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Endocrinologist visit left me more confused

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Old 06-11-2012, 02:36 PM   #1
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Default Endocrinologist visit left me more confused

Hi Guys,

I was diagnosed with PCOs at the end of last year. They immediately did an IR test and then swiftly lost the results... before finding them magically a few months ago. They then called me and told me I had IR.

Yesterday I had my app with the endocrinologist... started badly when the nurse said I had very high blood pressure which I have never had before. Then went in and was so confused. He told me my results didn't really show signs of IR like the other doctor said but combine them with the PCO it may show an insulin sensitivity. As I've been on the pill he said he couldn't run some tests he would like to. He's prescribed me metaformin to see if I can have a regular period with it and not have migraines and asked me to come back in a month.
He also felt my glands on my neck and temple as well as looking at my back and chest.
I don't have hair loss, or excess hair(though to be fair I have two brothers and a dad who are all almost hair less chest wise).

Honestly I left really confused... couldn't understand how this will work(he did explain but really I felt so stupid listening). I am willing to give it a try... willing to give anything a try really but just don't understand at all.

Can anyone help me get it?

This is what I get so far: My body sometimes does not send the signal to release the egg fully so it kinda stays on the edge of my ovaries. A hormone causes this. This hormone may or may not be related to my insulin levels. My migraines are because my hormones get confused and have sudden changes which again may or may not be related to insulin and thus blood sugar. Is that it? or am I missing something obvious??

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Old 06-11-2012, 10:28 PM   #2
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Welcome! Let's see if I can help you explain some of the things you listed:

Quote:
Originally Posted by polleta View Post
Yesterday I had my app with the endocrinologist... started badly when the nurse said I had very high blood pressure which I have never had before.
This sometimes happens if you're nervous before the appointment or if you were in bad traffic trying to get to the appointment on time. It's happened to me and my blood pressure is elevated. I've learned to leave a chunk of time on my schedule when I go to doctor's appointments so I don't have to rush AND I try not to get mad that they always make me wait an hour before seeing me!



Quote:
Originally Posted by polleta View Post
Then went in and was so confused. He told me my results didn't really show signs of IR like the other doctor said but combine them with the PCO it may show an insulin sensitivity.
Insulin resistance/sensitivity is really just a progression of your reaction to glucose in your blood. It's very clear when you're a diabetic compared to a non-diabetic (blood sugar levels in diabetics don't return to "normal" as quickly as a it should). But insulin resistance/sensitivity is degrees of difference.

For example, in my case, just 4 or 5 years ago, my blood sugar levels in the morning were at 85 or less (low 80s). That's a great blood sugar reading for fasting-blood-sugar levels.

However, in the last few years, my IR has gotten worse. My blood sugar is now in the 90s (upper 90s) and I am eating healthier than I was back then! But that's my body saying that it's not producing the right about of insulin for my body. (And why I have to watch my diet and exercise!)

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Originally Posted by polleta View Post
As I've been on the pill he said he couldn't run some tests he would like to.
Right. PCOS is not only about IR, it's also about a imbalance in your hormones -- progesterone, estrogen, and other androgens including testosterone.

However, if you're taking birth control pills, you can measure your hormones correctly because the PILL is giving your hormones. And hormones act together to activate more or diminish that and the hormone tests they would take would show you what you look like on the pill -- which is not really what's going on with your body, independent of the Pill.

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Originally Posted by polleta View Post
He's prescribed me metaformin to see if I can have a regular period with it and not have migraines and asked me to come back in a month.
Metformin is a drug that helps you to improve your insulin sensitivity (in other words, improve the amount of insulin that your body creates). This case also be done through exercise and improving your diet.

He wants to see you in a month so he can ask how you feel on Metformin and if you are tolerating it. Depending on how much he's given you, you may need more or less than the dosage he has first prescribed. You need to figure out if it's enough or not... Some people can tolerate it well (no side- effects ) and others do not (gastrointestinal problems). If you can't tolerate, he'll either reduce your dosage or look at extended release options.

