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Insulin Resistance, Metformin and weight loss

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Old 04-01-2009, 10:23 PM   #1
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Default Insulin Resistance, Metformin and weight loss

Hi all.

Gynaecologist's prescribed Metformin for me- for IR. Start out at 1000mg, then to 1500 if I can tolerate it. I haven't even filled the prescription yet because I'm honestly not sure I need it.

2 questions:
1- what blood tests (if any) are done to determine whether or not I'm IR or not. I had a battery of them done about 3 weeks ago, including fasting glucose.
2- IR has been shown to "reduce" weight loss. Before taking Metformin, did you find that you had really good weeks (1 pound-plus) and really crap weeks (less than 1/2 pound) and did it steady after you started Metformin?

Thanks.
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Old 04-01-2009, 10:54 PM   #2
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Your fasting glucose test would tell you whether you were insulin resistant or diabetic.

You should have your liver tested regularly when you take that drug. There can be a severe side effect if you liver isn't working properly. I was on metformin for a few months and then my liver tests were abnormal (not from the metformin) and my doctor stopped the metformin right away.

I was given it for diabetes so I can't really help you on the weight loss advantage from it.
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Old 04-01-2009, 10:57 PM   #3
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By "reduce weight loss," do you mean help or hinder weight loss. I've always heard that it more often aids than hinders weight loss (but both reactions can happen). For me, I think it helped, but only a tiny, little bit (reducing carbs is more reliably effective - I'm still struggling with the right level. My doctor told me to try low carb, but not to go "too low," but when I asked how low was too low, he admitted that he didn't know, and I'd just have to experiment.

I was diagnosed IR by my general practitioner, based on the results of the fasting blood sugar test. I was later referred to an endocrinologist, and she said I needed a "glucose tolerance test" to definitively diagnose IR. I had that test, and it confirmed the gp's diagnosis. To be honest, she irritated me, because she was quite critical of my doctor for "jumping the gun" and diagnosing IR without the more expensive (and more inconvenient) test. Ok, that didn't irritate me, she was just being thorough. What irritated me was that she seemed annoyed and irritated that the tests she ordered confirmed the original doctor's diagnosis. It seemed as though she had wanted to prove my doctor wrong.

Ok, that's all besides the point (I seem unable to tell a short, straight story). I didn't have any side effects with metformin, but I was prescribed 1000mg of the extended release. My husband takes the standard formula, but 1000mg twice a day and he was fairly nauseous the first week, but the side effects disappeared completely within two weeks. It's hard to know for sure, because the effects were rather subtle, both of us feel that it helped (initially) with a little boost in weight loss - but it wasn't a dramatic difference. Hubby felt that for him, he lost a little extra weight in the first month, mostly because of the nausea. I didn't have any nausea, but the weight loss was a little bit more than I had been losing (but not by an entire pound's difference each week).

One thing that I do notice with the metformin is that I have to be more conscious of eating regularly. If I skip a meal or go too long without eating, I'm more prone to a sudden drop in blood sugar (which isn't particularly fun). While on the surface it feels like metformin "does nothing for me," my blood sugar levels and A1C (the long-term blood sugar test) results have been much improved, and since high blood sugar is a silent organ damager, I believe that for me, the metformin is worth the potential risks and side effects. It is important not to skip the scheduled bloodwork though, as you've got to monitor not only the blood sugar, but as kodama mentions the liver function as well. I'm on a couple medications that need that kind of monitoring, so it's just part of the routine.
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Old 04-01-2009, 11:32 PM   #4
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I was diagnosed with IR by a fertility specialist years ago. She had me on 2500 mg of Met, and 2.5 mg of Avandia. She made me go to WW and I lost an average of 3 pounds a week for a long time. When I became pregnant I had lost a total of 60 pounds.

