1

votes

Hack My Bloodwork - PCOS? Should I really start metformin?

Answered on January 29, 2016
Created May 03, 2013 at 4:47 AM

I'm a 5'3" 205lb 31 y.o. female who has been overweight to obese the last 12 years. I'd say ever since I started going through puberty at 7 (body hair, etc) and starting menses at 10 I've struggled with my weight. I was the thinnest playing 2 sports in high school and sticking to a 1300 calorie diet while working out every day minimum 3 hours. I felt absolutely starved and probably only could get down to 135lbs. But I was also a size 4 so I feel I had a fair amount of muscle going on. I did have insanely low blood pressure and heart rate but surprisingly was a high 99 out of 100 for fasting blood sugar. In college I was pretty sick of monitoring every morsel (and having my eating monitored by everyone else in the house who seem to be able to eat what they want) and kinda rebelled. I think I gained 40lbs my first year and have gained about 10lbs each year. During stressful times in college I could gain about 25lbs in a month (and have the medical center records to prove it). So obviously I was doing bad bad binge stress eating. In my mid 20s I started having bad acne and hair growth on my face. At this time they did a pelvic ultrasound and tested thyroid, hormones, etc. and couldn't find anything abnormal. I was also having terrible stomach issues, diagnosed as "the worst case of IBS" the dr had ever seen, and finally after medications and unpleasant tests I figured out dairy was upsetting my tummy so I cut that out of my diet completely. At 28 in 2009, I moved to go to grad school, was totally a mess in terms of not exercising and bad eating habits minus dairy to cope with the particularly hard time I was having with my advisor. In 2010 my fasting glucose was still normal as was my TSH/T4. My calcium was low probably from all my stomach issues. As, I was still having awful stomach issues I'm sure aggravated by stress so I also cut out gluten and did a lot better in terms of doubled over pain all the time. After a year of shitty eating habits, craptastic exercise, and basically going many days without sleeping (anxiety), my weight ballooned up to 240 and my fasting glucose was 109 and my HB1AC came back 6.4! Yikes. I immediately started exercising and eating better because diabetes scares the crap out of me. I quit that awful program that was basically compounding my already compromised health, have gone basically paleo in that I don't eat grains, diary, legumes and most processed foods. I do have to eat some carbs (like 1/2c brown rice) every other day or else I'm a snarling asshole with rage issues. I prefer to feel happy and easy going and have trouble controlling the urge not to punch people if I'm too low carb. But the acne has not resolved, I still have icky body hair, and I lost 35lbs but am stuck at 205lbs. So I exercise about 4 days a week for 2 hours and lift weights as part of that routine. Leg press is 420lbs, bench is 145lbs, squats always hurt my back so I'm stuck at 250lbs and I'm doing HITs for cardio. My HB1AC is 5.0, fasting glucose is back to 99 and my cholesterol is 142, HDL 67. So that's good. BUT in the last 3 months I've not ovulated (I can feel when I do), started loosing hair rapidly at my temples and I normally have a ton of hair, my periods are suddenly not perfectly 28 days, and I feel tired/fatigued. Also, I've had weird tingling and numbness in my hands and feet that seems to never be the same part from day-to-day, total mood collapse 3-4 days for about 12 hours before I menstruate and by that I mean uncontrollable sobbing to the point of being inconsolable (yea fun for everyone around me) and feelings of hopelessness. Plus anxiety attacks around that time. Got my bloodwork done 2 weeks ago and my testosterone was 100 which is high. I went to Endocrinologist today and she wants me to try Metformin and birth control. She also took bloodwork. Prolactin 5, Estradol 46, FSH 6, LUTEINIZING HORMONE 5.3, TSH ULTRASENSITIVE 1.44, non-signifant thyroid antibodies, Vitamin D 16, testosterone now 44. I menstrated (late of course) 6 days ago and my period lasted about 48 hours for follicular reference.

1.) Now my differential diagnosis is PCOS but I'm not so sure. Thoughts? 2.) Vitamin D is clearly an issue and since I can't eat any dairy (caesin/whey sensitive too) with serious gut issues (still but so much better than before where I couldn't leave the house) it's not surprising. If I vomit from multivitamins (too much calcium/iron makes me wretch hard core), is there an easy way to supplement it that's readily bioavailable? I have a really hard time with supplements so anything non pill form would be awesome. 3.) B vitamins are supposed to be altered as a result of taking metformin. Endo thinks metformin will help me loose weight, but I'm worried I already have vitamin deficiencies from upset gut. Thoughts on this? 4.) I'm really mostly not happy with the birth control prescription. I've taken it before and it not only kills my high libido (which I kinda like), it just makes me feel bloaty and grouchy. Plus long term studies about sexual satisfaction post-menopause, etc. Some sites suggest doing 15 to 20 mg of progesterone cream daily for the last two weeks of your cycle instead of BC. Anyone had success with this method?

