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JULMUT's Photo JULMUT SparkPoints: (20,952)
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10/15/12 1:10 P

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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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THRIFTINGQUEEN's Photo THRIFTINGQUEEN SparkPoints: (14,517)
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10/11/12 9:33 P

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I've been on Metformin for the past month and have been having horrible leg cramps. Like so much that I feel like I went hiking the day before, it sucks. I went to my endo yesterday (a new one) and he upped my dosage to 1000mg a day (one in the morning and night) so I'm hoping I start to see some difference. I have a ton of weight to lose, measure my food, work out and am not seeing any progress at all. It's so frustrating but I hope something kicks in soon. Good luck to you!

NEELIXNKES's Photo NEELIXNKES Posts: 6,389
8/16/12 11:23 A

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I've been on 2000 mg of Metformin a day for quite awhile. I take the regular release (1000mg tablet 2x a day) since I could not tolerate the extended release. It has helped to lose about 30lbs but I've been stuck in the same range for quite awhile. I saw a dietician to help get unstuck and she agreed that I needed to stay around 175g of carbs per day due to my IR. Basically I need to eat like she would recommend a diabetic to eat. When I follow those recommendations I see it working but I have a real problem with reducing my carbs to even that point.

Your endo is basing the prediction on other patients and research. It doesn't mean that you are only going to lose 20lbs and then the scale will stop moving. Since you are pretty active it might just trigger your metabolism into working more efficiently and you will exceed that estimate. I have a friend that just went thru duodenal switch surgery 3 months ago. She has lost 75lbs.... in 3 months. I'm happy for her but nervous about the potential health risks of losing weight that fast. As a previous poster mentioned, surgery is a tool, not the easy fix. I know someone else that essentially went on the gastric bypass diet without the surgery and she lost over 100lbs.... at age 60. It was a medically supervised diet. Again, a tool to get the results that she couldn't achieve herself by following weight watchers. Hopefully the higher dosage of metformin will be the tool to help you get the results you desire!

~Deb


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RAININGDOWN's Photo RAININGDOWN SparkPoints: (18,226)
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8/12/12 7:56 A

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From what I can tell, it's the combination of them all. The insulin resistance triggers our hormones to do things that aren't quite normal. All of which triggers the weight loss. Women's systems are very complicated and very intertwined.

~Amanda
Michigan

A journey of a thousand miles begins with a single step.
Lao-tzu,


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SPARKLGRRRL Posts: 129
8/11/12 11:49 P

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Stupid question as I am just learning about PCOS and my endo really only talked w/ me for a few minutes.

Is it the insulin resistance that makes our weight loss so difficult or other imbalances?

Just curious. Thanks. And sorry, didn't mean to intrude on your post!

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RAININGDOWN's Photo RAININGDOWN SparkPoints: (18,226)
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8/11/12 4:23 P

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Oh, I like that idea!! Measuring out everything at once so it's done.

~Amanda
Michigan

A journey of a thousand miles begins with a single step.
Lao-tzu,


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COWSLIPPERS230 SparkPoints: (353)
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8/11/12 4:23 P

