is this right?

mix · 10-17-2005, 09:37 PM

i'm back on the metformin and am happy with it so far (i'm doing it in conjunction with weightwatchers and lost 3.6 lbs last week).

however, i'm a little concerned that my obgyn didn't bother to test my hormone levels prior to starting metformin. it was a new doctor, so it was only my word that said i suffered from pcos - she had no previous blood tests or diagnosis to refer to.

is this right? i did ask for a blood test before she gave me the metformin, but she said it wouldn't make any difference.

i'm due to go back and see her (as my pap smear needs to be repeated) - should i tell her i want some blood tests? if so, which range should i be asking for?

any advice would be welcome.

mom_of_3_boys · 10-18-2005, 12:08 PM

Sorry I can't help answer the question about what tests to get done. I just wanted to add that my General Dr. did the same thing to me yesterday. I told him about my PCOS diagnosis and he immediately asked if I was on met, I said no and he gave me and Rx for it. I asked him if I needed any tests to confirm IR he said no pretty much all overweight people are IR and gave me 500mg/day. Never said anything about returning for b/w or anything. Rx runs out in 2 months guess I'll see what that brings if the met doesn't kill me in the mean time!! I was kinda leary to take it after some of the things I have read.

mix · 11-04-2005, 12:13 AM

i'm bumping this and asking another question

i'm on 1000mg right now - should i maybe ask for 1500? is 1000mg too low to be effective?

i'm really concerned that no bloodwork has been done... i guess if i'm that concerned i should go back to the doc, but i'd love some opinions from other ladies who have had some experience of being on met.

innkeepermommy · 11-04-2005, 02:59 AM

My bloodwork is all normal, so I don't think it is unreasonable for a dr. to prescribe met without doing bloodwork. Most cysters seem to be on 1500 mg as a minimum effective dose, with some going up to 2500 mg.

christyz · 11-04-2005, 11:23 AM

I have to disagree.

Like all meds, met can have some possible problems if the wrong people are on it and that's why it's crucial to have regular bloodwork done. Not only will you know which hormones need to improve on the drug, you'll need regular testing of your vit B12 (which can be malabsorbed in people on it). As well, regular tests of your liver and kidneys are imperative to make sure the drug is propoerly being excreted from the body. A build up of met in the body is called lactic acidosis and it is rare, but you need to be monitored. I have no risk factors for LA, but my Dr monitors me every 6 months and I'm glad he's so thorough since I will be on the drug long-term.

Good luck!

mix · 11-04-2005, 12:30 PM

thanks ladies. ok, i'm going back to the doc and i'm going to politely demand blood tests. i forgot about the B12 thing. that's something for me to definitely be concerned about as i suffered from B12 deficiency a couple of years ago (due to being vegetarian). it wasn't fun.

christy, what do you think about the dose? i don't feel that i've been prescribed the dose most useful for pcos.

hmmm... maybe i should switch obgyn's.

christyz · 11-04-2005, 02:10 PM

Mix: I'm glad you are going to talk with your Dr. I would not want to be on this drug unmonitored.

Regarding the dosage, there is no RIGHT dose for pcos. Proper dosage depends on many factors: how easy your hormones are to move, weight, diet, activity level, genetics etc. The only way to know if it's working for you is via bloodwork. If the insulin/hormones labs are moving in the right direction, then you are on the right dose for you.

For me, the right dose was 1500 mg for the first 4 years. It took 3 years to get everything to normal and any lower would have just been ineffective. But as of June of this year, I was lowered to 1000 mg due to my diet and exercise levels. I was starting to have consistent low sugars on 1500 and 1000 has kept my hormones where they needed to be without any sugar issues. So trial and error is really big on this drug.

Take note of how your feeling, watch your bloodwork numbers carefully and you and your dr can decide together if your dose is sufficient for your needs.

All the best!

RunnerDuck · 11-04-2005, 04:58 PM

With regard to hormones, I have had doctors who monitor closely and I have had doctors who go based on symptoms alone. It can go either way.

With regard to liver and kidney function, I have always had those tested every few months on met. But I got a new endocrinologist in January of this year and he said the liver function tests are no longer considered as important as they once were... I think he said they only need to be run once a year or every other year now? But I have started taking Avandia, too, so I am having them checked because of that. I have a feeling he'd order a lot less blood work if I was just on met. (He does look at hormones, too, BTW)

As far as I know I have never had my B vitamin levels checked... but met does interfere with absorption of them so I take a B complex every day in addition to my normal daily multi-vite (prenatal)... I take one in the AM and one in the PM so as not to flood my system and just end up peeing it all out at once. (B vites are water soluble so your body can easily dump the excess)

In short... well i guess the hormone thing varies by doctor and I am not sure one way or the other is better. If your symptoms are improved it doesn't really matter what your levels are you know? And if your symptoms aren't improved well I guess it still doesn't matter since you can deduce they are going to be off LOL. It's just one more marker to know or not know. But I think you probably should have at least yearly liver and kidney function checked.

mix · 11-09-2005, 08:08 PM

well, i just got back from seeing my obgyn. i actually went in for another reason - i found another breast lump and needed it checked out. i asked her if she'd give me some blood tests and she asked why. i told her that my pcos wasn't on record with them, so that'd be a good idea. i said i'd also like to know what my levels are doing. she told me that metformin wouldn't change any levels.

anyway, after practially pleading with her, she finally agreed. i felt like she wasn't happy with me though. with all the stress of everything else, i forgot to ask her to include a test for B12 (i was deficient a few years ago).

i came out of there feeling so down.

christyz · 11-09-2005, 11:14 PM

Sheesh..I can't believe we have to go and plead with Dr's to keep an eye on us on a diabetic drug...oy vey. I think you did the right thing and I hope they will shed some light on everything for you.