meds again

jmzz1

I just wanted to know how many mg of metformin did you guys start taking initially?
Was it 1 tablet of 500 mg or 2 tablet of 500mg per day?

I also want to know what where the macros you where maintaining while on metformin?
Thanks in advance

Alliwan

did you decide to go the med route? I know you've been trying not to for awhile now.

My doctor did and initial blood test to test for my fasting insulin level. Then she put me on 1 pill of 500mg of Metformin each night for a week and then bumped me up to 2 pills of 500mg each every night. I was on that dose for 2 months and then she did another fasting insulin test and my numbers were right smack dab in the middle of normal so we are holding at that dose for now.

She told me to keep a low carb diet, which is typically under 100g NET carbs a day but that I would find what works for me. I have sensitive tummy issues and took ginger pills during the first month of taking Metformin but don't have to take them now. but if I go over about 50g net carbs a day my tummy will remind me that that's too much for me in a very painful way. So I do about 50g net carbs, 100g protein and about 130g fats each day but those numbers fluctuate a little each day.

You've got to find what works for you. I know some PCOSers who can do 100g of carbs a day and lose weight and pcos symptoms and others like me, who have to go lower to see any weightloss at all. Exercise especially weight lifting has helped most PCOSers lose weight steadily.

jmzz1

yep i decided to go the med route since my doctor strongly adviced me to have metformin for atleast 3 months. i tried without meds for 2 years but alas no result so thought this to be the only way left for me

my doc did not advice me anything related to my carbs intake

Dragonwolf

yep i decided to go the med route since my doctor strongly adviced me to have metformin for atleast 3 months. i tried without meds for 2 years but alas no result so thought this to be the only way left for me

my doc did not advice me anything related to my carbs intake

Unfortunately, most doctors won't. Too many people have it in their heads that diet doesn't make a difference, despite the huge number of people who are successfully controlling a number of ailments (PCOS included) through diet. And most doctors have almost zero training in nutrition (seriously, it's like one one-semester class in med school, and it's all the USDA party line crap).

Low-carb, high-fat does well for women with Type 1 PCOS (insulin resistant; those that respond well to Metformin). How low carb you go will depend on your needs, but I've found 50-100g to be a good starting place. Pick a number for your max carbs, calculate your protein needs by finding your lean body mass (1g/lb or 2g/kg of lean body mass), and fill the rest in with fat. Yes, that will result in what seems to be a crazy amount of fat, but that's a good thing (and no, it won't raise your cholesterol, even if it's high to begin with). You want to fill in with fat, not protein, because protein causes an insulin response, and that's not what you want. Also, fat and carbs are for fuel, protein isn't. Protein is for building and maintaining muscle. Fat is also essential for absorbing Vitamins A, D, E, and K, and for maintaining proper hormone balance, and cholesterol is required for making Vitamin D, and for brain health. And, of course, stick with whole foods, ideally organic for at least "the dirty dozen" produce (thin, edible skinned stuff, basically), and pastured animal products, both for the better nutrition profiles and the reduced contamination with the various synthetic hormones and other endocrine disruptors.

More on topic, I'm at 1000mg twice daily. I started out walking it up from 500mg at night, then 500mg in the morning and night. I was on that dose for a while, but my doctor upped it when I wasn't really responding to that amount (no surprise, there, I was at 2000mg the last time I was on it). I tried for a few days to walk it up the same way, but after that I just went up to my full dosage, because it was hard to remember how many to take when, and I was still getting the GI issues. The GI issues are the same for me regardless of whether I go up by 500mg or 1000, so I just went the band-aid route and upped it, dealt with the GI issues for a week, and was done (provided I don't eat trigger foods).

I try to eat low-ish carb - between 75-100g is most sustainable for me right now (I find it hard right now to get much below 75g, though I plan on trying a Whole 30 in March, so I might be able to drop lower with the eliminated dairy and added sugar intake from all sources, I'll be playing that by ear, though). My fat and protein are determined by the aforementioned method, which results in a split of about 15c/25p/60f for 1980 calories (75g c, 124g p, 132g f). Since carbs and protein are calculated by grams, your percentage values might vary. I also follow a Paleo/Primal eating framework, so I stay away from grains, since I've found my body can't really tolerate them (between the Met reaction, eczema, and headaches...), and legumes (particularly soy, because of the high levels of phytoestrogens, and I just don't like legumes, anyway). Doing something similar, or at least getting away from gluten might be worth a try, since a lot of women with PCOS are also gluten sensitive.

jmzz1

Dragonwolf if you don't mind can i have the list of food items which you consume mostly.

Dragonwolf

Dragonwolf if you don't mind can i have the list of food items which you consume mostly.