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I am not saying this is what you should do, I'm only telling my story. I was diagnosed PCOS in May 2011. I am on 1500 mg of metformin. In January I went back to my doctor and I had gained some weight. He was concerned, so he wanted to see me monthly as a way to just track my progress on diet. Truthfully, this was a good thing for me, but I had told him I had done everything before and I could lose about 5-10 pounds and nothing more. I knew that my inability to lose weight had nothing to do with my discipline in the past. I was totally OCD about counting calories and I walked 2 hours a day or so. It just gets to the point that when the scale doesn't budge for 6 months of making a full effort, you don't really want to try anymore. Anyway, I started meeting with my doctor monthly and I lost the weight I put on, then--nothing. Three months go by of maintaining. I'm journalling everyday and walking and doing some weights. Finally the doctor believes me and gives me three options. 1. Get a trainer and exercise myself to death (Um--if I can't lose weight with all the exercise I'm doing now, do you think it will really help?) 2. Get lap band surgery 3. Try a prescription (phentermine). Truthfully, none of those options looked all that good to me. I have been trying for a long time to get pregnant, and it hasn't happened yet. If I get surgery, it will be quite a while before I can try to get pregnant. The exercise I didn't think would be that effective. The phentermine I would have to stop trying, but it was only 3-4 months. I decided to try that and to be honest, it is the first real weight loss I have seen in my life. I haven't lost nearly as much as some people do on it, but I'm still pretty happy with my progress. It's not magic, you still have to work, as I'm sure you would if you have surgery. I do believe that PCOS can make it almost impossible for some people to lose weight and sometimes you need more outside help than just diet and exercise. My advice--give it six months or so of honest effort, and if you can't lose anything, start researching different options. I could be that you are one of the people who can't lose weight any other way.

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HEALTHYDAISY's Photo HEALTHYDAISY Posts: 94
8/11/12 2:55 P

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One thing that helped me with portion size was to measure the whole package out at one time. I put the serving into a snack sized ziplock bag and then put all the servings back in the original container. That way if I was rushing and did not have time to measure there was no problem.

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RAININGDOWN's Photo RAININGDOWN SparkPoints: (18,226)
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8/7/12 3:17 P

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I'm glad your working with the doctors to get everything figured out. And nice job on measuring your food!! Hopefully with the doctors they'll get you on track and healthy!

~Amanda
Michigan

A journey of a thousand miles begins with a single step.
Lao-tzu,


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NEWSGIRL2177's Photo NEWSGIRL2177 SparkPoints: (43,129)
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8/7/12 10:47 A

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Thank you all for your responses!

I do measure my food regularly, and I have been using a kitchen scale, too. It helps quite a bit with getting used to smaller (and accurate) portions. I was surprised at what a serving of cereal looked like, too. emoticon

-Heather

"Pursue the things that make you feel alive." - SP


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CHRIMSONFYRE's Photo CHRIMSONFYRE SparkPoints: (92,915)
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8/7/12 9:34 A

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I need to look into the measuring my portions, that might be a mistake I am making as well.

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RAININGDOWN's Photo RAININGDOWN SparkPoints: (18,226)
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8/7/12 8:39 A

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I am on 1500 mg, extended release. It bothered me when I first started on it, mostly gas and diarrhea, and when I miss too many doses. No leg cramps or liver or kidney problem. I haven't been on it very long.

I haven't had a doctor tell me that I needed surgery to loose weight. But I hear many stories of people who have lost weight anyway. I know the Biggest Loser puts contestants through an extreme program, but they're able to loose weight even though many of them are morbidly obese.

And I'm sorry, but I don't understand the point of weight surgery. They change the physical size of your stomach so that you get a different physical response when you eat too much. But you still have to go on a very reduced calorie diet specific for your physical needs. You still have to go through the stress of changing your eating habits. Surgery doesn't make that easier. It just gives you a more drastic reason for changing your habits. So I don't think I could ever personally undergo weight loss surgery.

Are you actively measuring out your portions?

One thing that I would suggest to you, coming from my own personal experience, is to take the time to measure out your portions. You may be surprised how many extra calories are sneaking into your diet when you start measuring how much you're actually eating.

I was dumbfounded when I started measuring my food. I thought I was eating 1 serving of cereal and it was actually 1 3/4 cups. But serving size was actually only 3/4 cups! I kept running into this over and over again. I found that even though I thought I was in my calorie range, I was actually way, way out of it. I've realized over and over again - I'm going to have to keep doing it to keep my portions realistic

Edited by: RAININGDOWN at: 8/7/2012 (15:15)
~Amanda
Michigan

A journey of a thousand miles begins with a single step.
Lao-tzu,


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SPARKLGRRRL Posts: 129
8/6/12 7:29 P

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Wish I had info for you but just adding my best that you can make a decision that is right for you.

