Thread: PCOS and Just prescribed Metformin RX for high A1C...

There's really no reason to NOT start the metformin. In your case, you are insulin resistant (most likely....goes along with pcos). And the diet doesn't necessarily cure this issue. I am now at a very healthy weight, my triglycerides are silly low, my a1c is 5.0....but my fasting glucose is always around 100 and my insulin levels are high. Recent research has shown that high insulin levels, and therefore insulin resistance is just as harmful to your body in the long run as high glucose levels....and left untreated, your pancreas eventually says enough already and stops producing insulin altogether. Most do fine with metformin while on hcg. You mentioned your a1c was high....all the more reason to start the metformin. Just watch your glucose levels and report any dizziness or signs of low glucose to your doctor.

ILuvKats - does that mean that even if you'd be in the normal BMI range, you'd still be insulin resistant? Mweh. I've found that all my PCOS symptoms get triggered once I'm above 80kg (176 lb), especially losing weight is atrociously difficult and slow. I know that in the US you'd be considered glucose intolerant (IR) from a fasting glucose of 5.6 mmol/L whereas in the UK, the range starts at 6.1 mmol/L. My fasting glucose test last April was 5.9 mmol/L, up from 5.7 mmol/L last November. So basically, I really have to help myself because the doctor won't move a finger until I slide even deeper into pre-diabetes territory.

However, reading your comment has me worried that despite my losing weight won't help reverse IR? Ever??

Originally Posted by HappiestMom

I havent started the metformin yet, we go through medco so it'll be a while before its here..I dont have any blood sugar episodes..wondering if I should even start the metformin or just start my HCG diet once my HCG gets here..which will also be a few weeks...I figure if I havent started the metformin yet it cant hurt to not start it until after the diet if I even need it then...as opposed to what would happen if I just stopped it cold turkey...my hubby also takes metformin as well..so if I end up not using it he can just use it so no loss money wise really.....

anyone else on metformin but did the diet instead or stopped the metformin for your diet?

I have taken my 850 mg dose through both of my rounds and I've been just fine. Having said that, I've been on Metformin for years so it doesn't really affect my blood sugars or make me sick or dizzy anymore. I'm not sure about taking it right when you start this very low carb/calorie diet but most do fine with it from what I hear. I agree with the PP though, if you feel dizzy or weird or weak, you might need to reevaluate and definitely report those things to your Dr. Does your Dr. know you're doing the diet?

Originally Posted by teutonica

ILuvKats - does that mean that even if you'd be in the normal BMI range, you'd still be insulin resistant? Mweh. I've found that all my PCOS symptoms get triggered once I'm above 80kg (176 lb), especially losing weight is atrociously difficult and slow. I know that in the US you'd be considered glucose intolerant (IR) from a fasting glucose of 5.6 mmol/L whereas in the UK, the range starts at 6.1 mmol/L. My fasting glucose test last April was 5.9 mmol/L, up from 5.7 mmol/L last November. So basically, I really have to help myself because the doctor won't move a finger until I slide even deeper into pre-diabetes territory.

However, reading your comment has me worried that despite my losing weight won't help reverse IR? Ever??

My PCOS definitely gets worse at higher weights too. It's almost non-existant when my weight drops below a certain point. Weird how that works. I am not sure we can ever be CURED of PCOS. I think we can manage it with diet and sometimes drugs, but it's an endocrine disorder from what I understand, something you either have or you don't, and there is no cure. Just my take on it but I am definitely not an expert either. I do know that low carb diets are the only way to go with PCOS. We are very sensitive to starches, grains and sugars.

Feel free to PM me if you want someone to talk to. I had my DX 10 years ago in 2002 (wow has it really been that long?) and only found out FINALLY what was wrong with me when I struggled with infertility to try to get pregnant with my daughter. Still took three years to conceive her even after knowing what i had and how to basically manage it. PCOS just stinks :/

Originally Posted by teutonica

ILuvKats - does that mean that even if you'd be in the normal BMI range, you'd still be insulin resistant? Mweh. I've found that all my PCOS symptoms get triggered once I'm above 80kg (176 lb), especially losing weight is atrociously difficult and slow. I know that in the US you'd be considered glucose intolerant (IR) from a fasting glucose of 5.6 mmol/L whereas in the UK, the range starts at 6.1 mmol/L. My fasting glucose test last April was 5.9 mmol/L, up from 5.7 mmol/L last November. So basically, I really have to help myself because the doctor won't move a finger until I slide even deeper into pre-diabetes territory.

However, reading your comment has me worried that despite my losing weight won't help reverse IR? Ever??

Ah geez, are you going to make me look up mmol/L equivalents . The latest research shows that the old method of waiting until your pre diabetes gets worse is the wrong thing to do...early treatment and continued treatment are the best methods to permanently assure you do not progress to full blown diabetes, and to reduce your insulin levels which are now the known causes of chronic disease and inflammation and will shorten your life. Now, if you are not insulin resistant....simply losing weight and eating a healthy diet are probably enough to reverse your condition....but if you have pcos, and are insulin resistant....you will probably continue to be insulin resistant at a lower BMI. They diagnose by fasting glucose levels. They now treat a fasting level of 90 in the US with metformin. They now want the level down into the 70s. And they want your circulating insulin lower. I will now jet off to google your numbers and I'll be right back.

Im back...multiply by 18 to convert....so your level was around 100, now it's around 104. You are about the same as me....I asked my obgyn about metformin and he said ok.

