Will Glucophage/Lipitor combo help lower Cholest better than Lipitor alone?

[Storm8]

I have an appt this afternoon with my pcp. she is more concerned with my high trigycerides than my sugar or pcos. Boy, do i have alot to say about that! I have printed off reams of information to prove to her that they're all interconnected. I really really really want to be put on Glucophage XR after reading so much about it.

Once I convince her that the high cholesterol is connected to the Insulin Resistance and that is connected to the PCOS...perhaps she will finally be convinced. She told me last time i saw her that she wasn't concerned about my borderline diabetes (i am 6.0 right on the border), but just my cholesterol!!! I really think if i take the Gluc/met i will improve in the cholesterol area too, right?

She had me on Lipitor 10mg a day and she has upped that to 20mg a day. I started this on Wednesday, it is now Friday. I think the Lipitor in combo with the gluc is all i need. Would you agree? I would love some feedback on this, as all this is still new to me.

On a side note. I am currently 5 weeks post hysterectomy opertaion. They took EVERYTHING out, tubes, ovaries, uterus, and cervix. I had a mess in there! The bad news...I realized afterwards that the PCOS is still with me! (It stems mainly from your adenal gland not the ovaries) I was bummed out about that for a couple weeks. But I am a fighter. This PCOS won't beat me. I am currently taking 25mg of Spiro and I started using the Vaniqa cream lastnight. Fingers crossed for me, kay? I will let you know if it works. I am going to up my Spiro to 50mg. I will ask her today if i can. This hirsutism is so embarrassing...

Thanks for listening and please give me your input. Would relly love to hear your opinions regarding the gluc/met helping with the high cholesterol battle. Thanks!

[christyz]

I had nasty high triglycerides too...6 years ago (before my PCOS diagnosis) I had tri's of 510 and now they are 64, so I've taken some big strides in that dept. For me, a couple of years of met combined with dietary changes and cardio exercise really helped, but time will tell if that would be the case for you. I would definetly see if your Dr is open to the idea of a 6 month trial of met, diet and exercise and then re-test you and see if things are improving. Hopefully if he sees the information you've collected he'll be willing to meet you in the middle with your treatment options. You may still need lipitor, but it's worth a shot.

And KUDOS to you for doing your homework! The fact that you know the relationship between insulin and triglycerides is huge, and I hope your Dr will respond positively to your information. I have found a great Dr now, but many of my Dr's were angry and defensive when I brought things for them to read. I'm proud of you for arming yourslf with knowledge. Let us know how your appt goes, ok? Good luck!

[nobimbo]

My lipids improved dramatically after being on Met for only a few months (sorry I don't have the exact numbers), and they are completely in normal range now. The lipid lowering benefits of Met have been reported in numerous studies, and it makes much more sense to me to take Met INSTEAD of Lipitor, along with diet and exercise, to improve your cholesterol, and only resort to Lipitor down the road if there is no improvement. Here is a blurb from an article (and a link to the whole article) that you might want to take to your doc (I am appalled that she is not concerned about your borderline diabetes, especially since insulin-resistance and hyperglycemia go hand-in-hand with elevated cholesterol; have you had a Glucose Tolerance Test? You may be spiking high after meals, in diabetic range, which wouldn't necessarily show on an HBA1C or a fasting glucose test.):

Many helpful side benefits

Metformin's multiple effects benefit individuals with a propensity to develop diabetes, cardiovascular problems, endocrine problems, retinopathies, nephropathies, cancer or decreased immunity, infections and weigh gain.(1-5,8)

As with diabetes, metformin has been shown to cause a reduction in appetite, weight, and the body's total fat content. In associated heart disease conditions, there is plaque build-up that lines the arteries. This build-up of plaque can lead to atherosclerosis.(8) Metformin reduces or lowers the chances of developing atherosclerosis and reduces the rate of pro-aging cross linkages of collagen, which plays a role in the scar tissue build-up that cccurs during wound healing.(4)

Metformin has been shown to reduce the amount of supplemental insulin needed by type II diabetics who become insulin-dependent. They are able to take a lower insulin dose in conjunction with metformin without the risk of becoming hypoglycemic. For 40 years metformin has been used to control blood glucose levels in patients with type II diabetes. Physicians are recommending it to patients who are predisposed to diabetes for the prevention of developing the disease.(8)


Metformin prevents the acceleration of atherosclerosis and reduces the rate of pro-aging cross linking of collagen.

With the cluster of cardiovascular problems associated with hyperinsulinemia, metformin has proven effective in lowering total cholesterol, low density lipids, free fatty acids, tissue plasminogen activator antigen and insulin levels when patients present with symptoms of hypertension dyslipidemia, visceral obesity or hyperglycemia. Metformin prevents the acceleration of atherosclerosis and reduces the rate of pro-aging cross linking of collagen. The microvascular complications of hyperinsulinemia are improved by metformin due to the arterial clearance in small blood vessels of the eyes, kidneys and nerves.

There are other positive effects associated with metformin: decreased tumor growth and improved cellular immunity in individuals who are prone to chronic infections associated high blood sugar levels. In non diabetics, metformin reduced low density lipid, total cholesterol, free fatty acids, tissue plasminogen activator antigen, blood pressure and fasting triglyceride levels.(1-5,8)

Women suffering from polycystic ovary syndrome have been treated with metformin. Benefits include: lipid lowering effects, reduction in systolic blood pressure, hyperinsulinemia and insulin resistance syndrome. Metformin has also been shown to aid in normal menstrual regulation and pregnancy.(10,11)

http://216.239.51.104/search?q=cache...hl=en&start=14

If you can't convince this doc, I suggest you find an endo; this pcp sounds downright ignorant about metabolic syndrome in general, and PCOS in particular. Good luck!

