Metformin adjustment period?

swithrow656
swithrow656 Posts: 6 Member
diagnosed on Monday with PCOS. Elevated free testosterone 4.6, hdl 55 ldl 129 triglycerides 129, A1c 5.7 and vitamin d deficient. Ultrasound was normal. 5'5" 245lbs

Doc put me on 500mg metformin at bedtime and I started eating Paleo. I've been getting really bad heartburn and can't sleep due to heart palpitations. 4-5 hrs of sleep a night. Working out cardio and strength.

I'm doing what I should be. How long do I suffer with heartburn and anxiety? How long before I see and feel results?

*btw called the doc to get her views, no update from her yet.

Replies

  • aSearch4Me
    aSearch4Me Posts: 397 Member
    Quick question: Are you drinking enough water? I drink *way* more water throughout the day than the suggested general guidelines because if I don't, I get heartburn/palpitations issues. I'm not currently on Metformin but headed that way soon.

    I do eat a Low Carb High Fat Diet, and I find that if I am not drinking a lot of water, I'm prone to the dehydration issues that cause the above symptoms.
  • swithrow656
    swithrow656 Posts: 6 Member
    I average 10 cups a day. May no t be enough I guess. I'll try anything! I want this to work so badly
  • aSearch4Me
    aSearch4Me Posts: 397 Member
    I would try upping by a couple glasses a day, every few days, until you find your comfortable limit. The heart palpitations/anxiety are also "less common" side effects of Met, so it is possible it could be the Met. But, I know a lot of people get GI issues when they are first on Met, so you may be requiring a bit more water-intake than you did before.

    I also found out that when I went Low Carb, my water intake requirement went WAY up to keep the palpitations/heartburn at bay, but I have always become dehydrated easily. If you've also recently bumped up activity/strength, you could be requiring more water.
  • swithrow656
    swithrow656 Posts: 6 Member
    I drink until I'm sloshing around. Urine is mostly clear. Doc told me I'd have to go in again to talk about Zoloft. Still can't sleep though. Lol
  • KnitOrMiss
    KnitOrMiss Posts: 10,104 Member
    You might consider switching the time of day you take your Metformin. For me, it triggered such a high energy response that I had to take it during the day. I waited a full day plus about 12 hours to shift it from being at night to being in the morning, and I took the 500 mg ER. It made such a difference for me... I don't know what different it might make in heartburn and such, but if you take it shortly before laying down, it might be a gastro effect that takes a modified form...
  • ravenstar25
    ravenstar25 Posts: 126 Member
    I have doubts, serious ones, over the use of "paleo" or other low carb diets as "reatment" for PCOS> There is not actually much in the way of studies to support it, only one small one I ever found that suggests women with PCOS lose a tiny amount more weight on a low carb diet than on a typical low calorie diet. I also had heart palpitations on extreme low carb, so I stopped. I suggest listening to what your body tells you.

    Metformin has helped my weight loss, although I think my doctor should raise my dosage as I seem to have stalled... it helps a lot of women with PCOS, but not all. If you are on met, you shouldn't need to do low carb as metformin regulates your insulin so you have a more normal blood sugar curve. Although I would still avoid sugar, no need to push the issue (plus sugar with metformin will make you sick!)
  • swithrow656
    swithrow656 Posts: 6 Member
    My body finally adjusted! If I have a say of palpitations, I drink more water and add some healthy carbs to my next meal. I'm still keeping carbs between 50-75 daily.

    I'm a little nervous; upping the metformin dose to 1000mg tonight. My fiancé is so supportive and totally on board. He thinks paleo is stupid and I love to joke with him about it. He made Zoodles last night for dinner and BOTH of us loved them. Yay! Next up cauliflower rice with the new ricer.
    Still hoping to feel better and lose weight. That wedding dress may need alterations!
  • Dragonwolf
    Dragonwolf Posts: 5,614 Member
    I have doubts, serious ones, over the use of "paleo" or other low carb diets as "reatment" for PCOS> There is not actually much in the way of studies to support it, only one small one I ever found that suggests women with PCOS lose a tiny amount more weight on a low carb diet than on a typical low calorie diet. I also had heart palpitations on extreme low carb, so I stopped. I suggest listening to what your body tells you.

    Metformin has helped my weight loss, although I think my doctor should raise my dosage as I seem to have stalled... it helps a lot of women with PCOS, but not all. If you are on met, you shouldn't need to do low carb as metformin regulates your insulin so you have a more normal blood sugar curve. Although I would still avoid sugar, no need to push the issue (plus sugar with metformin will make you sick!)

