PCOS and Metformin???

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kirianna55
kirianna55 Posts: 459 Member
So 7/31 I had my IUD removed because of complications with it migrating. SInce then I have been to the hospital and diagnosed with ovarian cysts and the possibility of PCOS and PID. I am going to an obgyn to confirm this. I am hoping to get on Metformin and possible a balanced estrogen/progesterone birth control. I have not had a steady period since removal, so I want to get back to being regular again. I have been tested for pregnancy and am not. I would like to be but my husband and I are not in a place to support a baby, and my weight could cause the baby health issues.

Last time I tried to lose weight, I lost 20 lbs in 5 months and then could not lose any more weight after than, no matter what I did.

Has anyone else had success with PCOS and Metformin?

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  • kirianna55
    kirianna55 Posts: 459 Member
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    I also did not have PCOS before my IUD.

    From the research I have done, my doctor will likely put me on a diet with less than 40% carbs. I will also have to cut out all sugar and refined carbs.

    I have been hypoglycemic since I was in middle school. I am very sensitive if I go to long without food. I have to eat every 2-4 hours or I have a sugar crash and get sick.

    I have not been on metformin before. I have always been told "you are fat, lose weight" by doctors but they do not give solutions or advice other than "don't eat carbs". I have tried everything from high calorie/ low exercise, low calorie/ high exercise, high exercise/high calories, atkins, paleo, and primal. I cant seem to get more than 5-10 lbs off before I struggle to lose weight. I need to lose 100-140 lbs. I am currently 294.8 lbs and would like to be 180-160 lbs.

    Before my iud, I had regular periods but I was on pills or nuvaring. I have been on hormones since I ws 16. Now I am 23. We thought I was pregnant since I had not had a period in 50 days. We were so excited to have a baby since we just got marries last month. But the hospital said that I am not pregnant and that the baseball sized cyst on my left ovary is causing my pregnancy symptoms. Heck, today I drank my morning coffee and proceeded to throw up while on the phone with a nurse. I see my obgyn friday.

    Also my paternal aunt has PCOS and so does my mother.
  • WV_Fit
    WV_Fit Posts: 14 Member
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    I wasn't diagnosed with PCOS until 8 months after having an IUD removed, but I had an unexplained miscarriage 1 year before the IUD that the doctors believe was PCSO related, so who knows.

    I was diagnosed with PCOS last November but I was only just put on medicine last week Thursday due to issues I am having. I never had acne before and now I look like a teenager, I am tired all the time and in the last 2.5 years I have gained 60lbs despite constantly being on some kind of diet. My doctor prescribed me tri-sprintec bc hoping it would help with the acne and started me on MetFormin ER 500mg twice a day. He recommended that I eat a low carbohydrate diet and avoid processed foods altogether.

    I reviewed MetFormin before starting and the reviews have been pretty spot on for me. My stomach has been a roller-coaster since starting but today is day 6 on it and already that seems to have eased some. I have lost 3lbs in the last 6 days but it could easily be water weight.

    I'm very optimistic about the Metformin and the Tri-sprintec. I would love to feel like myself again. This past year, every time I look in the mirror I just don't recognize this sad, woman looking back at me.
  • memedandy1
    memedandy1 Posts: 10 Member
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    I have found that Metformin seems to be helping a bit in my weight loss. It is important however to still pare this with exercise and watching your calories. I used to go to the gym regularly and then got stuck after about 20lbs no matter how much I worked out it wouldn't change. I am now at about 20lb lost in 2 months (fastest I've lost weight,) and am still going strong. It's worth a try to talk to your doctor about it.
  • kirianna55
    kirianna55 Posts: 459 Member
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    Thanks! I see the doctor Friday.
  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
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    Last time I tried to lose weight, I lost 20 lbs in 5 months and then could not lose any more weight after than, no matter what I did.
    I have always been told "you are fat, lose weight" by doctors

    Both of these suggest that you might have had PCOS long before you got the IUD, even though you say you didn't. A lot of women with PCOS still have regular periods. Most doctors are pretty clueless about it and are very quick to blame your weight on shortcomings on your part.
    I have been hypoglycemic since I was in middle school. I am very sensitive if I go to long without food. I have to eat every 2-4 hours or I have a sugar crash and get sick.

    Generally speaking, hypoglycemia actually comes from a high-carb diet, which is what the USDA recommends. In my experience, you can reverse hypoglycemia and other glucose/insulin related disorders by following a diet that limits the amount of refined carbs you take in. (I know Type I Diabetics who have reduced the amount of insulin down pretty much to the basal levels, and a number of Type II Diabetics who have basically reversed their Diabetes through the use of LCHF/ketogenic diets.)

    I did some spot-checking of your diary, and one of the big things that I noticed was that even when your diary goals were set to a low carb style, you weren't actually eating low carb (in fact, it almost looked like you rebelled against the idea). Do you have a time logged when you felt you were actually following low carb?