After I had my boys I never had to go back on it. My periods were normal from the day she put me on Met up in til now. She also told me that if anyone asked me to say I had IR and I was not diabetic. Since then I have learned through nursing school that it means you are at the beginning stages of type 2 diabetes. If she had of told me that I may have lost more than th 60 pounds.
Met will help you drop the pounds faster, but any time you drink a coke or eat high sugar foods, be prepared for them to go right through you. I noticed lately that a lot of doctors, especially GYN docs are prescribing it for weight loss, even on women with no signs of IR.
My doc told me that being IR not only made it harder for me to lose weight but it was actually making me gain weight. I would never have lost 60 pounds with out it nor would I have gotten pregnant. My advice is look up everything you can online to help you understand it better, and realize the "side effects" are all different for different people. I took a really high dose and I know people who took as little as 500 to 1500 mg and had almost no side effects.
Hope my experience helps you some.
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Old 04-02-2009, 02:01 AM   #5
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Thank you everyone for your insight.

It's not so much the side effects I'm worried about, it's whether or not I should be taking it to begin with. I was a pharmacy tech for a few years, but don't know the effects of Met if I take it and don't need to. Something to talk to the pharmacist about.

I don't have a high sugar diet: most of the things I eat I make from scratch (wholemeal multigrain bread and no-sugar yoghurt), a lot of low GI/low sugar foods, plenty of veggies and fruit (though I have dessert on Friday nights- it's my night-away-from-the-kitchen!), low amounts of processed food, and I measure out my foods like a good girl.

Kaplods: I meant to say that IR hinders weight loss since the body holds on to the excess sugar (seems like a fairly simple explanation!). I go through weeks where I lose 700gm, then go through weeks where I lose virtually nothing, depending on whether I write down what I eat or not.

I have a sneaking suspicion that I didn't really explain what was happening correctly to my gynaecologist, or he might have taken what I said out of context. It's hard to know with him, he's got a very thick Indian accent, but is an absolute FOUNTAIN of information! The best ob/gyn I've ever had besides my grandpa (I know-- ).

I'm trying to get an appointment with the GP tomorrow to find out the results of my fasting glucose (which he didn't forward to my gyn). I did a glucose tolerance test years ago, and those results were normal, though I know that it can change in a few years.

Scary thought that I could be pre-diabetic.
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Old 04-02-2009, 02:42 AM   #6
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Sorry, I misread, I was thinking that you were concerned that metformin might hinder weight loss.

Since I was prescribed the metformin before I had a firm IR diagnosis, I had some of the same questions. Firstly, my gp said he was sure that I did have IR, because anyone severely overweight, almost by definition has IR, especially if they have at least one other risk factor such as elevated cholesterol or high blood pressure - I had both (not very badly, but did have both). I asked my pharmacist too (because I always do) and can't remember what she said (other than it obviously reassured me). I think your pharmacist definitely will be able to help. In my experience they know far more about the drugs than the doctors prescribing them do.
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Old 04-02-2009, 02:52 PM   #7
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Kaplods:

Thanks for that. It's put me more at ease with talking to the chemist and getting the script filled.

And yes, they do know a lot more about drugs... they've got more chemistry and drug classes than doctors do. Sometimes I think the docs should have some of the same training as pharmacists.
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Old 04-02-2009, 05:05 PM   #8
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fasting glucose tests are important, but also testing the actual amount of insulin at the same time is what will really tell you. A lot of doctors don't do this test, and I'm not sure why (perhaps price and easiness?)

I'm on 1500 (spread out into two doses) and it really saved my weight loss. Before, I was losing maybe 3 pounds a month during a "plateau-like" period, even though I was OP.

I've lost 18 pounds in the last month and a half on Metformin. In the past, I've warned others against using it, because I had a bad experience (lots of stomach problems and little weight loss) when I was younger, but now that I'm back on it, it's really helped me a lot. I guess it depends on who you are.
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Old 04-05-2009, 10:41 PM   #9
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Well, results are in. Fasting glucose is 4.5mmol/L (normal is 3.5-7.7 mmol/L) (on a side note: my cholesterol is 3.51 and my HbA1c is 5.4% indicating excellent glycaemic control).