Originally Posted by thirteenblessings

My PCOS definitely gets worse at higher weights too. It's almost non-existant when my weight drops below a certain point. Weird how that works. I am not sure we can ever be CURED of PCOS. I think we can manage it with diet and sometimes drugs, but it's an endocrine disorder from what I understand, something you either have or you don't, and there is no cure. Just my take on it but I am definitely not an expert either. I do know that low carb diets are the only way to go with PCOS. We are very sensitive to starches, grains and sugars.

Feel free to PM me if you want someone to talk to. I had my DX 10 years ago in 2002 (wow has it really been that long?) and only found out FINALLY what was wrong with me when I struggled with infertility to try to get pregnant with my daughter. Still took three years to conceive her even after knowing what i had and how to basically manage it. PCOS just stinks :/

Hi there, thanks so much for this post! I was diagnosed in 1999 and it was a struggle as I wasn't concerned about infertility but 'vanity' issues like excessive hair growth, acne, mood swings, and difficulty losing weight. At the time they offered me the contraceptive pill to regulate elevated androgen levels but I politely declined as I was in my mid-30s and a smoker (I quit in 2006 ). Between 2004-6 my weight escalated to 233 lb (I've never been severely obese before) which is when I was prescribed Metformin, too. Well, by 2008 my weight was below 175 lb again, so I stopped taking it. But then I ended up in my 190's (lb) and struggled with losing weight (before hcg).

Anyway, I don't know if it's my age but in the last years everything seems to be out of whack so that I don't know what's what! I also am hypothyroid and am probably struggling with adrenal fatigue as I can't cope with stress of any sort any more! So, for example, the hair growth on my legs has slowed down, now, I have sort of bald areas where no hair grows at all! Basically, not bad but still makes you wonder what's going on ... I've read now this is a sign of hypothyroidism, go figure! Then, the extreme loss of skin elasticity after losing 60 lbs (a nice way of saying everything sags now!) and physical changes before TOM all point to estrogen dominance (or progesterone deficiency - whichever way you want to look at it), hence I'm confused how I have too much estrogen when a symptom of PCOS is an excess of testosterone? Are my hormones acting up prior to menopause??

It would be fantastic to have a knowledgeable doctor but that's only possible if you can afford private specialists and I don't have the money for that ... yup, I realized that I fare best with a low-carb diet, but it's hard to break the addiction to starches and sugars when this was the food you were brought up and comforted with as a child!

Teutonica, have you thought about bioidentical hormones? They can address your estrogen dominance, adrenal fatigue and thyroid issues. I agree with you, it seems several things are out of whack. I just started bioidenticals 3 weeks ago and I have most of the same symptoms as you. I was never diadpgnosed with pcos, but I was never more than 50 lbs over weight. I had infertility, lost an ovary at a young age, am an untreated hypothyroid, etc etc....

Originally Posted by ILuvKats

Ah geez, are you going to make me look up mmol/L equivalents .

uh, sorry for the trouble ... or not, lol! Just helping to keep your brain in shape

Originally Posted by ILuvKats

The latest research shows that the old method of waiting until your pre diabetes gets worse is the wrong thing to do...early treatment and continued treatment are the best methods to permanently assure you do not progress to full blown diabetes, and to reduce your insulin levels which are now the known causes of chronic disease and inflammation and will shorten your life. Now, if you are not insulin resistant....simply losing weight and eating a healthy diet are probably enough to reverse your condition....but if you have pcos, and are insulin resistant....you will probably continue to be insulin resistant at a lower BMI. They diagnose by fasting glucose levels. They now treat a fasting level of 90 in the US with metformin. They now want the level down into the 70s. And they want your circulating insulin lower. I will now jet off to google your numbers and I'll be right back.

Im back...multiply by 18 to convert....so your level was around 100, now it's around 104. You are about the same as me....I asked my obgyn about metformin and he said ok.

It's always the same sad ole tale over here in the UK. The reference ranges set up by the local laboratories determine your fate. WRT measuring TSH (I know it's not the test of tests to measure thyroid function), the ref range in the US is 0.3-3.0 miu/L, so if you're above 3.0, you're considered hypothyroid in the US. Not so here, worse even, it totally depends WHERE you live! I recently requested access to my medical records and it turned out that while living in Scotland my condition was in good hands, as their labs' ref range is 0.3-3.5 miu/L. Not so where I live now, the lab here has a ref range of 0.3-5.5 miu/L! What a joke! Even worse, the British Thyroid Association (which is backed by Dept of Health) have even suggested to up the ref range to 10.0 miu/L before considering treatment! Do they want to breed a country of zombies??! I wouldn't be surprised if it had to do with costs ... when you're diagnosed with a thyroid condition, all medication is free. The fewer are diagnosed, the more money saved.

So, every time I'd tell the doc that my blood levels for either fasting glucose or TSH would lead to a diagnosis of glucose intolerance or hypothyroidism, respectively, in the States, he retorts with "this isn't the US", sigh. Do you have a link to any of the recent studies you mentioned?

How exactly would I know that I'm IR? I mean, there's Type II age-related onset of diabetes throughout my entire family, obesity with prevalent abdominal fat accumulation. I don't have high BP; apparently, it also requires high triglycerides which I don't have either. Other than knowing that PCOS is usually accompanied with IR I don't have much more to go on. And is Metformin really the way forward long-term?

Apologies to the OP for doing a bit of hijacking here ...

Lol...sometimes the us is not as friendly toward hypothyroidism either. My tsh has been 6 to 7 for years, and my doc has insisted "its not toooooo high yet". Lol. I'll have to look for the links you requested. The ObGYNs in the US have really jumped on the pre diabetes/ insulin resistance thing and are treating it aggressively. Have you had your fasting insulin levels checked? That is more diagnostic than fasting glucose. I hear you about UK medicine. The US is trying to copy your system. .