There is very little risk of hypoglycemia while taking metformin because of it's mechanism of action. That why it is so frequently/liberally prescribed- the risks of side effects are so low. So you really shouldn't need to worry about it- just keep doing what you are doing!

I was on it for 5 years (20 years ago) with good results but I stopped it because i was having some low blood sugar episodes ( i thought it was the metformin and I had reached a normal weight so i though i didn't need it anymore. In reality I was probably just not eating enough at that time) Wrong decision. I just restarted it 5 days ago to HELP my low blood sugar and it is helping ALOT I made an uninformed decision that probably made things harder for me for 15 years. My daughter who is 30 has been on it for many years, whenever she tries to go off of it she feels worse, is hungrier and gains weight. She has PCOS, i do not, i just have bad insulin resistance. The last 5 days, i am having less low blood sugar, less hunger and I have had a much easier time eating within my calorie and carb limitations. I dont do low carb, but I do moderateamts of very high quality carbs.

I have emailed doctors before and had them email me back or call me back or dropped off a letter to be placed on his or her desk. You have a valid question. I am an RN. Most Doctors will get back to you witin a few days.

Also my daughter and I are both on the extended release version. I take it at night, she takes it in the am. It is much easier to take once a day. something to consider. good luck!

I've been put on Metformin, 500mg. I know that this is half the dosage of a Type II diabetic (I dated one for four years, so I'm very familiar with Metformin).

Not necessarily. It was just half the dose of the one you dated. Metformin is dosed based on how you respond to it, so it's very individualized.

But this is the problem. Since I know that it lowers insulin levels, and I know I'm trying to lose weight, I'm worried that I will not eat enough to counteract the Metformin, and I don't want my blood sugar to plummet overnight, since I take the pills in the morning and in the evening.

As others have mentioned, Metformin's mechanism of action does not result in low blood sugar. Metformin simply increases the liver's insulin sensitivity, allowing the body to better gauge when it needs to release glucose into the blood and when to quit doing so.

You can actually be on Metformin and not eat any carbohydrates at all, and in fact, many women find they have to reduce their carbohydrate intake in order to get Metformin to stop causing GI upset issues.

I just started Metformin for PCOS myself. I'm on week 2 and full of curiosity and questions- this thread was great! :-)

I have PCOS so am going to bump this to read completely later on

I just started Metformin last night, and I'm glad there's a community here for support!

My background: I was diagnosed with PCOS in 2009 at the age of 31, but I've probably had it since adolescence. My mother died of uterine cancer in 2011 (and had estrogen-positive breast cancer before that), most likely caused by the Hormonal Replacement Therapy she was on for 3 years after menopause, so I am prohibited from taking any kind of hormonal medication (like birth control) to control my PCOS.

About ten years ago, I got up to 195 pounds and managed to lose 50 lbs through a combination of eating within a strict calorie limit of 1350, exercising A LOT, and eating low-carb (and thanks to going to a dietician to create a food plan and help me stick to it!). Unfortunately, depression stuck after my mother died, and a combination of eating for comfort, the depression meds, and well, the depression itself has caused me to gain the 50 pounds back within the past two years.

That, combined with recently realizing PCOS is making my hair a lot thinner, motivated me to go to an endocrinologist last week, and now I'm on Metformin ER (500 mg/day for the first week, 1000 mg/day after that). My stomach feels a little upset this morning, but it's not bad and if anything, it's just making me not want to eat a snack before lunch. I know Metformin can cause stomach upset if you eat a lot of refined carbs, so I'm focusing on eating a lot of protein and vegetables and avoiding carb-heavy meals and sweets.

Hopefully, the combination of Metformin and gently reducing carbs will help me get back to a healthy weight without needing to strictly track and count my calories/carbs. That kind of tracking did make me lose weight, but it got really obsessive for me, to the point where I would rather remain overweight than get back into that mindset again.

I'd love to hear your experiences on Metformin and what it's done for your weight and other PCOS symptoms like period regularity, unwanted body hair, thinning head hair, acne, etc.!

@ALNoog - have you altered your way of eating since you started the Metformin? My blood sugars went crazy when I began eating low-carb. My doctor made me stop checking and just checked my A1C every 6 months and I have been fine.

I continued to take Metformin for months after I began to lose weight and stopped taking insulin at the suggestion of my endocrinologist. I am not sure what impact it had on my symptoms. I think it was the weight loss and increase in exercise that lessened the facial hair and regulated my periods. An ultrasound 3 years later revealed that I still had cysts on my ovaries but my symptoms were still abated.

ravenstar25 wrote: »

I only cut down on sugars with metformin for GI issues.

I had to scale carbs way back, and it eventually got to the point where even fiber would trigger GI issues. It definitely takes some experimentation.

I had tried low carb but actually it can be super unhealthy and make you REALLY sick, as it did me.

There is a known adaptation phase, during which if you don't know how to deal with it, you can get really sick. It largely boils down to electrolyte imbalances and sodium deficiency.

Likewise, many people conflate the usual "low fat!" mantra with low carb, resulting in a low fat, low carb, high protein plan, which is dangerous and isn't really sustainable. Healthy, sustainable low carb is not also low fat, but at least moderate, if not high, fat.

