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stasia_ana · 01-22-2004, 02:25 PM

thanks for discussing this issue!

over the last year my tests have shown elevated results as well! my re was not surprised by it nor was my cardiologists who said it had a lot to do with the IR factor! both of the rec me staying on met (even though i just recently started!) because it most likely will decrease !

although i am tested every 3 months to see if changes are occurring to be on safe side!

nobimbo · 01-22-2004, 07:29 PM

Quote:

both of the rec me staying on met

How wonderful that you have such knowledgable docs!

Linda

Raiderette · 02-07-2004, 08:59 PM

Since being on Met for 3 months, no iron and taking Milk thistle my liver enzymes have dropped from 105 to 56. I am extremely pleased !

I have recently upped my Met and I take another BW test this month...I hope to see that it has dropped even more.

KristyK · 02-09-2004, 01:55 AM

When I was first diagnosed with PCOS, my labs came back with elevated ALT/AST levels. I was referred to a liver specialist at University of Cincinnati hospital. My hep specialist said there is a really strong connection between PCOS sufferers and fatty liver. He supports the theory of Metformin actually helping the condition. I take 1000mg twice daily. He also said that modest weight loss of 10% of weight (from the time of diagnosis) often causes enzyme levels to normalize. Additionally, I take 800 IU of Vitamin E daily (natural vitamin E supposedly is more effective than synthetic), along with 1250 mg of Urso (also known as actigall or ursodiol), which decreases the amount of cholesterol produced in the liver, thus decreasing the amount of fat in the liver. It is normally given to patients with gallstones, but my doc has had much success using it to treat his patients with fatty liver. Originally, my numbers were 110 AST/84 ALT - they are now 40 AST/24 ALT. Hope this helps!!!

stasia_ana · 02-09-2004, 12:26 PM

i am so glad people are continuing to post on this! i recently had all my blood work reviewed- and my ALT's have continued to rise - now up to 84 in Feb 04 from 32 last June! however my ast is normal- each time my blood has been taken though i have not been taking glucophage or ihave been off it for three weeks so that i could get baseline stats! i am having it tested again in three months to see if liver tests are ok! if they continue to rise i think i am on my way to see a liver specialist b/c my RE does not want to make that decision (out of his scope of practice)! but at least i am starting to feel better! i have now made it 8 days on 1500mg- (6 of those days had pretty nasty side effects - but i am feeling better as i adjust)

KristyK · 02-09-2004, 07:19 PM

My RE was the same way. He did not want to make any conclusions out of his specialty, so he suggested that I see a liver specialist. Also, my labs were just like yours - going up each time the bloodwork was run. I seriously began to freak out about it!! You may want to see a hepatic specialist anyway, just to get another opinion - it never hurts! Good luck with everything!!!

nobimbo · 02-22-2004, 11:53 AM

http://yalenewhavenhealth.org/Librar...wid=hn-1437003

Glucophage®

Metformin is a drug used to lower blood sugar levels in people with non-insulin-dependent (type 2) diabetes.

Herbs
Summary of Interactions for Metformin

Depletion or interference Folic acid*

Vitamin B12
Adverse interaction Ginkgo biloba
Side effect reduction/prevention Calcium
Supportive interaction None known
Reduced drug absorption/bioavailability Guar gum*
Other (see text) DHEA

Magnesium

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Supplements
Dehydroepiandrosterone (DHEA)

Metformin has been reported to increase blood levels of DHEA-sulfate in at least two studies. 1, 2

Folic acid and Vitamin B12

Metformin therapy has been shown to deplete vitamin B12 and sometimes, but not always, 3 folic acid as well. 4 This depletion occurs through the interruption of a calcium-dependent mechanism. Supplementation with calcium has reversed this effect in a clinical trial. 5 People taking metformin should supplement vitamin B12 and folic acid or ask their doctor to monitor folic acid and vitamin B12 levels.

Magnesium

In a study of patients with poorly controlled type 2 diabetes, low blood levels of magnesium, and high urine magnesium loss, metformin therapy was associated with reduced urinary magnesium losses but no change in low blood levels of magnesium. 6 Whether this interaction has clinical importance remains unclear.

Guar gum

In a small, controlled study, guar gum plus metformin slowed the rate of metformin absorption. 7 In people with diabetes this interaction could reduce the blood sugar-lowering effectiveness of metformin. Until more is known, metformin should be taken two hours before or two hours after guar gum-containing supplements. It remains unclear whether the small amounts of guar gum found in many processed foods is enough to significantly affect metformin absorption.

