1. Is anyone on such a high dosage of Metformin? 2000 mg seems like a lot, but I know that 500 is too low.
Yes, I take 2000mg of extended release a day. I couldn't tolerate the regular, but I have no side effects on ER.
2. Has anyone had any problems with your liver or kidneys on a higher dosage? What about leg cramps?
No, but my doctor does periodically do bloodwork to check and make sure they are still ok.
3. Has anyone had an experience like this where a doctor said basically the only option is surgery?
People have told me they have encountered this, but I never have. People also tell me that doctors tell them to just diet and exercise and refuse any other treatment.
For what its worth, here is my two cents. I have both PCOS and diabetes, so my metabolism was pretty much broken when I first went to the endo. Besides the metformin, I take birth control and spironolactone to regulate everything. I am definitely a medication as a last resort person, but this "coctail" has really helped me. I could never lose weight no matter what I did before, and since starting the meds, I have lost almost 50 lbs. Its still slow and I still have to work at it, but I am getting better.
I believe, and I have read research to back this up, that you can reverse diabetes, insulin resistance, pcos, etc. with lifestyle changes. Unfortunately for some people, including me, the problems are so bad, that pharmaceutical intervention is necessary to get things moving in the right direction again. I don't know much about the weight surgeries, but I assume they would be similiar. It will help, but you still have to do some work on your own. So you will have to figure out what is best for you.
And regarding what insulin resistance is and such... I don't know if a doctor would endorse this definition, but from what I understand, PCOS, insulin resistance, metabolic syndrome, and type 2 diabetes are all basically the same thing. They have very similar yet slightly different symptoms, but they are all caused by the same thing -- hormone inbalance and sensitivity or lack thereof.
If insulin and glucose are not getting matched up in the bloodstream, your body is insulin resistant. If this happens to a great extent and over a long period of time, you are likely to develop diabetes and have a constantly elevated glucose level. The hormones that cause pcos symptoms travel through the bloodstrem linked with the insulin, so when the insulin is not getting used by the body, or if the hormone receptors are too sensitive or not sensitive enough, you may start to develop the symptoms of hormonal imbalance, like pcos. Unfortunately it tends to snowball from there. Your cholesterol and triglycerides are part of the metabolic system, so hormonal imbalance can start to affect those areas as well.
Therefore, this is why exercise is so important, it forces the body to use that insulin. That's why pcos is so often treated with metformin, because it forces the body to process the insulin along with the accompanying hormones.
I apologize for being so long-winded, but hopefully that made sense and was helpful.
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