    Here's what I generally recommend for a way of eating for PCOS:

    Focus on whole foods - Processed crap not only tend to have a lot of carbs and sugar, but also a bunch of other additives that can act as endocrine disruptors. Additionally, they provide very little nutritional value. By focusing on whole foods, you get all the nutrients you need and then some.

    Avoid/limit soy - They phytoestrogens in soy can screw with our already screwed up endocrine system.

    Avoid/limit whey - Yes, the poster child for healthy eating, Greek yogurt, isn't all that great for us. Whey, one of the primary proteins found in milk, is highly insulinogenic. Since our weight loss issues generally stem from too much insulin, consuming a food that raises it even more is counterproductive. Butter is generally still okay, as it is primarily fat and contains very little of the other parts of milk.

    Avoid/limit gluten - There's some rather compelling anecdotal evidence that there's quite a bit of overlap between PCOS and gluten sensitivity. I, personally, just limit all grains, but at least aim to limit the gluten grains - barley, rye, oats (unless specifically labelled), wheat. This is actually quite a bit easier to do when you focus on whole foods, and start basing your meals around meats and vegetables, instead of grains and starches.

    Limit all sugar sources, especially refined - Our bodies, by and large, can't really process carbohydrates all that well, and sugar is sugar, regardless of the source. Fruit is only marginally better, because it has fiber and micronutrients, but you can get the same things from vegetables, without the sugar. If you want fruit, try favoring low-sugar ones, such as berries, over high-sugar fruits.

    This may seem daunting at first, which is probably why you've failed so many other times, so here's a way to go about it:

    Base your meals around a protein/fat and non-starchy vegetables - Omelets with spinach, mushrooms, and ham, for example, or grilled steak and steamed broccoli with butter. This mental shift in meal approach makes the above so much easier.

    Pair proteins and carbs with fats - You may have heard the Diabetic addage "pair carbs with proteins," but we need to limit insulin. While limiting glucose is part of the path to limiting insulin, it's not everything. Protein also raises insulin, but fats don't raise either glucose or insulin. So, for both, it will provide fuel and blunt the insulin release.

    Now, what about settings?

    Set a maximum carb goal of no more than 100g - This is a more realistic goal for most people, and will still give you a lot of the benefits of lower-carb eating. This provides a good starting point, and can easily be tweaked from here.

    Set your protein goal to about 100g - The actual formula for adequate protein is 1g/lb of lean body mass (total weight minus fat). What I've found is that this generally works out to about 100g (+/- ~20g) for most women, and since the 1g rule is the high end of a guideline range, 100g is generally more than sufficient. It's also a doable number as long as you have a protein at each meal.

    Fill the rest in with fat and don't fear it - Yeah, with the above settings, this number is going to be fairly large. That's okay. Fat is not just good for you, but vital for your health. The big thing for women with PCOS is that it helps balance hormones and aids nutrient absorption. It also provides steady fuel, without the hypoglycemic episodes.

    Additionally, like I said, don't fear fat. The only fat you need to avoid is trans fat (hydrogenated oils, basically). Saturated and monounsatured fats, especially, are your friends, as are Omega-3 dominant fats. Start cooking with coconut oil, butter, and lard (ideally, from pastured animals). Coconut oil is loaded with Lauric Acid, a fatty acid that has been shown to help blood glucose regulation. Butter and lard are 40% monounsaturated fats, including the same fatty acids that are in olive oil. Butter also contains conjugated linoleic acid (CLA) and Butyric Acid, compounds revered for their health benefits. Put olive and nut oils on your salads and in other cold uses (such as homemade mayo). This gives you the benefits of these fats, without risking oxidation (which has basically the same effect as trans fats). These fats also provide you with satiety and fuel, making it easier to stay below your calorie goals.

    Yes, it's basically high fat, low carb, Paleo/Primal. It also works, but you have to give it a solid, fair shot for at least 21-30 days. Try it, strict, for a month, and see how you feel after it. Don't do it for a couple days, or even a week or two, and give up. Give it the full month.

    With this approach, weight loss may not be immediate - There is a caveat - weight loss may not be immediate. The idea of something like Paleo is to heal the body, first and foremost. Attain that healthy state, and weight loss comes a lot easier. Don't focus on the weight to judge whether or not a way of eating is successful. Look at the health markers -- skin and hair changes (especially if you have acne or are dealing with hair loss or excess hair), bloating, energy, cholesterol levels, insulin levels, etc.

    One of the problems with losing weight with PCOS is that unless you're one of the lucky ones that aren't insulin resistant (which, from the sound of it, you don't fall into that category), the only way to lose weight is to force your insulin down. There are four ways to do that -- Metformin, Inositol supplementation, low-carb, or very low calorie. The catch, of course, is that any one of those may or may not work, it may take a combination of them to work, and not all of them are particularly healthy (especially in the long run).

