Ask MetaFilter questions tagged with Metformin

Rec. needed for NYC doctor knowledgeable about antipsychotics & metformin

Anonymous — Sat, 23 Feb 2013 10:58:23 -0800

Can anyone provide a recommendation(s) for a primary care doctor(s) in NYC or the Jersey City/Hoboken area who is knowledgeable about using Metformin to help with weight gain associated with antipsychotics use? I have gained 20-25 pounds while using Seroquel, and I have tried exercise and diet with no results. My psychiatrist told me to ask my primary care doctor about Metformin if that is something that I want to try. However, I do not have a primary care doctor. I tried going to a random doctor on my insurance, and he didn't know anything about the subject. I'd like to find someone who has read research about antipsychotics and Metformin's effect on their weight gain side effects.

Please feel free to ask me any questions or send information to seroquelquestion@fastmail.fm

School me, please, for I am ignorant.

Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! — Wed, 07 Mar 2012 16:54:06 -0800

I am a nutritional newbie - I never took any classes on the subject, I'm a lifelong selective eater, and what little I know has been memorized, mostly in the last two months. I'm in need of some specific schooling on my current peculiar weight-loss situation. The question: what is making me lose weight? And how can I keep this happening? And why does it seem like I'm breaking all the rules here?

The background: In September/October, I was prescribed Geodon, which spiked my blood sugar from 88 to 163 in a matter of a bit less than two weeks. This freaked everyone the heck out, and rightly so. Amongst many other changes, I was enrolled in the YMCA's Diabetes Prevention Program, and starting on December 20th, I started tracking my food intake daily.

I have OCPD and OCD, and am totally confident that if anything, I am underestimating my caloric intake (due to ignorance of things like "how much fat do you add if you fry a tortilla.") I believe these underestimation problems are decreasing over time - that is, what once was in the diary as 100 calories with 8 grams of fat is now 150 calories with 12 grams of fat. Over the last two and a half months, however, my daily caloric intake, daily carb intake, daily soda intake, and daily fat intake have all dropped - by very modest amounts. The December 20-31 average was 2700 calories a day, the March 1-6 average is 2370. It's been a very slow, gradual decrease as I make various adjustments, though I suspect the actual difference (again, I'm improving my calculations over time) is more like 500-600 calories a day, and that really this last week I was around 2400 a day.

I exercised, at the very most, a half hour on any one of those days, primarily in the form of jogging down three or four flights of stairs. Due to depression, upper respiratory illness, and other issues, there were whole entire days where I literally woke up, went down the stairs once, sat in a chair for eight hours, went up the stairs, and went to bed. If I had to guess, I'd say I was doing 5 to 9 minutes (averaged out) of low-intensity exercise a day, or 35 to 63 minutes per week. This didn't really change over time. In fact, this last week was the upper respiratory illness, and I doubt I was even hitting my normal "sedentary" activity levels on three of the seven days in question.

I weigh 243.6 pounds (as of an hour ago) - on December 20th, I weighed 262.0 pounds. I am 5'4" and female.

I don't understand how this is possible.

I know (within reasonable limits) that this is "real" weight loss - my pants are loose enough now that I need to buy a belt, a skirt I haven't been able to fully zip up in months is now fully zip-up-able and I can stick the first part of my arm in it besides. I don't feel skinnier (in a subjective "my body feels smaller, my double chin is gone" sort of sense,) and in fact I walked in to today's weigh-in very, very sure I'd regained some of the weight I've lost - instead I dropped from 246.8 to 243.6. It's been a steady 1.8-2.6 pounds per week for the last four weeks (since the program started.) If anything, I've been losing weight faster as the number of calories I eat goes down, which would sort of make sense, except that MyFitnessPal keeps giving me giant red "YOU ARE EATING TOO MUCH" warnings.

All I've really done is some very basic "be less than insane" dietary changes. I think this week's "calories from soda" percentage may finally be in the single digits, I try to only cook my beans in one tablespoon of Crisco instead of two. I'm still very clearly eating too much, by every single standard I can find online - I'm reading that in order to obtain these results I should be eating 1500 calories, or 1800 plus exercising for an hour and a half.

Again, my question is:
1. Since this is true, does this mean I'm magical or something? Or are those averages online for the 50th percentile, and there's a ton of people for whom they don't really apply?
2. Is the rule really "decrease your average intake over time" instead of "get to this fixed number of calories," or is my fixed number of calories simply wrong? Is the key to weight loss, for me, eating 2300 calories a day and sitting around motionless? Or is it "continue to decrease until the only way forward is pain?"
3. Given that these are the results I'm seeing, how should I be formulating my goals? I'm nearing the point where I have to start actively doing things that make me unhappy (whole meals of nothing but vegetables, only allowing myself spaghetti once a week) and I'd really like some sense of what I have to do, here.