No, it's a secret. :laugh:

Nah, I'm just kidding, I'm more than happy to give a run-down. It varies largely with the seasons, especially with produce (so like, right now, I'm eating more citrus and potatoes than I would in the summer, for example), and again, my planned Whole 30 attempt will change things up a bit (by dropping the dairy, coffee, and any sources of added sugar), just a head's up.

Breakfast (one of the listed items)
Bulletproof coffee (or the Primal Egg variation; BPC is butter and coconut oil blended into coffee; Primal Egg is 3 eggs, butter, (optionally) coconut oil, a little milk, and a little sugar blended into coffee)
Bacon and eggs
Omelet muffins (eggs, bacon, veggies, baked in a muffin pan)

Lunch (usually a protein, veggie, and sometimes fruit)
Whatever's left over from last night's dinner (particularly in the protein and cooked veggie departments)
Oranges/clementines (winter)
Strawberries (summer)
Raw carrots or bell peppers

Dinner (usually a protein and one or two veggies)
Beef, bison, chicken, lamb, venison, or pork in some variation (one of the latest experiments was bacon-wrapped chicken breast, that was a meat-gasm right there, let me tell you), sourced from local farms that pasture the animals; usually grilled, sometimes baked, occasionally stir-fried or tossed in a slow cooker/crockpot with random onions and veggies and whatever else is on hand; fattier cuts are rarely drained of fat when not grilled (can't really help it with grilled), and excess fat is generally left on and eaten (or at least attempted, I'm still getting used to eating the pieces of fat on the meat, especially the larger pieces of fat, but it's full of nutrients)
Salad w/ whatever greens are available, tomatoes, cheese, peppers, carrots (and whatever other veggies of choice), sunflower seeds and/or almonds (instead of croutons), and whatever dressing I'm in the mood for (I'm a Ranch fanatic, so at home I use Annie's Cowgirl Ranch, or just sour cream if I'm doing a taco salad)
Steamed broccoli and/or carrots (generally drowned in butter, I love buttered broccoli)
Mashed sweet or white potatoes (winter, usually)
Spaghetti squash (especially autumn, sometimes in other seasons), usually made as spaghetti, so buttered lightly and with a meat and tomato sauce, and some shredded cheese if we have any on hand

Snacks (I don't generally do snacks, but when I do, it's usually one of the following)
Piece of cheese
Handful of nuts
Piece of dark chocolate (the darker, the better; chocolate is full of antioxidants, but milk destroys them all; aim for around 80%+ dark to get the benefits and minimize the sugar without getting too bitter)
Piece of fruit
Cottage cheese
Glass of milk (whole milk to get the good nutrients; not homogenized over homogenized, raw or low-heat pasteurized over conventionally pasteurized, local if at all possible; raw milk is illegal to sell in my state, so I get low-heat pasteurized, non-homogenized from one of a couple of local dairies; the protein in milk generates quite an insulin response, though, so be wary of that, though homogenized is the only one tested to my knowledge, see some details here - http://www.marksdailyapple.com/dairy-insulin )

Also, some things that are not on the list - anything that gets fried in a skillet usually has some coconut oil to start with (it has a low melting temperature, which makes it good to keep food from sticking before the other fats melt, the unrefined kind adds a nice light flavor, and the medium chain fat content is great for the body in general). Meats are often marinated in a vinegar and olive oil based marinade, and we make huge use of herbs and spices of all sorts in just about everything.

While it sounds/looks like a heart attack waiting to happen, all of my lipid numbers are optimal and had significant improvements since I started eating this way (including increased HDL and decreased triglycerides), and the results are pretty typical of diets like this.

jmzz1

today is day 3 of metformin and i am getting stomach discomfort . is it normal?

dragonwolf thanks for the list of food items . they are of great help to me . just wanted to ask you how many tablespoon of coconut oil do you consume in a day?

Alliwan

today is day 3 of metformin and i am getting stomach discomfort . is it normal?

dragonwolf thanks for the list of food items . they are of great help to me . just wanted to ask you how many tablespoon of coconut oil do you consume in a day?

yes its normal. but I found that Ginger helps a lot. I took ginger pills but others have taken ginger tea. I only had to take it for about a month and a half and then the metformin didn't bother me anymore, but ginger used for a lot of tummy upset problems.

Dragonwolf

today is day 3 of metformin and i am getting stomach discomfort . is it normal?

dragonwolf thanks for the list of food items . they are of great help to me . just wanted to ask you how many tablespoon of coconut oil do you consume in a day?

I don't keep much track, and it varies greatly depending on what I cook and I don't eat it straight (something about the way it melts when you eat it just doesn't do it for me). When I use it for pan frying stuff, I'll generally toss about a tablespoon or so into the pan (enough to give the pan a good coating). So, it can be anywhere from none at all to 3 or 4 tablespoons.

And yeah, stomach discomfort is normal and can last upwards of a week (and sometimes more), and can recur if you eat a food that it disagrees with.