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Eating LC, on Metformin, and not insulin resistant??

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stacymarie01
stacymarie01 Posts: 20 Member
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I was diagnosed with PCOS in Nov. of last year and was prescribed Met even though my IR came back "good." After 4 months of taking the Met and seeing no results with my weight, acne, or exhaustion, I've finally come to accept that I need to eat low carb in order to see any changes. So my question is this: Does is really make sense to take the Met if I'm eating low carb and am not IR???

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  • KnitOrMiss
    KnitOrMiss Posts: 10,104 Member
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    Met has a lot of things it can help with...but I honestly don't understand the full mechanism. If you are in the LCD group, @cstehansen over there is T2D, but not IR, despite his body acting like he was. I think he found that his main issue was managing his stress and cortisol levels to bring his elevated glucose numbers down, but being a man, he doesn't have the same hormonal issues. However, my insulin levels are technically "in range," but I'm honestly not happy with a 7.8. It's been as high as 15 and as low as 5.8... I don't honestly feel too different now, though admittedly, my fasting glucose yesterday was the lowest it's been in as far back as I have numbers 2009). Kind of was a shock...
  • bellaa_x0
    bellaa_x0 Posts: 1,062 Member
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    I'm also on Metformin for PCOS - not insulin resistant either. What dose are you taking? I am on the maximum dose (1,000 mg twice daily) for over a year now and have dropped over thirty pounds. I still have irregular periods (which is when I get cystic acne) but my endocrinologist said that it takes time for your hormones to be regulated again by the medicine after having been off for so long. I would speak to your doctor about it before you stop taking it completely.
  • stacymarie01
    stacymarie01 Posts: 20 Member
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    I am on 500 mg 3x a day.

    I'll keep taking it, and see how things go over the next 9 months until my followup appt.
  • bellaa_x0
    bellaa_x0 Posts: 1,062 Member
    edited April 2017
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    stacymarie01 wrote: »
    I am on 500 mg 3x a day.

    I'll keep taking it, and see how things go over the next 9 months until my followup appt.

    your next appointment isn't for nine months? my endocrinologist had me coming in WAY more frequently than that initially. granted, i also have hypothyroidism. but i would consider speaking to your doctor about increasing your dosage to the max.
  • Dragonwolf
    Dragonwolf Posts: 5,600 Member
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    KnitOrMiss wrote: »
    Met has a lot of things it can help with...but I honestly don't understand the full mechanism. If you are in the LCD group, @cstehansen over there is T2D, but not IR, despite his body acting like he was. I think he found that his main issue was managing his stress and cortisol levels to bring his elevated glucose numbers down, but being a man, he doesn't have the same hormonal issues. However, my insulin levels are technically "in range," but I'm honestly not happy with a 7.8. It's been as high as 15 and as low as 5.8... I don't honestly feel too different now, though admittedly, my fasting glucose yesterday was the lowest it's been in as far back as I have numbers 2009). Kind of was a shock...

    Based on my knowledge of how Metformin works (basically, by making the liver more sensitive to insulin), it doesn't make sense to me to use Metformin if you're not insulin resistant. Managing stress goes a long way, as do supplements that work through other mechanisms (Inositol works by improving the neurological communication pathways, for example), and I think would be a better route for people with PCOS without insulin resistance.
  • bellaa_x0
    bellaa_x0 Posts: 1,062 Member
    edited April 2017
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    Dragonwolf wrote: »
    KnitOrMiss wrote: »
    Met has a lot of things it can help with...but I honestly don't understand the full mechanism. If you are in the LCD group, @cstehansen over there is T2D, but not IR, despite his body acting like he was. I think he found that his main issue was managing his stress and cortisol levels to bring his elevated glucose numbers down, but being a man, he doesn't have the same hormonal issues. However, my insulin levels are technically "in range," but I'm honestly not happy with a 7.8. It's been as high as 15 and as low as 5.8... I don't honestly feel too different now, though admittedly, my fasting glucose yesterday was the lowest it's been in as far back as I have numbers 2009). Kind of was a shock...

    Based on my knowledge of how Metformin works (basically, by making the liver more sensitive to insulin), it doesn't make sense to me to use Metformin if you're not insulin resistant. Managing stress goes a long way, as do supplements that work through other mechanisms (Inositol works by improving the neurological communication pathways, for example), and I think would be a better route for people with PCOS without insulin resistance.