    1. Paleo is not necessarily low carb. It is generally lower carb by default, simply by virtue of shifting the foundation of one's diet away from grains, but fruits and tubers are still fair game and can quickly increase the amount of carbohydrate in the diet.

    2. PCOS responds quite well to lower carb diets, and not just on the weight front, and Metformin's job is often augmented, and its side effects reduced, by said lower carb diet. The exact carb amount depends largely on how well a person responds to the changes. Some women do just fine doing the "low-GI" or "slow carb" route, while others may need to go further down. More study needs to be done (because unfortunately, there haven't been many formal studies), but here's one of the pilot studies on the matter, here's a larger study, as well (the real cool part about this one is that it was a weight-maintaining diet, so weight loss can't take credit for the improvements). And another one.
    KnitOrMiss wrote: »
    You might consider switching the time of day you take your Metformin. For me, it triggered such a high energy response that I had to take it during the day. I waited a full day plus about 12 hours to shift it from being at night to being in the morning, and I took the 500 mg ER. It made such a difference for me... I don't know what different it might make in heartburn and such, but if you take it shortly before laying down, it might be a gastro effect that takes a modified form...

    My thinking was along the same lines.

    Also, what are you usually eating for dinner? I found that if I have starch or sugar with or after dinner, I'm pretty much guaranteed heartburn. If you're still getting heartburn, try evaluating what you're eating for dinner and give eating fewer starches/sugars at that meal a try for a week or so and see if you notice a difference.
    I drink until I'm sloshing around. Urine is mostly clear. Doc told me I'd have to go in again to talk about Zoloft. Still can't sleep though. Lol

    If it comes back to that, check out Phosphatidyl Serine before going to the SSRI route, especially since there seems to be a known trigger and it's a temporary thing. Phosphatidyl Serine is a type of phospholipid that is important in cell signalling. Supplements of it are known to help reduce cortisol levels. The nice thing about it is that it has fewer side effects and acts faster than SSRIs like Zoloft (you can take the PS on an as-needed basis, which is a nice bonus).
  • KnitOrMiss
    KnitOrMiss Posts: 10,104 Member
    Dragonwolf wrote: »
    I have doubts, serious ones, over the use of "paleo" or other low carb diets as "reatment" for PCOS> There is not actually much in the way of studies to support it, only one small one I ever found that suggests women with PCOS lose a tiny amount more weight on a low carb diet than on a typical low calorie diet. I also had heart palpitations on extreme low carb, so I stopped. I suggest listening to what your body tells you.

    Metformin has helped my weight loss, although I think my doctor should raise my dosage as I seem to have stalled... it helps a lot of women with PCOS, but not all. If you are on met, you shouldn't need to do low carb as metformin regulates your insulin so you have a more normal blood sugar curve. Although I would still avoid sugar, no need to push the issue (plus sugar with metformin will make you sick!)

    1. Paleo is not necessarily low carb. It is generally lower carb by default, simply by virtue of shifting the foundation of one's diet away from grains, but fruits and tubers are still fair game and can quickly increase the amount of carbohydrate in the diet.

    2. PCOS responds quite well to lower carb diets, and not just on the weight front, and Metformin's job is often augmented, and its side effects reduced, by said lower carb diet. The exact carb amount depends largely on how well a person responds to the changes. Some women do just fine doing the "low-GI" or "slow carb" route, while others may need to go further down. More study needs to be done (because unfortunately, there haven't been many formal studies), but here's one of the pilot studies on the matter, here's a larger study, as well (the real cool part about this one is that it was a weight-maintaining diet, so weight loss can't take credit for the improvements). And another one.
    KnitOrMiss wrote: »
    You might consider switching the time of day you take your Metformin. For me, it triggered such a high energy response that I had to take it during the day. I waited a full day plus about 12 hours to shift it from being at night to being in the morning, and I took the 500 mg ER. It made such a difference for me... I don't know what different it might make in heartburn and such, but if you take it shortly before laying down, it might be a gastro effect that takes a modified form...

    My thinking was along the same lines.

    Also, what are you usually eating for dinner? I found that if I have starch or sugar with or after dinner, I'm pretty much guaranteed heartburn. If you're still getting heartburn, try evaluating what you're eating for dinner and give eating fewer starches/sugars at that meal a try for a week or so and see if you notice a difference.
    I drink until I'm sloshing around. Urine is mostly clear. Doc told me I'd have to go in again to talk about Zoloft. Still can't sleep though. Lol

    If it comes back to that, check out Phosphatidyl Serine before going to the SSRI route, especially since there seems to be a known trigger and it's a temporary thing. Phosphatidyl Serine is a type of phospholipid that is important in cell signalling. Supplements of it are known to help reduce cortisol levels. The nice thing about it is that it has fewer side effects and acts faster than SSRIs like Zoloft (you can take the PS on an as-needed basis, which is a nice bonus).