Potentially relevant factors:

My cholesterol is now and has always been excellent
I'm taking Metformin, Trileptal, Lexapro, Seasonique, Vyvanse, fish oil, Vitamin D, Vitamin C, a multivitamin, and Propranolol (as needed for anxiety.)
I've weighed over 240 for at least six years, and over 185 since 1995. In 1997 I weighed 185 despite doing about 200 minutes a week of extremely intense aerobic exercise. In 2003 I weighed 225 despite working in a job that required me to run up and down concrete steps with heavy boxes most of the day, four days a week. I gained 15 pounds at about a pound a week, starting about a month after that job ended.
My meals lately have been 65% carb and 22% fat. I only track these, I don't try to eat things to mess with the numbers except in a very general "ugh, too much fat" kind of way.
I'm trying to drink more water, but I'm still in the 50-100oz/day range.
The Diabetes Prevention Program official goal is for me to hit 233.4 on or around the 16th week of the program. At the rate I'm going, I'll be there on week 8 or 9. If that happens, it'll be the least I've weighed since 2005.
I eat ridiculous amounts of pasta and refried beans. Absolutely insane. I'd guess, offhand, that I go through a pound of pasta and 3 15oz cans of beans per week.
The Metformin is the only thing I've started, in any real quantity, since the weight loss began. BUT I don't feel less hungry at all, and I'm on the lowest effective dose (it does seem to be helping my blood sugar.) I certainly haven't experienced anything like looking at the plate and deciding I'm not hungry anymore, and the way I cook, I'd know.

Any advice, analysis, suggestions, resources, etc., are more than appreciated.

I also wouldn't mind finding out how much fat/calories/etc. I need to add to my corn tortillas after frying them in corn oil, by the way.

PCOS and pre-diabetes - do I really need to go on Metformin?

zoetrope — Wed, 30 Nov 2011 11:15:31 -0800

PCOS and pre-diabetes - do I really need to go on Metformin? I'm a 31 year old woman, and I have what I have is a fairly common medical issue: PCOS. I am currently taking Yasmin and spironolactone for it, which have been helpful in reducing some of the symptoms. I am overweight by maybe 50lbs. I do some moderate exercise every day. I've been working on improving my diet since the summer, lost five pounds, hey ya! I felt like I was getting better.

However, I went for my well woman exam last week, and my reproductive endocrinologist noticed that my insulin levels are elevated - I'm prediabetic, apparently. My mom has diabetes so I'm a bit freaked out at the prospect of developing it, and am not sure of what to do next. My doctor emailed me to say that they have faxed a prescription for Metformin to my pharmacy, and that I need to follow a low-GI diet and exercise more, and they will see me in eight weeks.

I am somewhat reluctant to go on another medication without trying to correct the problem on my own first, especially because Metformin has some nasty side effects such as stomach upset and diarrhea. Do I need to go on Metformin right away, or is it feasible to try a low-GI diet for a few months? I emailed my doc about this but haven't heard back yet. I work full-time and am also in graduate school, so this is a very hectic time of year for me and would be a bad time to acclimate to a new medicine (although possible, I'm sure).

From those of you familiar with PCOS and insulin resistance/pre-diabetes - should I hop on the Metformin posthaste? Also, should I try the South Beach diet or is there some other special magic diet that is better for pre-diabetics?

Metformin woes (diarrhea-free!)

low_horrible_immoral — Fri, 27 Aug 2010 03:02:26 -0800

I'd like to hear about your experience taking metformin for PCOS, especially if it didn't work quite as you expected... Hi all

A couple of years ago I was prescribed metformin to improve my fertility and regulate my cycles (I have PCOS and looong cycles of around 40-45 days). I ovulated more quickly and I got pregnant about a month later, yay!

Now I'm taking it again (1500mg), and after about a month it's not working as well. In fact it's doing the opposite - I didn't ovulate when I normally do and my morning temperatures have gone all spiky so I think my body may have gone into a annovulatory state.

When I told my GP she told me to stick with it a bit longer, and my husband feels the same.

Has anyone had any experience of this? Should I stick with it, change the dosage or throw the pills away?? Any advice/anecdotes appreciated.

Should I just gnaw on a head of lettuce?

MultiFaceted — Sat, 01 May 2010 15:07:38 -0800

I've had insulin resistance and PCOS for about 8 years now. I've been on metformin off and on for most of that time. My lab results this week show elevated liver enzymes, which means I have to stop the metformin. But it also showed elevated blood sugars over the last 3 months, which means I have to get the sugars better controlled. Since I can't take the metformin right now, I have to try to manage this with diet. I have no idea what to eat. Can you help? Relevant info: 34/female, single, no children, overweight by about 30 pounds (although BMI says I should lose 50 pounds...I'm not OK with that). Insulin resistance and PCOS diagnosed about 8 years ago. On birth control pills to regulate my cycle and keep the cysts under control.

Metformin is prescribed as 1,000 mg twice a day, but I've maybe taken that much for about 5 days in the past year. Most days I can get 1,000 mg in, but I'm not consistent AT ALL with taking it, and I've gone at least a month or two at a time not taking it. Over the past month I've done better, but it's still not a daily thing.

I have been taking 5HTP for not quite 30 days, 100mg at night. I don't drink a lot...I'll drink a bottle of wine over the course of a week, then won't drink any for another week or two. Definitely not enough for liver damage.