Interactions with Herbs
Ginkgo biloba

In a preliminary trial, administration of Ginkgo biloba extract (120 mg per day) for three months to patients with type 2 diabetes who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. 8 Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

Other Interactions
Food

Food interferes with metformin absorption. 9, 10, 11 Taking metformin with food can reduce the absorption of the drug. Therefore, metformin should be taken an hour before or two hours after a meal unless stomach upset occurs.

Alcohol

Lactic acidosis is a rare but serious side effect of metformin. Alcohol increases the production of lactic acid caused by metformin, increasing the risk of lactic acidosis. 12 People taking metformin should avoid alcohol or consult with their doctor before consuming alcohol.

santa'sbaby · 02-22-2004, 01:08 PM

Thank you so much for your efforts!!

I have printed this for future reference!

christyz · 02-22-2004, 08:47 PM

Guar gum: In a small, controlled study, guar gum plus metformin slowed the rate of metformin absorption.

Ginkgo biloba: In a preliminary trial, administration of Ginkgo biloba extract (120 mg per day) for three months to patients with type 2 diabetes who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet.

nobimbo · 02-22-2004, 08:51 PM

Christy, I'm not sure what you were trying to say in your post? That info was in the article.

Maybe this could be put somewhere in the stickies? I know there is already info there about the guar gum, but there is some different info in this article as well.

Thanks,
Linda

christyz · 02-22-2004, 09:08 PM

Sorry! LOL I skimmed it and didn't see the guar gum and ginko biloba. Was adding them so the list was complete, but it was complete already.

I am not a moderator in this forum anymore, but KYBLUEGRASS took my position and is still around from time to time and can move it. She's got the "power".

ljl7171 · 02-23-2004, 02:29 PM

I have been taking Met for just over a year for my IR and my mother has been on it for over 10 years to help her control her Diabetes. When you look at our perscription bottles they tell you to take Met with food.

I have read on here that you shouldn't take Met with food so I asked my good friend who is a pharmacist at a Hospital. She told me that you should take Met with food, this is the normal practice for administering the drug.

She said that Met is very hard on your digetive tract and taking it with food helps in that aspect. When she gets a perscription ready at the hospital she sends it with directions for it to be administered with a meal.

This leaves me all puzzled now. When should you take Met?

I have concluded for me that to follow what my body tells me. If I take it 1 hr before to with a meal and I don't get side effects then that is my window for taking the medication otherwise I may pay the consequences.

Thanks,

Lana

angsum · 02-23-2004, 02:34 PM

Since I take Met should I take extra folic acid and B12 supplements? I already take prenatal vitamins, but how much of each do we need a day to counteract the Met's interaction?

Thanks,
Angie

christyz · 02-23-2004, 03:49 PM

ljl: Your friend is right. As my Dr says, it's better to take met with food and have a slight decrease of absortion, than take it without food and lose 99% of it because you're in the bathroom with the runs.

It really is a mtter of how if affects your body. I have learned to never take met without taking a few bites of food first, otherwise I pay for it dearly.

Ang: As Linda's article says, taking calcium with it, tends to reverse the B12 malabsorption. If you are eating B complex in your diet and taking a pre-natal, you'll probably be fine. I also get my B12 checked every 3 months to make sure that my body is getting what it needs.

Hope it helps.

angsum · 02-23-2004, 04:36 PM

Thanks, Christy! I will ask my doctor to check my B12 levels with my next bloodwork!

Angie

02-07-2004, 08:59 PM	#18 (permalink)
Raiderette Proud Mommy ! Join Date: Oct 2003 Location: Alameda, California Posts: 299 My Mood: Points: 8,827.06 Bank: 0.00 Total Points: 8,827.06 Donate	Since being on Met for 3 months, no iron and taking Milk thistle my liver enzymes have dropped from 105 to 56. I am extremely pleased ! I have recently upped my Met and I take another BW test this month...I hope to see that it has dropped even more. __________________ Angi: 38 DH: 38 To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Noah arrived early Sept. 16, 2006 @ 1:49 pm.