Quote:
Originally Posted by polleta View Post
He also felt my glands on my neck and temple as well as looking at my back and chest.
I don't have hair loss, or excess hair(though to be fair I have two brothers and a dad who are all almost hair less chest wise).
You're lucky!


Quote:
Originally Posted by polleta View Post
Honestly I left really confused... couldn't understand how this will work(he did explain but really I felt so stupid listening). I am willing to give it a try... willing to give anything a try really but just don't understand at all.

Can anyone help me get it?
It sounds like you're just now developing some symptoms of PCOS. Which is great, because the more you can treat it now, the better it will be for the long term. I think I waited too long.

Now, on to what is PCOS......


Quote:
Originally Posted by polleta View Post
This is what I get so far: My body sometimes does not send the signal to release the egg fully so it kinda stays on the edge of my ovaries. A hormone causes this. This hormone may or may not be related to my insulin levels. My migraines are because my hormones get confused and have sudden changes which again may or may not be related to insulin and thus blood sugar. Is that it? or am I missing something obvious??

Kind of. PCOS is a series of symptoms, which only now doctors and scientists are beginning to piece together.

There are different types of PCOS patients and while the general consensus is that you should watch what you eat and exercise and maintain your weight at a healthy level, there are other things that will vary and be very specific to an individual.

The new research indicates that our entire endocrine system is really the source of PCOS. For a long time, many people through it was related to the ovaries, since the ultrasounds of ovaries would show a string of pearls (eggs that never matured and were released). However, the research is showing that this is more of a disorder of all glands that we have in our body which comprise the endocrine system -- that means that you can have PCOS and a problem with your thyroid. Or PCOS and a problem with your pancreas (which would be Insulin resistance). Both the thyroid and pancreas are part of the endocrine system. So are our ovaries, but PCOS isn't a disease of the ovaries, it's just a symptom, although some PCOS patients will handle issues with their reproductive systems and find relief.

The biggest problem is that PCOS isn't black and white. It's not on one blood test, not one pill can fix you, and it's a condition that you just have to manage for the rest of your life.

With enough changes, you can be one of those lucky PCOS patients where the symptoms are hidden and doctors would never think you ever had anything wrong with you. Others are not so lucky and the signs remain, even as they work on it.

Does this information help?

There's tons of information on this site and on the rest of the internet, so feel free to do research when you don't feel so overwhelmed. It takes a while to absorb and you'll have to play around to figure out what works for you.

And welcome again!
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Old 06-11-2012, 10:39 PM   #3
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Welcome. And I couldn't have said it better myself. Rana did an awesome job explaining it all.
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Old 06-12-2012, 02:09 PM   #4
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That's really helpful Rana. Explained it way better than both my gynea and the endocrinologist! I will see how it goes. Started on the metaformin last night, had nausea and some gastro issues but not as bad as the doctor has said might hit me.

I started managing my diet and ramped up my exercising when I was diagnosed so am already making progress there. Lost 2 kilo's or 5 pounds in 2 months which I am happy enough with, especially as I have maintained it despite eating not so well the last two weeks. Will see how I can keep it going in the next few weeks.
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Old 06-12-2012, 10:13 PM   #5
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Rana nailed it.

Here's a few other links to explore.

PCOS patients can present in at least 5 different ways.

Poll: What type PCOS patient are you?

