Has anyone else heard this????

Audra · 05-03-2002, 12:52 PM

Hi thin cysters!

I just went to an RE for the first time yesterday to confirm my OB/GYN's diagnosis that I have PCOS. In addition to agreeing with my gyn., the RE told me something that was news to me, and I wondered if any of you thin pcosers have heard it: he said that women who are normal weight and have PCOS are inherently VERY isulin resistant, much more so than overweight women with PCOS. This was a shock to me, and so was the fact that he told me there's an 18% chance I have diabetes right now, and a 50/50 chance I will develop diabetes in my lifetime.

Apparently, women who are normal weight have even more resistant insulin receivers on their cells than women who are overweight whose insulin resistance is caused mainly by fatty tissue (which is by nature very insulin resistant).

So, the RE took me off clomid, and put me on 3 times as much met as I was on before (now I'll be on 1500 mg). He believes it will be very easy to get me pregnant within like 3 months on just 1500 mg. of met.

Have any other thin cysters heard a similar story from their REs??

I'd really appreciate any responses. I am so confused right now. I always thought that met. was much more a cure for women who are overweight than for us skinny minnies. Is my doc off his rocker??

Please let me know what your experience has been, either with ttc, or even getting PG on met.

~Audra

------------------
~ me: 23, dh: 23
~ DX PCOS Feb. 02
~ 1 failed clomid/met round (50 mg. clomid cd 5-9 + 500 mg. met)
~ moving on to 100 mg. clomid... wish me luck!

Bitsy · 05-03-2002, 01:16 PM

Hi Audra,
I haven't heard anything to confirm your info. My RE was going to put me on metformin but I first asked for a fasting insulin and glucose blood test. My numbers came back on the lower end of "normal" so the RE said to hold off on the Metformin, that it probably wouldn't help.
In the meantime, I have been reading more and more that Metformin might actually help thin cysters who don't test positive for insulin resistance, but I'm not sure that I would believe that thin cysters are actually more insulin resistant than our cysters who are overweight.
If you have a chance I would ask your doctor for his/her sources of information. That way, you can research the information yourself.
I would love to hear from you and others on this topic. I would definitely take the metformin if I though it would help me get pg!!!!!!
Best of luck ttc!!

------------------
Me: 29
DH: 29
Diagnosed PCOS 2/02
TTC #1 since 8/01
2nd round Clomid 50 mg, 8 dpo

(Thincyster, no IR)

Sabrina02 · 05-03-2002, 04:33 PM

I'm very surprised to hear this. I haven't read anything about this and I've read many journal articles and many more abstracts on PCOS especially focusing on those that looked at thin cysters and those with regular cycles. I actually thought thin cysters were less IR because many have low normal fasting insulin levels. I know fasting insulin isn't the best test for IR, but low insulin must mean something and I thought it was a good something. Doesn't it contradict the thought that PCOS, or more specifically the IR supposidly causes PCOS, causes a person to have problems controlling her weight? Isn't that why so many with PCOS have weight troubles? I know excess weight inherently makes a person more IR, but isn't it the IR that is causing the excess weight in PCOS?

I'm interested in knowing more though because then I would persue getting an IGTT done more seriously, but I have my doubts. Does your doctor have a source for this information because I would be interested in reading it and showing it to my doctor. Sabrina

Audra · 05-03-2002, 05:33 PM

Hi Bitsy and Sabrina,

Thanks for responding! I am also sort of confused by this concept that thin cysters could be more IR than heavy ones. All I can tell you is that the RE explained it to me like this: our insulin resistance is more extreme because it is caused by an inherent high level of resistance to insulin in all of our cells, whereas overweight people with PCOS end up becoming insulin resistant and diabetic because they have a lot of adipose tissue (fat) which is highly insulin resistant.

So, I think the better question is (one that I was too nervous and tongue-tied to ask the RE), is WHY, if in fact we are very insulin resistant, aren't we OBESE??? Don't the two just go hand in hand? The whole thing seems like a Catch 22, and I just don't get it.

As far as the fasting glucose tests go, I'm not sure how reliable they are. My RE told me not to bother getting one because they are not accurate for people like us--what we really need is a Glucose challenge test, where you eat something very sugary and then your blood glucose levels get monitored over the next 2 hours... or something like that.

Anyway, I will try to ask my doctor what his info source is, but I probably won't be seeing him for about 3 months (since he wants me to try the met alone for that amount of time).

Has anyone else heard about all of this??? I hope my doctor is not a complete quack because he is like the only RE in this town, so I am sort of stuck with him...

~Audra

------------------
~ me: 23, dh: 23
~ DX PCOS Feb. 02
~ 1 failed clomid/met round (50 mg. clomid cd 5-9 + 500 mg. met)
~ moving on to 100 mg. clomid... wish me luck!

diamond*lily · 05-03-2002, 08:23 PM

I am so glad you brought this up because I was recently (FINALLY) diagnosed as having PCOS and the specialist I saw, who works at a University and specifically studies PCOS and it's relationship to Insulin Resistance, believes that ALL women with PCOS have some level of IR. Now my tests (performed by my former doctor) showed that I was not IR, but this doctor insisted that though my blood levels weren't supporting an IR diagnosis, my body was more sensitive to insulin and was reacting in such a way that I was IR.