02-22-2004, 11:53 AM	#22 (permalink)
nobimbo Google Junkie Join Date: Jul 2003 Location: St. Louis, MO Posts: 3,414 Points: 101,006.93 Bank: 18,549.71 Total Points: 119,556.64 Donate	Summary of Interactions For Met and Herbs, Vitamins, Minerals, Food, and Alcohol http://yalenewhavenhealth.org/Librar...wid=hn-1437003 Glucophage® Metformin is a drug used to lower blood sugar levels in people with non-insulin-dependent (type 2) diabetes. Herbs Summary of Interactions for Metformin Depletion or interference Folic acid* Vitamin B12 Adverse interaction Ginkgo biloba Side effect reduction/prevention Calcium Supportive interaction None known Reduced drug absorption/bioavailability Guar gum* Other (see text) DHEA Magnesium For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence. Interactions with Supplements Dehydroepiandrosterone (DHEA) Metformin has been reported to increase blood levels of DHEA-sulfate in at least two studies. 1, 2 Folic acid and Vitamin B12 Metformin therapy has been shown to deplete vitamin B12 and sometimes, but not always, 3 folic acid as well. 4 This depletion occurs through the interruption of a calcium-dependent mechanism. Supplementation with calcium has reversed this effect in a clinical trial. 5 People taking metformin should supplement vitamin B12 and folic acid or ask their doctor to monitor folic acid and vitamin B12 levels. Magnesium In a study of patients with poorly controlled type 2 diabetes, low blood levels of magnesium, and high urine magnesium loss, metformin therapy was associated with reduced urinary magnesium losses but no change in low blood levels of magnesium. 6 Whether this interaction has clinical importance remains unclear. Guar gum In a small, controlled study, guar gum plus metformin slowed the rate of metformin absorption. 7 In people with diabetes this interaction could reduce the blood sugar-lowering effectiveness of metformin. Until more is known, metformin should be taken two hours before or two hours after guar gum-containing supplements. It remains unclear whether the small amounts of guar gum found in many processed foods is enough to significantly affect metformin absorption. Interactions with Herbs Ginkgo biloba In a preliminary trial, administration of Ginkgo biloba extract (120 mg per day) for three months to patients with type 2 diabetes who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. 8 Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba. Other Interactions Food Food interferes with metformin absorption. 9, 10, 11 Taking metformin with food can reduce the absorption of the drug. Therefore, metformin should be taken an hour before or two hours after a meal unless stomach upset occurs. Alcohol Lactic acidosis is a rare but serious side effect of metformin. Alcohol increases the production of lactic acid caused by metformin, increasing the risk of lactic acidosis. 12 People taking metformin should avoid alcohol or consult with their doctor before consuming alcohol. __________________ dx pcos 1984, type II diabetes 2001, also hypertension Met 2000mg since 2001, started Glucophage XR 4/22/04, then switched to Met ER 6/04; also: multi, Vit. C, Vit. E, B12/folic acid combo, fish oil & borage oil combo, garlic capsules, cinnamon, Vitex, calcium with magnesium/zinc, biotin, CoQ10, selenium,iron Other meds: Verapamil and Altace(for blood pressure) Started laser hair removal 7/29/03, completed 3/04 (it works!) UAE for fibroid 3/24/03 and 3/16/04

02-22-2004, 01:08 PM	#23 (permalink)
santa'sbaby A new day......... Join Date: May 2002 Location: Canada Eh? Posts: 925 Points: 53,579.15 Bank: 5,533.84 Total Points: 59,112.99 Donate	This is so helpful.. Thank you so much for your efforts!! I have printed this for future reference! __________________ Me 35, DH 52. DSS 22, DD 15 150mg of Effexor Hysterectomy on Jan 17, 2006 Going back on Meds June 1st to treat PCOS symptoms though ovaries are gone. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Mod for Depression and Diet and Exercise Buddies. Check out my new message board for Traditional Christian Women To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

02-22-2004, 08:47 PM	#24 (permalink)
christyz Running & Biking Fool! Join Date: Aug 2002 Location: SK, CANADA Posts: 9,523 Points: 19,567.01 Bank: 3,348,243.84 Total Points: 3,367,810.85 Donate	Others: Guar gum: In a small, controlled study, guar gum plus metformin slowed the rate of metformin absorption. Ginkgo biloba: In a preliminary trial, administration of Ginkgo biloba extract (120 mg per day) for three months to patients with type 2 diabetes who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet. __________________ Christy 33 yrs, 1 precious hubby, 2 miracle kids, At Goal Wt for 4 yrs, Trygly's down 445 pts, Free Androgen down from 20 to 2, 3 half 'thons ran, 2 mtns hiked, 1 crazy run in the Rockies, 4 forest trail races, profiled in 2 magazines...1 woman determined to kick PCOS butt! To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Before & Aug 2007 '08: Duathlon and another half?