    Now, for the thing you specifically asked about -- Yes, Metformin can work. For some people, it works great. I lost about 60lbs initially with its help. I also lost about 20lbs the second time I was on it. However, Metformin is not a magical weight loss pill. It does one thing, and one thing only -- increases the liver's insulin sensitivity. If you are by chance not insulin resistant, then it will have limited, if any, effect for you. Even if you are insulin resistant, there's a chance it won't help you, or its effects may be limited. Additionally, it has a couple nasty side effects.

    I actually ran into this the last time I was on it. I was on 2,000mg (the max for extended release). It worked great for me for the first few months. My insulin was down, I'd lost about 20lbs. However, then I stalled out, and even with the Metformin, my insulin went back up to slightly more than it was before I'd even started it. Additionally, I never lost the "GI upset" side effect that more than half of people on it get. Fiber was my worst enemy for a while, let's just leave it at that. Additionally, that higher level risks B12 deficiency, because high doses of Metformin can result in B12 malabsorption. So, I ended up making the executive decision to stop taking it. (Side note - I went into detail about how Metformin works in my blog, feel free to check it out, here -- http://www.myfitnesspal.com/blog/Dragonwolf/view/pcos-insulin-and-metformin-614886 )

    Inositol supplementation can also work. Inositol is a pseudo-vitamin (ie - it's a compound we make) and comes in several forms. The kinds you can get for supplementation and are most important to PCOS are D-Chiro Inositol and Myo-Inositol. Like Metformin, Inositol increases insulin sensitivity. However, Inositol is a step above in that it does this for all cells, not just the liver. It also doesn't have the side effects of Metformin and has a positive influence on your cycle. The catch here, though, is that it's nowhere near as cheap as Metformin -- compare about $1/month for Metformin vs about $15-$30/month for Inositol -- and most doctors don't know about it, or dismiss it as quickly as they dismiss the possibility of your weight being due to PCOS.

    I personally think that the best course of action is the above diet/lifestyle changes in combination with Metformin and/or Inositol, if necessary. Not only do I think the diet changes will go a long way on their own, but they also help to work with the Met/Ino, instead of against them. Think about it this way -- if you have a cut that required stitches, what are you going to do in the following days? Are you going to pick and pull at it, keeping it open (eating a high-carb diet while taking Metformin)? Or are you going to do what you can to help it heal, or at least not get in the way of the healing process (limit the sugars/refined carbs, etc)? The stitches (Metformin) can help solve the problem, but it has its limits, and can't be as effective if you're doing things to undermine its purpose.

    I know this was long-winded, but I hope it provides some more insight into not only Metformin, but also the "reduce carbs" dietary recommendation.
  • kirianna55
    kirianna55 Posts: 459 Member
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    Thank you. I plan on switching to under 100 carbs a day when my husband and I can go shopping again. Until then I have to eat what we have.

    I went in to a obgyn when I was 17 with all of the symptoms of pcos and showed multiple cysts on my.ovaries, but she did not feel that it was pcos but all the symptoms were caused by my weight.

    When we go shopping again on the 3rd, I plan on switching to 80-90% meat and veggies with 100-120 grams of protein a day, 100 or less grams of carbs, and the rest in healthy fats. I recently found out that I am allergic to eggs, gluten, and kiwi so those will be out. I use to eat 3 eggs a day for breakfast until I started getting sick. I will likely.cut out most dairy except butter and half and half. I have cut out all soy, HFCS, processed foods, and we are working toward cutting out gluten once we can go shopping again.

    Also I usually try to do something like steak with a side of veggies. Yesterday we had baked chicken with steamed kale for dinner. We are discussing doing paleo/primal one the 3rd comes around again.
  • Alliwan
    Alliwan Posts: 1,245 Member
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    I will likely.cut out most dairy except butter and half and half. I

    try whole cream instead of half and half, more fat and flavor, less carbs and you can make cool things like cool whip with it
  • kirianna55
    kirianna55 Posts: 459 Member
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    My husband am do alternate between half & half and whipping cream
  • bewright09
    bewright09 Posts: 4 Member
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    I was diagnosed with PCOS about 5-6 years ago. I was mostly controlling the symptoms with birth control since my husband and I weren't planning on having kids at the time. My Doctor prescribed me Metformin in February of this year after I told her we had been unsuccessful in conceiving. She gave me the meds to aid in my weight loss, hoping that shedding the extra pounds would 'reset' my cycle and make me fertile. I honestly don't think I could have lost the weight I did without the medication. Insulin resistance and PCOS typically go hand in hand, and it can be very difficult to maintain or lose weight without medications.

    So, Long answer short: yes, Metformin helped me lose weight. Unfortunately, that is all it did! I still have an irregular cycle, etc.

    p.s. I also started off with a low dose of Metformin and eventually tripled it in order to get the desired effect. So if its not helping right away don't give up! Good luck :)
  • kirianna55
    kirianna55 Posts: 459 Member
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    Thanks