It's also easy to undereat unintentionally (and even worse if you're already used to chronically undereating), which can lead to lack-of-food related issues. Low carb generally doesn't encourage very low calorie, because the point is that you don't need to starve yourself, but rather, can eat a sane amount of food and get comparable results.

In short, don't dive in (to any major lifestyle change, really) head first without doing some homework, so you know what to expect, how to ease any transition discomforts, and so you know the difference between "normal" and "something is genuinely wrong."

It's not a natural or healthy way to eat

There's nothing unnatural at all about eating meat and vegetables. It's arguably more natural than what most of society eats today.

It's also not unhealthy by itself. There are unhealthy ways to do it, yes, but there are unhealthy ways to implement the ways of eating that many consider inherently healthy (see also: junk food veg*ns). Subsisting off of hydrogenated vegetable oil margarine and "sugar free!" foods is largely the low carb equivalent of a junk food veg*n who lives off peanut butter on white bread sandwiches and Oreo cookies.

Also, the Inuit, plains Indians, and Maasai people, among others, have all historically lived -- and thrived -- on diets low in carbohydrates for countless generations prior to contact with Western Europeans. I think that qualifies as "natural."

and there isn't medical support behind it

Fun fact: prior to 1980, the medical community did not believe that blood sugar could be controlled at all, and did not believe that, even if it could, it was necessary to controlling the progression of Diabetes.

There is actually about 150 years of medical support behind low carb diets, if you know where to look. There are books and papers dating back to at least the mid to late 1800s of people like Dr. James Salisbury, who have sent various disorders into remission through the use of very low (and even zero) carbohydrate diets. The ketogenic diet has been studied for nearly a century for its neurological benefits.

Contemporary general doctors don't support it largely because they don't stay current with research and run off of what they were taught in med school, which is also largely behind the times. The medical industry has a ton of inertia when it comes to changing their minds on how things are (with keto, for example, they still go off of the studies that used the old method of inducing ketosis, which has been largely abandoned for superior methods that don't require starving and dehydrating the patients). It's also a highly competitive industry, leading to heavy crab mentality, which results in the character (and career) assassination of those who speak too loudly against the party lines. You'll actually find a lot more medical support of it in the specialist arenas, particularly among endocrinologists.

and I wish people would stop pushing it as a cure because it isn't.

Hippocrates saw centuries ago that food is, in fact, the cure. While not everyone may benefit (or benefit fully) from a properly implemented low carb diet, many, many people are. Just like anything else, they're going to share their successes and encourage others to try it, because it just might work. You (general "you") don't know until you give it a try, though.

For many of us, particularly the subset of us here with insulin resistance, it very much is a cure, and has saved us from the mental and emotional toll that comes with starving ourselves and exercising to death for very little (if any) progress.

Foods with carbohydrates also have a lot of vitamins you need. Taking them as a supplement just isn't the same.

You don't need supplements to get the vitamins and minerals you need. However, you don't need "foods with carbohydrates," either (unless you're defining that so loosely that even liver falls into that category, but I'm going to assume you mean the same as most people when they say that -- starchy foods like grains and potatoes, and sugary foods like fruit). Also, going low carb does not mean going low vegetable. In fact, most people report eating more vegetables (and more variety of vegetables) after going low carb than they did before.

Technically speaking, you don't need plant material at all to get all of the nutrients you need. When it comes to superfoods, liver actually blows away all of the others out of the water on nearly every metric. The vitamins and minerals aren't bound up in insoluble fiber or phytates, either, come with a dose of fat built in (required for vitamins A, D, E, and K), and are generally in the bioactive forms (K2 vs K1, vitamin A vs beta carotene, etc), making them more bioavailable than most of their plant-based counterparts.

If you want to include vegetables, that's perfectly fine, too (low carb, generally speaking, isn't about no vegetables, remember). Non-starchy vegetables are fine sources of vitamins and minerals, as well as phytonutrients, antioxidants, and fiber, without the starch or sugar hit that grains, starchy vegetables, and fruits have.

All the nutrition, none of the major blood sugar/insulin hit.

Then, there's also the matter that for many people, eating some of these types of foods actively hinder nutrient absorption and even actively make them sick. For example, I was chronically anemic, despite consuming upwards of 400% the RDA for iron, until I cut grains out of my diet. Turns out that grains have phytates in them that block iron absorption and it was enough to make me anemic. Likewise, I know a number of people with salicylate sensitivity which means that eating nearly any plant material (because all plants make salicylates) makes them sick and malnourished. Both of these issues are generally considered "idiopathic" (aka - "we don't know why it happens, it just does"), and so the cause of the issue, and the path to the cure is, in fact, the food.

If you feel better on a comparable diet containing more carbohydrates and it's working for you, then great! Seriously, that's awesome and I encourage you to share your success story. However, please do not make vague claims to low carb being "unnatural," "super unhealthy," or vitamin deficient. If that is your opinion, please back it up with more detail on why you believe that, otherwise there's no way to tell whether it was your implementation that needed tweaking or if it's the way of eating itself.