There's a lot of information, but I wanted to make sure I provided enough for some degree of feedback. I've read through the other PCOS posts and saw a lot of ranting about synthetic hormones = bad which yes I know, but I need alternatives because working out/90% paleo isn't working anymore/my symptoms appear to be worsening.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 12, 2013
at 08:35 PM

Doing one's own research in addition to what a doctor might prescribe is hardly "dangerous".

229faa9f9cb551cbf9d1d766b84cf8f5

(112)

on August 12, 2013
at 05:00 PM

Learning what others have done and making decisions based off of people who venture off the accepted, well researched and defined treatments is dangerous. Anecdotal evidence from individuals on the internet should not direct treatment.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 12, 2013
at 04:58 PM

It goes without saying that doctors' advise should be heeded, but educating oneself and learning what others have done when in the same boat is valuable as well.

091423a30c0188fbff51e39397e7e056

(384)

on July 15, 2013
at 07:52 PM

Work on your paragraph formatting. This gave me eye strain.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on July 01, 2013
at 04:58 PM

What is your reason for saying stay off of Metformin? It's a generic drug proven for its efficacy and is helpful for overweight T2 diabetics, though not all diabetics. Its side-effect is GI distress in those who are sensitive and B-12 deficiency, which can be limited by extending its release and supplementing. It's been around for many, many years and is one of the most effective and helpful drugs. Before assuming that Metformin is bad because all drugs are bad, I wanna hear your reasoned argument as to how Metformin specifically is bad.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on July 01, 2013
at 04:57 PM

What is your reason for saying stay off of Metformin? It's a generic drug proven for its efficacy and is helpful for overweight T2 diabetics, though not all diabetics. Its side-effect is GI distress in those who are sensitive and B-12 deficiency, which can be limited by extending its release and supplementing. It's been around for many, many years and is one of the most effective and helpful drugs. Before assuming that Metformin is bad because all drugs are bad, I wanna hear your reasoned argument as to how Metformin specifically is bad. can be Its only side effeclose weight

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8 Answers

0
Ccc70fda9cb652cf01f6ebb8cf8ff575

on January 29, 2016
at 10:46 PM

Hi KC_6,

Please check out Wray White's web site. There is a page regarding PCOS and progesterone.

progesteronetherapy.org

I can vouch for it. I've been on 300mg for 5 months and have seen great results. Progesterone should be a lot higher than you think and it's completely safe to supplement A LOT. Give it a go!

Best regards

0
61dadf631f8bf0e8555fdfdc04d4c4ec

on August 12, 2013
at 06:21 PM

I have taken n-acetyl-cystenice (however its spelling) mentioned above...and it didn't help me at all :( I so wish that it did. I have "cured" my PCOS and lost 100 lbs since February of 2012 all through changing my diet (strict paleo diet and lifestyle), seeing a chiropractor (helped balance my hormones to where losing weight was easier and healing my adrenals)....I tried to lose weight for about the last 4 years and it just wasn't working. My hormones were crazy and I found that when my adrenals and other hormones became more regulated losing weight and sticking with a plan became easier. Not for sure if you mentioned this within your post somewhere but you need to gluten and dairy free consistenly....dairy and gluten are awful for PCOS as they add to your already inflamed body. Also consider swapping your carbs for a serving a quinoa or other tuber....since you do need to lose weight I wouldn't recommend over 1 serving of a tuber a day...your other carbs should come from vegetables....juice organic fresh green beans(great source of insulin), cucumbers, wheat grass, etc. A typical meal for me

Breakfast: Serving of Pecans, 3 Eggs (with a runny yolk), and 1/2 serving of berries (or other low sugar fruit) Lunch: Wild tuna, 2 boiled eggs, with paleo mayo (homemade because I react to the vinegar) sm. apple Supper: Quinoa spaghetti with meat sauce (we don't eat this often because it can be quite carb heavy) when we don't eat it we will have a serving of roast, hamburgers, bacon and eggs, or any other carb free option...

We will also add in 14 ounces of a fresh green juice mixture to one of the meals above :)

Exercise is also really important because it helps your body become more insulin sensitive....Also all meats need to be grass fed and everything else needs to be organic and/or non gmo....hope this helps!

0
Fdcf36dfb78aa17ec21800cc5a80a439

on July 01, 2013
at 11:13 AM

Honestly I'd stay as far away from the metaformin as possible. Have you looked into the research from Stefani Rupper at Paleo for women ? She has a PCOS guide and has some excellent suggestions for managing PCOS drug free.

www.paleoforwomen.com

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on July 01, 2013
at 04:58 PM

What is your reason for saying stay off of Metformin? It's a generic drug proven for its efficacy and is helpful for overweight T2 diabetics, though not all diabetics. Its side-effect is GI distress in those who are sensitive and B-12 deficiency, which can be limited by extending its release and supplementing. It's been around for many, many years and is one of the most effective and helpful drugs. Before assuming that Metformin is bad because all drugs are bad, I wanna hear your reasoned argument as to how Metformin specifically is bad.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on July 01, 2013
at 04:57 PM

What is your reason for saying stay off of Metformin? It's a generic drug proven for its efficacy and is helpful for overweight T2 diabetics, though not all diabetics. Its side-effect is GI distress in those who are sensitive and B-12 deficiency, which can be limited by extending its release and supplementing. It's been around for many, many years and is one of the most effective and helpful drugs. Before assuming that Metformin is bad because all drugs are bad, I wanna hear your reasoned argument as to how Metformin specifically is bad. can be Its only side effeclose weight

0
D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on July 01, 2013
at 03:21 AM

I think Metformin could definitely help you. If you have GI symptoms, take the extended release version. It's helpful for prediabetics and you definitely become more sensitive to insulin and those with weight issues find that weight loss is easier with Metformin.