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SARELLPOL Posts: 12
8/6/12 3:10 P

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I'm officially on 2500 mg of regular release metformin, though I conveniently "forget" to take it because of how sick it makes me. I get severe gastro problems and wind up losing weight only because I can't keep anything down! I'm due back to my reproductive endo soon and I hope to talk him down on the dosage. I understand the importance it plays in maintaining PCOS, but I can't eat right or exercise if I'm sick all the time. Keep in mind though, that everyone is different and you may tolerate it better than I do.

I had a RE suggest gastric bypass only because my husband had offered up that I had tried many weight loss programs that have not worked. It was a suggestion only though, no one was forcing me to do anything and in fact he was willing to work with me just as I am - 110 lbs + overweight.

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CHRIMSONFYRE's Photo CHRIMSONFYRE SparkPoints: (92,915)
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8/6/12 3:10 P

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1. Is anyone on such a high dosage of Metformin? 2000 mg seems like a lot, but I know that 500 is too low.
I currently take 1000mg per day, and it makes me feel yucky.

2. Has anyone had any problems with your liver or kidneys on a higher dosage? What about leg cramps?
I get leg cramps all the time, and feet cramps, but I don't know that it's because of the metformin, are you making sure you stay hydrated. As for my kidneys, I'm having them checked this Friday, because I have been having constant aching in that part of my back and I want to make sure the metformin is not effecting them.

3. Has anyone had an experience like this where a doctor said basically the only option is surgery?
I have not had a doctor tell me that for weight loss. In fact there are success stories of people on spark people losing more than what you want to lose, it sounds like a ploy to get money IMO. I would look into low glycemic type diet, Paleo if you know anything about it, it has made a huge difference in my weight loss plateau.

Interested in joining a team, I lead the following teams:

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NEWSGIRL2177's Photo NEWSGIRL2177 SparkPoints: (43,129)
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8/6/12 2:58 P

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Hi ladies!

I was unofficially diagnosed with PCOS several years ago, but I finally had an appointment with an endocrinologist last week and was officially diagnosed with it. I got an ultrasound, which showed several small cysts on my ovaries, but she said they shouldnít get bigger or cause problems.

My main concern with PCOS is losing the weight. I have no intention of getting pregnant, I just want help losing the weight Iíve packed on over the years. I exercise regularly, but I don't see results and it's very frustrating. Previous doctors put me on 500 mg of Metformin, which is pretty low and never did anything for me. This new doctor wants to put me on 2000 mg a day (eek) after I get my liver and kidneys tested. She said I could expect to lose about 20 pounds with the higher dosage, exercise and eating right.

I have 120 pounds to lose, so 20 doesnít sound like much. BUT itís more than I can manage to take off on my own at this point, so Iíd be very happy with that! The doctor said that the only way for me to really lose any significant weight would be to have gastric bypass.

This news is a bit upsetting for me. I run 3 days a week, do Zumba, swim or hike at least one other day a week, so itís not like Iím not active. I stay within my SparkPeople calorie range and drink plenty of water. Iíve been frustrated and discouraged in the past year or so because Iím living a fairly healthy and active lifestyle and not seeing results. So now my only option is surgery?! This freaks me out.

Sorry to rambleÖ Here are my questions:

1. Is anyone on such a high dosage of Metformin? 2000 mg seems like a lot, but I know that 500 is too low.

2. Has anyone had any problems with your liver or kidneys on a higher dosage? What about leg cramps?

3. Has anyone had an experience like this where a doctor said basically the only option is surgery?

My husband doesnít want me to get the surgery, but Iím not willing to shut the door on it yet. I know that having it would change my entire life for a few years, and thatís whatís scary to me.

Anyway, any help or advice or input would be appreciated. Thanks!


-Heather

"Pursue the things that make you feel alive." - SP


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