got sick this time around (during the adjustment period)...
Was supposed to do labs this week to evaluate, but being sick will skew it all, so waiting a week or so... I hard crashed every day for weeks when I normally would have taken the T3 meds...
Which, btw, did you realize all of this, including your insulin management and all that, is compromised by poor digestion? Since I've FINALLY added the right doses of digestive enzymes, I've been able to get my D3 and B12 and Ferritin levels up some, but still working on optimal. T4 is converted to the active, usable T3 IN THE GUT...
So if you haven't gotten your gut completely level and fully functional again yet, that might be your next step!1 -
Doc just called in glucophage! Yay! Well... guess I'm not too excited about a $133 cost. But worth a shot!! I'm gonna try it. That's the only way I'll know for sure. I'm sure my doc thinks I'm insane but IDC. I do not want a possible twenty pound gain!!!2
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KnitOrMiss wrote: »@JessicaLCHF - You seem to be fairly well managed as far as TSH, the pituitary hormone that stimulates thyroid function release. I personally would request the testing for Total/Free T4 and Free and Reverse T3. I think @GaleHawkins or @RalfLott had links to where you could test it yourself, out of pocket (not too expensive, as I recall...maybe through lifeextension?) if your doc still refuses. You can have the TSH managed, but still need to add a T3 med. I convinced my Endo to test it, and the RT3 test got left off accidentally, so my PCP ran it for me, and the Endo added the med T3 only. We went on with that for a while, and this last time, I finally convinced him to put me on NDT (I'd tried it once before, in the middle of QC issues, and never adjusted the dosage to symptoms). It's been a painful adjustment, and in fact may be why I got sick this time around (during the adjustment period)...
Was supposed to do labs this week to evaluate, but being sick will skew it all, so waiting a week or so... I hard crashed every day for weeks when I normally would have taken the T3 meds...
Which, btw, did you realize all of this, including your insulin management and all that, is compromised by poor digestion? Since I've FINALLY added the right doses of digestive enzymes, I've been able to get my D3 and B12 and Ferritin levels up some, but still working on optimal. T4 is converted to the active, usable T3 IN THE GUT...
So if you haven't gotten your gut completely level and fully functional again yet, that might be your next step!
Yes, I do know that. I take two probiotics plus apple cider vinegar already. I've also had all those T tests. All came back within normal limits.0 -
I had to drop my ACV and go to strictly Digestive Enzymes. I'm not even managing any probiotics right now. My life is too chaotic to make sure I take them correctly, away from food, etc. The ACV started triggering asthmatic type episodes related to some kind of reflux. It has been the weirdest thing.
Since the thyroid and adrenals are so tied together, have you done the research on that side, too? @cstehansen may even have some insight into cortisol, too.
Carnitine is the one thing I finally decided to try that seems to be helping me with AM energy, though I don't understand the specify why, other than supporting muscle mitochondria energy usage...but my body is so weird, so I don't know if it translates into making sense for anyone else! I know during the hard office move we just did, I had very little muscle fatigue and soreness despite 5-10 times my normal activity for almost a week straight.0 -
I'm sure my chronic pain isn't helping either and the resultant poor sleep. On top of that I've been getting lockjaw every few days due I believe to teeth clenching in my sleep. I think I have the pillow trick for preventing it figured out. Hopefully.
After a long winter I'm sitting here in a 93 degree day in Vermont (nice!) with a heating pad on my knot in my shoulder for relief (not so nice). But maybe I'll lose some weight! It's like a sauna! Lol.0 -
In regard to berberine, there are several studies. This is one where you can get to the full text and shows pretty solid data that it is effective for BG control. However, like every study, it shows it is not 100% of people that gain benefit. The same can be said of metformin, though.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377488/1 -
As for thyroid and adrenals, I have not yet gone down that rabbit hole.0
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For pain, @GaleHawkins has been using some great protocols!
Personally, I've been experimenting with turmeric and ashwagandha...and boron/zinc. Seems to be making some improvements, though it's hard to tell yet.0 -
Tried tumeric. No dice. I have a frozen shoulder going on two years now. Had two surgeries on it. One with bone shaving. Doc took me off all pain meds three months ago due to him thinking I was becoming a drug addict. I take ibuprofen or Celebrex for it. Neither do much. Primary wants me to try acupunture. Once I have insurance I might try it but for now 300$ a week is out of reach. I already take zinc. Not sure what that other one is. I'll take a look but with my level of pain I doubt it will help. The only thing that was helping was hydrocodone. Even that only took the edge off, I still couldn't use my arm. But at least I was not grinding my teeth at night. My jaw hurts all the time (mildly), and some days I can't chew at all. My endocrinologist seems to think the frozen shoulder is related to my Hashimoto's.0
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