02-22-2004, 08:51 PM	#25 (permalink)
nobimbo Google Junkie Join Date: Jul 2003 Location: St. Louis, MO Posts: 3,414 Points: 101,006.93 Bank: 18,549.71 Total Points: 119,556.64 Donate	Christy, I'm not sure what you were trying to say in your post? That info was in the article. Maybe this could be put somewhere in the stickies? I know there is already info there about the guar gum, but there is some different info in this article as well. Thanks, Linda __________________ dx pcos 1984, type II diabetes 2001, also hypertension Met 2000mg since 2001, started Glucophage XR 4/22/04, then switched to Met ER 6/04; also: multi, Vit. C, Vit. E, B12/folic acid combo, fish oil & borage oil combo, garlic capsules, cinnamon, Vitex, calcium with magnesium/zinc, biotin, CoQ10, selenium,iron Other meds: Verapamil and Altace(for blood pressure) Started laser hair removal 7/29/03, completed 3/04 (it works!) UAE for fibroid 3/24/03 and 3/16/04

01-22-2004, 02:25 PM	#16 (permalink)
stasia_ana Registered User Join Date: Dec 2003 Posts: 23 Points: 80.06 Bank: 0.00 Total Points: 80.06 Donate	thanks for discussing this issue! over the last year my tests have shown elevated results as well! my re was not surprised by it nor was my cardiologists who said it had a lot to do with the IR factor! both of the rec me staying on met (even though i just recently started!) because it most likely will decrease ! although i am tested every 3 months to see if changes are occurring to be on safe side!

02-09-2004, 01:55 AM	#19 (permalink)
KristyK Registered User Join Date: Apr 2003 Location: Cincinnati, OH Posts: 2 Points: 16.00 Bank: 0.00 Total Points: 16.00 Donate	When I was first diagnosed with PCOS, my labs came back with elevated ALT/AST levels. I was referred to a liver specialist at University of Cincinnati hospital. My hep specialist said there is a really strong connection between PCOS sufferers and fatty liver. He supports the theory of Metformin actually helping the condition. I take 1000mg twice daily. He also said that modest weight loss of 10% of weight (from the time of diagnosis) often causes enzyme levels to normalize. Additionally, I take 800 IU of Vitamin E daily (natural vitamin E supposedly is more effective than synthetic), along with 1250 mg of Urso (also known as actigall or ursodiol), which decreases the amount of cholesterol produced in the liver, thus decreasing the amount of fat in the liver. It is normally given to patients with gallstones, but my doc has had much success using it to treat his patients with fatty liver. Originally, my numbers were 110 AST/84 ALT - they are now 40 AST/24 ALT. Hope this helps!!!

02-09-2004, 12:26 PM	#20 (permalink)
stasia_ana Registered User Join Date: Dec 2003 Posts: 23 Points: 80.06 Bank: 0.00 Total Points: 80.06 Donate	i am so glad people are continuing to post on this! i recently had all my blood work reviewed- and my ALT's have continued to rise - now up to 84 in Feb 04 from 32 last June! however my ast is normal- each time my blood has been taken though i have not been taking glucophage or ihave been off it for three weeks so that i could get baseline stats! i am having it tested again in three months to see if liver tests are ok! if they continue to rise i think i am on my way to see a liver specialist b/c my RE does not want to make that decision (out of his scope of practice)! but at least i am starting to feel better! i have now made it 8 days on 1500mg- (6 of those days had pretty nasty side effects - but i am feeling better as i adjust)

02-09-2004, 07:19 PM	#21 (permalink)
KristyK Registered User Join Date: Apr 2003 Location: Cincinnati, OH Posts: 2 Points: 16.00 Bank: 0.00 Total Points: 16.00 Donate	My RE was the same way. He did not want to make any conclusions out of his specialty, so he suggested that I see a liver specialist. Also, my labs were just like yours - going up each time the bloodwork was run. I seriously began to freak out about it!! You may want to see a hepatic specialist anyway, just to get another opinion - it never hurts! Good luck with everything!!!