He wanted to pull me off BC pills for three months and get a base-line hormone level and then start me on Metformin and see if I improved. According to him and his studies, even thin women with normal hormone levels who were diagnosed with PCOS, showed improvement on Metformin. I was too afraid to do that as the reason I started BC Pills was to bring down my elevated levels in hopes of halting my hairloss. Stopping BC Pills could send my body into a lovely episode of TE which I cannot afford. So I requested the addition of Aldactone and hopefully this will help with the problem that concerns me most.

Oh, before I started Aldactone, he did do an 2-hour OGTT to make sure I didn't have diabetes. I have not gotten the results back on that.

Frankly, the whole IR w/ normal G/I ratio thing confuses me; I've always understood that the lab values had to correspond with clinical features for there to be an accurate diagnoses, but apparently that isn't so.

~xoxo~
Dawn

[This message has been edited by diamond*lily (edited 05-03-2002).]

kimbryan · 05-05-2002, 03:19 AM

Hi Audra,This is definitely news to me. Thanks for posting it. My doctor actually insisted that I wasn't insulin resistant and I have never been tested since I have no weight problems and no skin tags or discolouration, which he says is a sure sign of IR. However I am on metformin because I insisted and he probably felt sorry for me at that time since I just had an mc ( and was about to cry!). So I am now on 850mg twice a day. I am still not ovulating well but my skin seems to be much clearer, a lot less oily. I suspect I am probably IR otherwise the metformin wouldn't do anything, right? I am also very confused.I am also now on clomid but haven't ovulated yet.

Autumn_1972 · 05-05-2002, 03:43 AM

Hi ladies

I am an overweight cyster but I have doing alot of research for my sister and my mom whom are both thin cysters.

Here is a link to a site that discusses this.
It does state in the article about IR being stronger in thin cysters. Its a medical journal.
http://www.ohiorepromed.com/pcos.htm

In the middle of this page in a box labeled "More on metformin and related subjects"

Is this article it is called

"Metformin and similar drugs to treat infertility in women with PCOS
(Review,Fertility & Sterility 2002, 93 KB"

I cant cut and paste the link directly because it is in adobe acrobat. Hope this helps ya

------------------
Autumn 30
Mike DH 34

actively trying 1/02
DX with PCOS 10/00
Meds I am currently on
Levoxyl 0.05mg--hypothyroid
Aldomet500 mg--hypertension
Glucophage XR 500 mg---
Insulin Resistance
No longer need provera to induce AF
I love glucophage

[This message has been edited by Autumn_1972 (edited 05-04-2002).]

Kari-Ann · 05-06-2002, 10:27 PM

Thanks for a wonderful new site to sift thru, Autumn!!
It's something new for me to bully my OBGYN with!!

See you around.Kari

MagPie · 05-07-2002, 01:47 AM

I'm not a thin cyster anymore, but I hope you don't mind my breaking in on the thread. I've been researching for a long time and this idea of women getting fat and thereby causing themselves to have insulin resistance and pcos a little disturbing. I am now 43 years old. I've had a lot of symptoms of PCOS since I was 14, but wasn't dx'd until I was 42..don't ask unless you wanna know, it's a long story. Anyway, I didn't start gaining weight until I was in my mid to late 20s, and I have found that fairly common among older cysters, some didn't gain until in their 30s and 40s. I had absolutely no lifestyle change. When I was in high school however, I did have dark skin on the back of my neck and developed skin tags before I gained weight. I do think that I was insulin resistant for years before I gained the weight. I believe that many more cysters are insulin resistant than most doctors believe. Because there isn't a definetive test, many doctors aren't really equipped to make the diagnosis. I am glad that IR in thin cysters might be getting closer to being recognized as we all need all the help we can get.

Hope this all makes the sense I want it to, I'm pretty sleepy now and didn't want to forget to post.

Margaret

bushbaby · 05-07-2002, 03:53 PM

Hi there,

Just a couple of things to add: I understand that diagnosing IR outside of the hospital (using the insulin clamp test) is very difficult to do accurately, so at this point, some REs are not even bothering. The point is that thin women respond to metformin - that's what really matters. Also, I believe there is a theory that in thin women, it is the ovary cells in particular that are IR, which would not show up on a GTT or a fasting test.

Metformin sure worked for me - ovulated and got pregnant my first month on it (1500), after multiple failed clomid rounds and only about 2 periods per year on my own.

Best of luck!

Cato · 05-21-2002, 05:49 PM

I've never heard this, but it makes total sense to me.

i've always wondered why, if you're insulin <i>resistant</i>, you would gain weight. Insulin is what enables your body's cells to take up energy, and also enables them to store fat... if they can't take up energy or store fat, surely you lose weight rather than gain it???

Oana · 05-22-2002, 12:50 PM

Ladies, here are some articles which talk about PCOS, met, IR and "nonobese" women.

http://jcem.endojournals.org/cgi/content/full/82/4/1147

http://jcem.endojournals.org/cgi/content/full/85/1/139

http://www.ncbi.nlm.nih.gov/htbin-po...=6&db=m&Dopt=r

http://www.easd.org/36th/abstracts/abs0713.html

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

http://www.macmcm.com/asrm/asrm98-pos.htm

http://www.fertilityplus.org/faq/metformin.html

If you have been prescribed met, please let us know how it goes (see my Poll post) and help shed light on this issue.

Thanks a lot,

Oana

Kittycat · 05-23-2002, 08:06 PM

I have heard this about the thin cysters. What I was told by my doctor is that women with PCOS who are thin have a moe 'severe' case of PCOS. I'm asuming this has to do with the severity of IR.