I'm now just worried about taking the damn stuff. Am starting tomorrow, but when is a good time to take the "first ever" dose?
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Old 04-06-2009, 10:45 PM   #10
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hi,
i have some questions about metformin. I just started taking metformin hcl 500 mg today. I have low blood sugar and insulin resistance. If i'm also on a low carb diet, will this drop my blood sugar too low? Also, does it mean that I can eat the occasional slice of bread or dessert and the metformin will simply pass it through my system? also any suggestions on how to deal with some of the side effects? mostly the loose stools? I don't have health insurance, my dr prescribed it over the phone, so I will have to wait till the end of the month to ask all these questions. Any insight would rock.

PS kelly, congrats on the ticker. you look really great. i'm going through the same plateau like phases, but i don't believe people when they say oh it happens you have to deal with it. Just doesn't feel right to work so hard for absolutely nothing.
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Old 04-20-2009, 05:21 PM   #11
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Hi all
i wanted to introduce myself and thank you for the thread, i have just been diagnosed with IR and started metformin this week, I was told to take one 500mg pill before breakfast on the first week, then add another before dinner on the second week and from the third week to have one before every meal. So far, all i have felt is that everything goes through me at an increased pace... i do hope it helps wioth the weioght loss. I have increased my intake of green vegetables and fruit (although i didnt usually had too many processed foods in the first place) and i am going to buy the insuline resistance diet book, my GP did not give too many details on the type of diet I am supposed to follow...
I am amazed and inspired to hear your stories, and i hope I will be able to reach the same weight loss goals than all of you
very nice meeting you all!
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Old 05-09-2009, 04:14 AM   #12
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I started on metformin about a month ago, starting with 500mg at dinner, then a week later one before breakfast and another before dinner, this week I am taking one at breakfast and two at dinner for 1500mg daily. At first the GI upset was insane, but after a little while at each dosage increase it does fade, then I dread going up a dose . Something I found very useful is keeping a food journal and taking notes on how my stomach reacts to what I ate. For me, among the things I expected, I was surprised to find out green veggies had a very bad effect on my stomach.

As for the actual effect of it, I definitely think it has helped me. I started eating better and exercising regularly with no effect, but since starting the met it has becoming an easier battle with the scale, I lost 6 lbs on my first week. The doc said that as I go up in dosage I will notice a bigger difference so to me it is totally worth it.
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Old 05-12-2009, 04:32 AM   #13
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Old 05-12-2009, 10:03 AM   #14
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for me, the metformin has made a huuuuge difference. i started on it at the end of october and lost about 15 lbs between then and new years without changing any of my habits. in january i decided to start dieting and have since lost an additional 10 lbs or so. ironically, i lost more weight in less time before i started counting calories, but i think that was just my body "righting" itself with the help of metformin.
as for the stomach problems. i don't know. i had them really badly. i still have them, to some extent, though at this point it's hard for me to separate the metformin stomach issues from stomach issues i had beforehand. maybe i'm back at equilibrium for me.
and regarding the insulin resistance and blood sugar issue, i'm not totally sure how it all works, however i was put on a lowish carb diet (no more than 130 grams per day. i still eat bread and oatmeal) because of the IR, not in spite of it. so my inclination is to say, no, but i would suggest you try calling that doctor back and asking.
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Old 05-14-2009, 09:57 PM   #15
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Oh my gosh!

I had no idea that metformin could be so helpful! I went about a year without getting a period, then I did research and asked the doctor to prescribe it. he did and within 3 days I got a period.

I was prescribed 1000 mg in two does but I got the bathroom issue pretty bad so I take it only once a day. After reading all of your stories and success with weightloss while on it, I am definately going to up my dosage. I'll have to find a way to deal with the bathroom issues....
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