Going against doctors dosage...

[lrose7]

Have any of you gone against a doctors dosage suggestions?
My doctor prescribed 1000mg of Metformin for 3 months. After 3 months we would evaluate to see how it was working because I wanted to go straight to clomid. My sister has PCOS and she knows what works better, dosages, etc. Well I went in at 3 months and she suggested I say on Met currently at the same EXACT dosage I was on at 1000mg. I have had no AF in almost 3 months. So last week I uped my dose to 2000mg of Metformin, as suggested by my sister as well.

What do ya all think??

[JosieFB]

I don't think its true that 1000mg of XR is equiv to 2000mg of regular. I took 1500mg of XR prescribed by my gyn, but when she referred me to an endo he upped it to 2000mg regular. He said XR does not help Insulin Resistance / PCOS as effectively as non-XR. The only thing about taking a higher dosage is that you could run out before you can get another month or quarter's worth.

[danare]

I have no experience with XR but as for me I would get a 2nd Drs opinion because everyones body is different and just because one dose works for your sister doesnt mean it will work for you. Did the Dr give you any reason for not upping your dosage??

[CrumpledCrystal]

I'm thinking of doing the same thing b/c the doc has me on the same schedule as you were on. I don't see how 3 more months of the same thing is going to help, it seems like she should have been willing to suggest something more. Has she checked your adrenals? I have been taking 1000mg of Fortamet, which is extended release and it has worked to bring down my testosterone levels, so I believe more would work even better and will be asking about the dosage the next time I call in.

[sheepiegirl]

I would caution against upping your dose on your own. I've read that Met can take up to 6 months to start working so maybe that's what your doctor is waiting for.

Also, everyone is different so what may work well for your sister may not be right for you. And Met is a pretty strong one to be messing with.

[lrose7]

I am taking the advice of getting a 2nd opinion. I am seeing a new doctor next Friday and I'm taking in copies of all my records so they can see all my tests. I'll let you all know what they say.

So far the GI reaction hasnt been any different than the 1000mg of Met XR uping it to the 2000mg XR but its only been a week after uping the dose. I dont think my sister would recommend something that would be harmful for me. She's been to many many many more doctors than I have since she's been dealing with PCOS for over 10 years now. I trust her suggestion. Just want to know if anyone else has questioned their dosage to their doctors or uped their doses and what reactions did you get?

I agree that being on it already for 3 mos it should have done something,... at least bring AF right? Not to mention she said that after 3mos if it didnt work she'd change me to clomid and now she is changing her story. They did more bloodwork at that time and are supposed to be sending me the data. I will have to ask her about my diff levels as I dont know much about that yet.

[sheepiegirl]

I think that's a great idea to get a second opinion.

Of course your sister wouldn't purposely do anything to harm you, but if she isn't a doctor or a pharmacist, she doesn't necessarily know all there is about the medicine or about your particular condition, so it could inadvertently happen.

Also, I've taken it for 8 months and it hasn't brought AF to me, so it doesn't necessarily work for everyone, and it also doesn't necessarily work right away, or at all or at certain doses...

I'm just usually of the mind that the doctor has reasons for doing things and they can certainly change their minds (maybe in the 3 months she decided you would need extra time before the Clomid, I don't know--just throwing stuff out there!)

[ibcnuldu]

Even though doctors aren't perfect, I think you should either seek a second opinion or speak with your doctor before upping your dosage. Plus I think most pharmacies have certain dates before you can refill your script and then you'll run out sooner and be without any. Also, lactic acidosis is nothing to laugh at so just for your own safety I think it's best you speak with a doctor before hand.

[kittykisses]

I was in your situation also. My dr. refused to up my dose for 8 months!! I went from Nov. to Feb. before I had af. Just this week she sent me up to 1,000. I also considered upping it on my own , but I was afraid it might have an adverse effect. If you end up sick and in the emergency room or hospital, think how embarrassing it would be to say "I doubled my dose against my doctor's wishes."

[TrishainAZ]

For what its worth, I have been on up to 2850 mg of met at one time and I was only 107 lbs at the time. (don't recommend that dose necessarily, but I don't think 2000 mg would hurt you) The standard dose these days seems to be 1500-2000 mg. I would also recommend talking to another doctor though, cause as they said if you run out of your prescription you'll have a hard time refilling it. I take regular met, not ER, but from what I have heard (and I am absolutely NOT an expert on this) that ER is not a higher dose and in some cases is not as effective as regular met (I kind of believe this, as if its easier to stomach, then why wouldn't they always prescribe it?). Could be wrong about that though. Check with your doctor about it. Good luck!

[lrose7]

Hey Everyone!

Thanks for the posts.

My new doctor is great! She did suggest I up my dose to 1500mg, and thats when I told her I'd been taking 2000mg for the past two weeks. She didnt seem upset or surprised, and asked me if I'd had any effects on that dose. I havent had any changes in symptoms, etc. She said I could stay on that dosage (2 pills and night and 2 pills in the am), but she said with my weight I dont need 2000mg, that 1500 should be sufficient.

I did take her recommendation and am now on 1500mg. She also gave me my first prescription for clomid which I start tomorrow . She is giving me 3 cycles on the 50mg to see if that works for me, along with the metformin.

Its great to get a 2nd opinion if you think your doctor is doing what you think they should be!!!!

[Nikki_26]

Can I ask what your weight is or a round about number? I have been on Met for over a year and I to have thought about taking 1800 or 2000mg. It seems to be more beneficial at 1800mg from what I've read. (don't know how true that is)

P.S. I'm 160lbs....

[sheepiegirl]

I've heard that weight doesn't have anything to do with it. I'm only 110 and have been on both 1500mg and 2000mg.

That's great that you like your new doctor--that seems like a long time to be on the same dose of Clomid though. I know my doctor upped me when my original dose of 100mg didn't work...

Good luck!

[lrose7]

Sheepiegirl - Did your doc up your dosage after 1 cycle? I thought it was wierd that she wanted to keep me on 50mg for 3 months also. I was thinking if 50 didnt work to go to 100mg..??

Maybe weight doesnt have anything to do with the metformin, who knows. But it makes sense since you'd think larger doses would be more effective in someone that weighed more. The doc also told me she thinks PCOS is something that women may have had all their lives and certain lifestyle changes can trigger the symptoms. Like in 2 years I gained over 40lbs and just recently I was diagonsed with PCOS. I guess thats why they said loosing weight it so effective in TTC w/ PCOS.

[TrishainAZ]

I've heard that weight doesn't have anything to do with it. I'm only 110 and have been on both 1500mg and 2000mg.


Good luck!

I think I wrote this before, but when I was 107 lbs they had me all the way up to 2850 mg (not that I recommend that dose... it was the going dose at the time... the going dose this time seems to be 2000 mg, so thats what I'm on this time)