    @Dragonwolf

    "In the group of patients without insulin resistance, BMI, LH and FAI showed significant reductions, and FSH/LH and SHBG considerable increases. Considering the favorable effects of metformin treatment in PCOS patients both with insulin resistance and without it, it is purposeful to use this drug in both groups of women."

    https://ncbi.nlm.nih.gov/pubmed/17505944
  • MeepleMuppet
    MeepleMuppet Posts: 226 Member
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    I'm in the same boat - Not insulin resistant, three years into active treatment for the PCOS but I was never prescribed Metformin until last week. I have been taking Spironolactone for two years and worked very well for a long while. I also started eating "lowish" carb, which also worked well....until they didn't and I started sliding backwards again. Nothing had changed so all my best efforts were just no longer working. Both my endo and my primary said it was time for a little help and I started Metformin just yesterday. Endo, GP, and pharmacist (who also has PCOS) all said the low carb lifestyle was key regardless of what meds I was on.
  • KnitOrMiss
    KnitOrMiss Posts: 10,104 Member
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    MeepleMuppet wrote: »
    I'm in the same boat - Not insulin resistant, three years into active treatment for the PCOS but I was never prescribed Metformin until last week. I have been taking Spironolactone for two years and worked very well for a long while. I also started eating "lowish" carb, which also worked well....until they didn't and I started sliding backwards again. Nothing had changed so all my best efforts were just no longer working. Both my endo and my primary said it was time for a little help and I started Metformin just yesterday. Endo, GP, and pharmacist (who also has PCOS) all said the low carb lifestyle was key regardless of what meds I was on.

    Ugh, warnings @MeepleMuppet - if you struggle with dehydration at all, ever, the combo of Metformin and Spiro about put me in the hospital. They are both dehydrating due to the way they work so just be aware!

    I take the brand name Glucophage, and other than the first 14-28 days adjustment, I don't have any of the normal digestive complaints or dairy interference, any of it. Most of my digestive dramas stem from going too long between meals and not having a gallbladder.
  • bellaa_x0
    bellaa_x0 Posts: 1,062 Member
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    KnitOrMiss wrote: »
    MeepleMuppet wrote: »
    I'm in the same boat - Not insulin resistant, three years into active treatment for the PCOS but I was never prescribed Metformin until last week. I have been taking Spironolactone for two years and worked very well for a long while. I also started eating "lowish" carb, which also worked well....until they didn't and I started sliding backwards again. Nothing had changed so all my best efforts were just no longer working. Both my endo and my primary said it was time for a little help and I started Metformin just yesterday. Endo, GP, and pharmacist (who also has PCOS) all said the low carb lifestyle was key regardless of what meds I was on.

    Ugh, warnings @MeepleMuppet - if you struggle with dehydration at all, ever, the combo of Metformin and Spiro about put me in the hospital. They are both dehydrating due to the way they work so just be aware!

    I take the brand name Glucophage, and other than the first 14-28 days adjustment, I don't have any of the normal digestive complaints or dairy interference, any of it. Most of my digestive dramas stem from going too long between meals and not having a gallbladder.

    metformin itself does not cause dehydration... the constant diarrhea some people encounter, perhaps, but never heard of of dehydration as a side effect of the medication itself.
  • MeepleMuppet
    MeepleMuppet Posts: 226 Member
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    On it! The Spiro is completely dehydrating and I've been painfully aware of JUST how dehydrating every time I need to get a blood draw and it fails. I'm amazed that I went from wanting to die to perfectly fine by just not having my glass of milk with dinner. We'll see what happens when I stop cutting the pill in half :)
  • stacymarie01
    stacymarie01 Posts: 20 Member
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    My Dr. prescribed the Met, followed up in 6 weeks, and then said she didn't need to see me for a year....I guess it would be closer to 8 months, but still.
  • stacicali
    stacicali Posts: 137 Member
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    Hi Stacy - I personally am a big fan of metformin but am on a higher dose (1000 mg twice a day - Please do have your dr monitor your B12 levels yearly and supplement if they fall below 500.) What tests did your dr use to say that you are not insulin resistant? You may have been put on Metformin to help prevent IR. This link has some helpful tests to request since IR is tricky and complicated to diagnose. It also has other options if you prefer to manage with diet and exercise alone: http://pcoschallenge.org/symposium/2016-atlanta-presentations/lean-pcos-fiona-mcculloch.pdf
  • stacicali
    stacicali Posts: 137 Member
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    I think this may be the full version of the study bella_xO referenced:
    http://m.eje-online.org/content/157/5/669.full
    Outlines the ways metformin is helping you, even if you aren't insulin resistant.

    I've read of berberine being an alternative to metformin: http://pcosdiva.com/2016/01/berberine-for-pcos-supplement/
    But please be careful and use under a dr's care and monitoring. Also, the FDA does not regulate supplements, so heaven knows what amounts are actually in the pills. Choose a manufacturer very carefully.
    I've also read about inflammation being a possible root cause/contributor of PCOS, so you may investigate an anti-inflammatory diet as a strategy to help your symptoms.
  • stacicali
    stacicali Posts: 137 Member
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    http://www.ovarian-cysts-pcos.com/gtir-insulin-resistance.html
  • stacymarie01
    stacymarie01 Posts: 20 Member
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    Thanks girls, I have been pretty off course the last month. I was traveling and then just didn't get back on track when I got back. I'm determined to get back on track today. I'm easing back onto the Met and will try to up my dose to 1000 mg/2 times a day. I'm also lowering my carbs, especially the bad ones. Interestingly after a month of being very off course I had a horrible period month, lots of pain with ovulation and with my period, so maybe things were helping more than I thought they were.

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