02-22-2004, 09:08 PM	#26 (permalink)
christyz Running & Biking Fool! Join Date: Aug 2002 Location: SK, CANADA Posts: 9,523 Points: 19,567.01 Bank: 3,348,243.84 Total Points: 3,367,810.85 Donate	Sorry! LOL I skimmed it and didn't see the guar gum and ginko biloba. Was adding them so the list was complete, but it was complete already. I am not a moderator in this forum anymore, but KYBLUEGRASS took my position and is still around from time to time and can move it. She's got the "power". __________________ Christy 33 yrs, 1 precious hubby, 2 miracle kids, At Goal Wt for 4 yrs, Trygly's down 445 pts, Free Androgen down from 20 to 2, 3 half 'thons ran, 2 mtns hiked, 1 crazy run in the Rockies, 4 forest trail races, profiled in 2 magazines...1 woman determined to kick PCOS butt! To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Before & Aug 2007 '08: Duathlon and another half?

02-23-2004, 02:29 PM	#27 (permalink)
ljl7171 Happy to be Me! Join Date: Jan 2004 Location: Ohio Posts: 245 My Mood: Points: 1,603.99 Bank: 33,276.03 Total Points: 34,880.02 Donate	Food & Met I have been taking Met for just over a year for my IR and my mother has been on it for over 10 years to help her control her Diabetes. When you look at our perscription bottles they tell you to take Met with food. I have read on here that you shouldn't take Met with food so I asked my good friend who is a pharmacist at a Hospital. She told me that you should take Met with food, this is the normal practice for administering the drug. She said that Met is very hard on your digetive tract and taking it with food helps in that aspect. When she gets a perscription ready at the hospital she sends it with directions for it to be administered with a meal. This leaves me all puzzled now. When should you take Met? I have concluded for me that to follow what my body tells me. If I take it 1 hr before to with a meal and I don't get side effects then that is my window for taking the medication otherwise I may pay the consequences. Thanks, Lana __________________ dx PCOS & IR 01/03; 1000 mg Metformin 2x a day; Hiraturism; Weight issues; HBP; H Cholesterol; Anxiety - Buspar 10 mg 2x a day; No AF

02-23-2004, 02:34 PM	#28 (permalink)
angsum Working too hard cyster Join Date: Oct 2003 Location: Western KY Posts: 317 My Mood: Points: 525.24 Bank: 0.00 Total Points: 525.24 Donate	Question.... Since I take Met should I take extra folic acid and B12 supplements? I already take prenatal vitamins, but how much of each do we need a day to counteract the Met's interaction? Thanks, Angie __________________ Angie, 32 ~ David, 37 ~ Married 5/28/04 DSS~ Jonathon, 10 Logan David arrived October 19th at 36w! 5 lb. 5 oz., 18 in. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

02-23-2004, 03:49 PM	#29 (permalink)
christyz Running & Biking Fool! Join Date: Aug 2002 Location: SK, CANADA Posts: 9,523 Points: 19,567.01 Bank: 3,348,243.84 Total Points: 3,367,810.85 Donate	ljl: Your friend is right. As my Dr says, it's better to take met with food and have a slight decrease of absortion, than take it without food and lose 99% of it because you're in the bathroom with the runs. It really is a mtter of how if affects your body. I have learned to never take met without taking a few bites of food first, otherwise I pay for it dearly. Ang: As Linda's article says, taking calcium with it, tends to reverse the B12 malabsorption. If you are eating B complex in your diet and taking a pre-natal, you'll probably be fine. I also get my B12 checked every 3 months to make sure that my body is getting what it needs. Hope it helps. __________________ Christy 33 yrs, 1 precious hubby, 2 miracle kids, At Goal Wt for 4 yrs, Trygly's down 445 pts, Free Androgen down from 20 to 2, 3 half 'thons ran, 2 mtns hiked, 1 crazy run in the Rockies, 4 forest trail races, profiled in 2 magazines...1 woman determined to kick PCOS butt! To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Before & Aug 2007 '08: Duathlon and another half?

02-23-2004, 04:36 PM	#30 (permalink)
angsum Working too hard cyster Join Date: Oct 2003 Location: Western KY Posts: 317 My Mood: Points: 525.24 Bank: 0.00 Total Points: 525.24 Donate	Thanks... Thanks, Christy! I will ask my doctor to check my B12 levels with my next bloodwork! Angie __________________ Angie, 32 ~ David, 37 ~ Married 5/28/04 DSS~ Jonathon, 10 Logan David arrived October 19th at 36w! 5 lb. 5 oz., 18 in. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

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