    I had cortisol testing done extensively, @Dragonwolf, including a 24-hour urine test, and did not show any problems. If I still have difficulties settling down to sleep and such, do you think something like this might help? I know L-Theanine helped in the past (Melatonin never did anything for me), but it isn't budget friendly...
  • Dragonwolf
    Dragonwolf Posts: 5,614 Member
    KnitOrMiss wrote: »
    Dragonwolf wrote: »
    I have doubts, serious ones, over the use of "paleo" or other low carb diets as "reatment" for PCOS> There is not actually much in the way of studies to support it, only one small one I ever found that suggests women with PCOS lose a tiny amount more weight on a low carb diet than on a typical low calorie diet. I also had heart palpitations on extreme low carb, so I stopped. I suggest listening to what your body tells you.

    Metformin has helped my weight loss, although I think my doctor should raise my dosage as I seem to have stalled... it helps a lot of women with PCOS, but not all. If you are on met, you shouldn't need to do low carb as metformin regulates your insulin so you have a more normal blood sugar curve. Although I would still avoid sugar, no need to push the issue (plus sugar with metformin will make you sick!)

    1. Paleo is not necessarily low carb. It is generally lower carb by default, simply by virtue of shifting the foundation of one's diet away from grains, but fruits and tubers are still fair game and can quickly increase the amount of carbohydrate in the diet.

    2. PCOS responds quite well to lower carb diets, and not just on the weight front, and Metformin's job is often augmented, and its side effects reduced, by said lower carb diet. The exact carb amount depends largely on how well a person responds to the changes. Some women do just fine doing the "low-GI" or "slow carb" route, while others may need to go further down. More study needs to be done (because unfortunately, there haven't been many formal studies), but here's one of the pilot studies on the matter, here's a larger study, as well (the real cool part about this one is that it was a weight-maintaining diet, so weight loss can't take credit for the improvements). And another one.
    KnitOrMiss wrote: »
    You might consider switching the time of day you take your Metformin. For me, it triggered such a high energy response that I had to take it during the day. I waited a full day plus about 12 hours to shift it from being at night to being in the morning, and I took the 500 mg ER. It made such a difference for me... I don't know what different it might make in heartburn and such, but if you take it shortly before laying down, it might be a gastro effect that takes a modified form...

    My thinking was along the same lines.

    Also, what are you usually eating for dinner? I found that if I have starch or sugar with or after dinner, I'm pretty much guaranteed heartburn. If you're still getting heartburn, try evaluating what you're eating for dinner and give eating fewer starches/sugars at that meal a try for a week or so and see if you notice a difference.
    I drink until I'm sloshing around. Urine is mostly clear. Doc told me I'd have to go in again to talk about Zoloft. Still can't sleep though. Lol

    If it comes back to that, check out Phosphatidyl Serine before going to the SSRI route, especially since there seems to be a known trigger and it's a temporary thing. Phosphatidyl Serine is a type of phospholipid that is important in cell signalling. Supplements of it are known to help reduce cortisol levels. The nice thing about it is that it has fewer side effects and acts faster than SSRIs like Zoloft (you can take the PS on an as-needed basis, which is a nice bonus).

    I had cortisol testing done extensively, @Dragonwolf, including a 24-hour urine test, and did not show any problems. If I still have difficulties settling down to sleep and such, do you think something like this might help? I know L-Theanine helped in the past (Melatonin never did anything for me), but it isn't budget friendly...

    It shouldn't hurt to try. PS is still a needed compound in the body, so the body will put it to use, even if it's not getting used for cortisol purposes.

    Have you checked out sleep hygiene resources yet? They might help, too. Things like f.lux for your computer and turning down the lights in the evening can go a long way to helping you sleep better at night, and many/most of them are free.
  • Cupcaker35
    Cupcaker35 Posts: 18 Member
    I also recommend taking the Metformin XR, it is easier on the digestive track. If you aren't able to switch to the extended version make sure you take in enough water and be mindful of the type of foods you eat. I. My experience fo
    atty foods and too much sugar can upset your tummy very quickly.

    Please make sure you do some sort of cardio regularly. As you become physically active your body uses insulin more effectively.