You went all the way up to 6.4 and you could still have blood sugar issues even while low-carbing. PCOS and insulin resistance (as well as hypothyroidism) are very closely related. What sticks out are your neuropathy symptoms, hair loss, and mood issues. If they continue, I would look into hypothyroidism, as the chance them stemming from hypo is higher than from just PCOS. I'd definitely get the Hashimoto antibodies checked and get your FT3 measured.

PCOS and hypothyroidism are very hard to dinstinguish, as the symptoms overlap. In your case, measuring Hashi Abs and FT3 could clarify things. For your own knowledge at least. Your doc might just go by TSH but we all know better that TSH isn't reliable and low FT3 and Abs are enough for the symptoms to show.

0
B77077b10dae8aacdd01ac61cb5bcfc3

(55)

on June 08, 2013
at 11:00 PM

Another option if you can't do metformin might be N-acetyl-cysteine. Some studies have shown it is just as effective without the negative digestive side effects.

http://www.ncbi.nlm.nih.gov/pubmed/12057717

Do a web search of NAC PCOS and there are a lot of results.

0
C96da0b2ee55c8412cbd37779f42491f

(5)

on May 25, 2013
at 09:44 PM

Hey Lazza, Thanks for the response. I'm averaging less than 80g carbs a day based on my food tracker. Usually if I eat more than that I notice immediate weight gain. I typically eat very low carb for breakfast (eggs, tomatoes) and tend to eat most of my carbs at lunch or dinner. That seems to help with the grouchies and late night sugar cravings. It's pretty easy to be low carb if you don't eat gluten/grains (except for a little rice and corn to prevent grouchies), legumes or dairy and watch your sugar intake. Most of my calories seem to come from coconut oil, olive oil and animal fat.

IBS and metformin did not get along AT ALL and I actually gained a little weight on it because I had to keep eating carbs every hour or so to help with the extreme room-spinning nausea. So I've switched to 1200mg of D-Chrio Inositol because it doesn't seem to effect my IBS and I've already lost a little weight on it (I suspect the gelatin in the capsule also helps with feelings of satiety). Studies show this helps with insulin resistance and ovulation in people with PCOS.

I've also added fish oil for omega 3s, and a Vitamin D3 liquid dropper. Actually I'd say that more than anything has also helped with IBS. Days I forget to dose morning and night with vitamin D3 = IBS symptoms. I realize that as a fat soluble vitamin I will have to monitor my vitamin D levels which I plan to do every 2 months.

I am taking the birth control just because the idea of more hair falling out on my temples frightened me and BC can stop the spikes of testosterone. My plan is to try to increase my insulin sensitivity and loose weight and then try to wean off BC down the road because extended exposure to hormones just doesn't seem like a good idea.

KC

0
75d65450b6ff0be7b969fb321f1200ac

(2506)

on May 03, 2013
at 11:32 AM

Oh my, where to begin? I think you might be over-analyzing your situation. Simplification, which certainly doesn't mean adding prescription meds, might be the right place to start. I can first off suggest:

1) Do a very careful look at your diet. Dairy free is great. But are you Paleo? What is your carb intake?

2) Read Perfect Health Diet (Jaminet) for a thorough discussion on what to eat and what supplements to take. The answers to all your problems might not be in this book but at least it should guide you in the right direction.

IBS is dreadful. I've suffered with it for years. It often sparks a wide variety of seemingly unrelated symptoms. No sense in tackling those symptoms directly. It's best to slain the IBS beast once and for all.

_Lazza

-1
229faa9f9cb551cbf9d1d766b84cf8f5

on August 12, 2013
at 04:22 PM

Consider asking your doctor these questions instead of unqualified internet "experts." If you were prescribed metformin, take it. It has been verified by multiple randomized controlled clinical trials to treat T2 diabetes and to help restore insulin sensitivity.

229faa9f9cb551cbf9d1d766b84cf8f5

(112)

on August 12, 2013
at 05:00 PM

Learning what others have done and making decisions based off of people who venture off the accepted, well researched and defined treatments is dangerous. Anecdotal evidence from individuals on the internet should not direct treatment.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 12, 2013
at 08:35 PM

Doing one's own research in addition to what a doctor might prescribe is hardly "dangerous".

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 12, 2013
at 04:58 PM

It goes without saying that doctors' advise should be heeded, but educating oneself and learning what others have done when in the same boat is valuable as well.

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