Inciid FAQ -- overview and esp good for newly diagnosed

http://www.inciid.org/faq.php?cat=infertility101&id=2

Mary's PCOS FAQ that rates treatment options
http://pcosfaq.com/

There are MORE articles in the PCOS article area covering birth control, nutrition, metformin, and other tidbits:

http://www.3fatchicks.com/forum/pcos-articles-125/

HTH!
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Old 06-23-2012, 11:30 AM   #6
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Thanks Ladies. I have been taking the glucophage and I appear thus far to be showing signs of having an on time natural period... from my memory of natural periods many years ago..
I am having a side effect of the tablets which is weight loss despite eating as normal and no extra exercise. Is that normal?
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Old 06-25-2012, 11:47 AM   #7
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For some people -- yes. Metformin (in balancing hormones, coping with insulin sensitivity, lowering testosterone, etc) can help chill the food thing, which in turn can turn to some weight loss.

In me, my " Met chill effect" just gets me to the "stop gaining more PCOS weight" place which I am grateful for. I hate the PCOS weight "creep" -- ugh.

Though I freely admit I envy that yours helps lose.

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Old 08-24-2012, 02:22 PM   #8
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Two on time periods in a row... this is unheard of! I can't help but wonder though if being on metformin permanently is really what I want to do... I am going to ask the endocrinologist on my next visit if I could try reducing my dosage and changing my diet to a low sugar diet. Does that work? I like the fact I can now be sure my problems are insulin related and that I can erradicate the migraines but I don't like idea of taking tablets forever.
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Old 09-22-2012, 10:42 AM   #9
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Thumbs up 3 In A Row!!

Hi ladies,

3 periods in a row.. unheard of in my life so far. I now know my natural cycle is 35 days and I literally never knew that before despite having my first period ten years ago.
I visited my endocrinologist again today and he's happy that my weight has been consistent and dropped to a good muscle/fat ratio. We are now going to trial me managing my exercise routines slightly differently to before(and keeping my food sugar levels low) while not taking metformin for a few months.

I have my list of things to watch out for. Weight creeping back on, migraines starting again and of course my period slipping off the radar.

For the first time I feel I know what is going on and how to control it. Wish me luck in the next few months journey!
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Old 09-22-2012, 10:55 AM   #10
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Quote:
Originally Posted by polleta View Post
He's prescribed me metaformin to see if I can have a regular period with it and not have migraines and asked me to come back in a month.
Metformin isn't perscribed to give you a regular period- your doc should have given you a bc pill for that. My period is more or less completely normal with bc, despite the PCOS.
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Old 09-22-2012, 11:05 AM   #11
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Hi Kelly, My endo disagrees with using the pill to control periods, he says its not helping figure out what is causing the PCOS in the first place. Had been on the pill for the few years before but was constantly having little issues and anytime I came off it my period was as irregular as always.

The metformins main aim was to control the insulin sensitivity but in his experience he said that insulin has a major effect on a woman ovaries and quite often just metformin and living a healthy lifestyle can reinstate your periods (as long as there is no other endocrine issues). For me it worked and I had 'natural' periods for the first time ever. I guess it totally depends person to person though, so your own doctor is the best expert for every person.

Ps. I also live in an arab country so male doctors generally don't prescribe the pill to unmarried women.

P
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Old 09-22-2012, 10:40 PM   #12
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Polleta is correct.

Birth Control Pills (BCP) don't fix the underlying issue of why you may not be getting your periods in the first place.

Treating IR or finding where the hormone imbalance is happening is actually the "better" treatment. BCPs often just mask the issue... why you aren't having your regular period in the first place!

My first doctors all recommended BCP for that reason, rather than suggesting diet changes or even Metformin.....but I was diagnosed almost 20 years ago, so I'm sure more doctors know about PCOS now than they did back then.

My current endoc/gyno/PCP don't suggest BCP as a "solution." I use an IUD for BC, diet and exercise to manage IR symptoms.
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Old 11-03-2012, 06:25 AM   #13
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Managed to have a period without the tablets! It was a few days late but it still came. So happy that I managed to keep things in check with just diet and exercise. I think I do need to improve to help it be on time but it is a good turnaround versus my previous life of periods being majorly erratic!
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Old 11-08-2012, 03:50 PM   #14
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YAY! That's great!
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