My labs this week had elevated ALT/SGPT of 137 and elevated AST/SGOT of 82. Doc said both should be around 35. She wants me to stop the metformin for a month and retest, since metformin can cause elevated liver enzymes.

My A1C test (review of blood sugars over the past 3 months) was 6.2, and I think she said my average BS was 131 (but at that point I was trying to write all this down so I may have that incorrect). I'm being sent to an endocrinologist for that. I'm also going to try and see a dietitian as well.

Here's the problem: I know I need to get serious about this...I've neglected myself for too long. I need to lose weight and I need to eat a diet that will control my blood sugar and will help my liver. The problem is that I have NO IDEA what to eat. I know that I need lots of protein to control the sugar, but it sounds like that's the last thing I need for my liver (too much fat).

In short, I'm overwhelmed, a little scared, and I don't know where to start. Reading the internet is overwhelming me even more. Right now I need someone to tell me "here, eat this on Monday, this on Tuesday, and this on Wednesday." In other words, I am horrible at structuring my diet and putting it all together. And I'm scared that I won't be able to get this under control.

Can you offer me any good ideas on what I should be eating and what I shouldn't? I don't mind cooking, and would love to learn new skills, so recipes are acceptable. I DO NOT LIKE FRUIT OF ANY KIND, so don't tell me to eat fruit or smoothies for breakfast. Not happening.

What should I be eating that will keep my blood sugar within the normal limits, and will also be good for my liver?

How do I care for a cat with diabetes?

dbgrady — Fri, 25 Sep 2009 10:17:38 -0800

How do I best care for a cat with diabetes? A few specific questions:

1. Is it really difficult to inject a cat with insulin?

2. Is insulin necessary if the diabetes isn't severe?

3. Has anyone given their cat metformin pills instead of insulin? What are the advantages and disadvantages of this?

4. Is there anything practical I should know or expect with regard to the cat's behavior, side-effects, etc?

(I am aware of this previous question.)

(Posted for a friend)

Thank you.

Can a non-diabetic stop taking Metformin for a few days?

Anonymous — Sun, 12 Jul 2009 16:11:32 -0800

Is it dangerous to suspend taking Metformin for a few days for a non-diabetic? I have been taking Metformin for a few months. My doctor wants me to eventually be on 1700 mg a day but to move up slowly. I haven't been able to get above 850 mg (1 pill a day, taken with dinner) because of the terrible stomach side effects. Basically, most days I have diarrhea several times a day, a little while after I eat anything.

I have read the other questions about how to avoid side effects and have followed the advice about things to eat, but, I am still having trouble. I can eat the same thing two days in a row then be fine one day and have trouble the next. There's no rhyme or reason to it.

Luckily I work alone most of the time, but now I have a problem. I am going to a very important business conference next week and I simply cannot run out of meetings constantly to go to the bathroom. My absensce would definitely be noted and while I suppose I could explain my problem as medication side effects, it would be much better if I didn't have trouble at all.

Basically I want to stop taking the Metformin for a few days, until I return from my conference.

I have appointments with my doctor and a nutritionist set up to talk about this but of course I couldn't get in until after I come back. I am NOT DIABETIC!! (Making that bold so people would see it.) I take the Metformin due to a hormone imbalance and have never had an abnormal blood sugar reading. I guess the point is to keep me from being diabetic.

Has anyone ever done this? Does it even stop the side effects immediately? I don't want to have a blood sugar rebound problem either.

Also, any other advice would be great. If I could keep taking the Metformin but avoid the stomach problems I would.

Thanks, everyone.

Might Metafilter Mitigate My Metformin Misery?

Lord Widebottom — Wed, 10 Jun 2009 12:14:59 -0800

So there is this lovely drug called Metformin that I take to help control the ole blood sugar and it works a treat. However, it seems to be leaving me with a constant low grade stomach ache and very very frequent Diarrhea. My Doctor and I have experimented with lowering the dose but it does not seem to make much difference. This is a known side-effect of the drug, but I am reluctant to start changing things and risking introduction of new side-effects or lose some of the effectiveness of my current cocktail since it does a good job of keeping the numbers where they should be.

Has anyone out there experienced this issue and found a way to help minimize the side effect? (besides taking it with food, which I do)

I'd like to eat more than cheese and butter.

orangemiles — Mon, 25 Feb 2008 07:33:36 -0800

Insulin Resistance Filter: I've just been put on metformin. What next? I'm overweight and my insulin levels are a little high. As the big D (diabetes) runs in my family, I take this seriously. I'm on Weight Watchers to lose the weight, and just requested a prescription for metformin as my online research said it can help prevent full-blown diabetes sometimes. A friend is on it, too, and it has helped her levels.

My doctor guffawed when I asked about it and said "if I buy into the insulin resistance notion" then I need to act like it and immediately cease any and all sugar and carb consumption. A.) Is this just a notion? My limited research seemed to confirm it wasn't a snake-oil situation.

B, C, and D.) Life is nuts right now, I work three jobs, and we have three straight weeks of visitors coming soon. Not a great time to make gigantic changes cold-turkey. What are some baby steps to take to make some lifestyle changes? What bigger changes do I need to eventually make? What resources can tell me more? Any and all experience stories are helpful.