Linda

[Storm8]

It went really really well!!!!

Thank you both so much for your support. And my goodness! Nobimbo, you certainly are NOT a bimbo! LOL Very informative! I wish I had that before I went in! However, I think she really had no choice but to cave in and give me the damned prescription! When she first walked through, i took it real easy. I didn;t want to overwhelm her all at once. I first showed her the nightmarish pics from my hysterctomy!!! She saw these oversized red veined angry ovaries. So gruesome they looked like they were gonna get ya in your sleep, gruesome! then...when i took out the REAMS of articles written by good sources, her eyes about bulged out of her head. I downplayed it of course because i know how some docs get defensive when you start doing the self-diagnosis thing...These articles were written by Docs and Specialists, (I had all the pertinent points in highlighter), she knew she had better listen and read before making any crazy decisions. She actually started to tell me that she hated the idea of putting me on any more pills. She is a very natural doc, and i DO like that about her...I am not crazy about taking pills. I am really not. I have trouble swallowing anything larger than a pea! But before she could finish her speal, I cut her off in desperation. And after reading some really good articles and me explaining to her that I was not trying to use this as a diet pill. I was just trying to get into the same playing field as other "normal" women who do not have the insulin problems we do. I had gained weight at an alarming rate with no change of diet or lifestyle. I had gained 25 lbs in 2 years...I am an apple shape. I hate it. So I felt that this is my last hope to have a real chance at doing something about it.

Well....:o She put me on exactly what I wanted. The metformin er...remember my earlier comment about not able to swallow pills? especially larger than a pea? And what do you thing extended release means? I did not use my brain and think this through properly at all! They are the size of HORSE PILLS!!!! How in the world am i supposed to get those down my neck????? This is killing me...

I have not been able to take one tonight after dinner as i had originally hoped...I will look up to see if I can take a poill in the morning and another at night. cause this is just too big...

Thank you so much for listening ! And your support is wonderful! I love this site. I would be totally lost without it AND more importantly, I would still be suffering unnecessarily in silence.

I forgot to mention, my Trigycerides were 460 and my hdl was 46. My ldl was unreadable due to tri's being so high. My sugar after the 12 hour fast was 117. the night before, I had grilled chicken and salad! i did not even have a starch or high carb. i told her this too. believe you me!

[nobimbo]

Congrats on your successful doc visit! Good job!!!

Sorry about how big the pills are. You cannot cut them, however (like you can with the regular Met) because that would mess up the time-release action. Here are some tips for swallowing pills:

Put liquid into your mouth and slip medication through pursed lips. Swallow entire contents at once.

Use a straw. Put the pill on your tongue. Then using a straw, suck down three big gulps of water (or whatever). With a straw there is no pill floating around in your mouth like there is if you just try to swallow a pill with a big mouthful of water.

Take a big scoop of jello and put it into your mouth along with the pill.

And some more:

Practice foods Swallow mini candies, or small bites of food, without chewing to simulate pill taking.
Embed a tablet in food and consume both together. IMPORTANT: Some prescription drugs are affected by certain foods, so check with your health care provider before trying this one.
Helpful liquids Sip a cold, carbonated beverage (sparkling water, lemon-lime soda) straight from the bottle when swallowing a pill.
Spray or gargle with an over-the-counter topical anesthetic (normally used for sore throats) before swallowing.
Different techniques Take a deep breath before putting the tablet in your mouth; some say that this can suppress gag reflexes.
Place the pill on the back of your tongue, drink some water, tilt your chin down toward your chest, and swallow.
Put the pill on the tip of your tongue, drink some water, tilt your head back, and swallow.

Combining some of the above ideas could yield a remedy for you, but if none of them help, it's time to consider some larger issues.

The fact is your throat is one part of your body, so it operates as part of a complex system. If you're tense about pill swallowing, that tension will most certainly surface when you try to swallow a pill. While it may seem as if you have an extraordinarily strong gag reflex or odd throat mannerisms, consider that it may actually be the power of your mind, not the power of your throat. Try to psych yourself out with this pill swallowing mantra — "I can swallow this." "I can see the pill going down."

Or, perhaps not being able to swallow tablets has something to do with a past event? Did you choke on a peach pit many years ago? Has a school nurse with dirty hands forced you to take a pill? Subconsciously, you may be dealing with issues such as these every time you try to swallow an aspirin or vitamin. Fear of choking, fear of medicine, or general anxiety may be preventing you from swallowing pills. If you think these mental factors are to blame, you might consider talking with a counselor.

While it seems unlikely, the possibility of a greater medical issue does exist. The medical term for difficulty swallowing is dysphagia, and the term is often used with regard to a disorder of the esophagus. At your next check-up, talk with your provider about your difficulty swallowing pills. Keep in mind, though, that if you can swallow your food without trouble, your esophagus is probably fine.

http://www.goaskalice.columbia.edu/1985.html

There is a liquid form of Met out now called Riomet, but I don't think it's extended release. Maybe ask your doc to switch you to that next time?

Linda

[Storm8]

Hey, I just thought od something. I think this may be a deeply imbedded thing in my subconscious mind. I chew all my food until it is mushy (sorry) no big bits get down my throat whatsoever. family and friends alike comment on how very thorough an eater i am and i eat slow and carefully. always have! I think it all started back when i was 2. I myself do not remember this incident but my mom has told me and others when i was older. When i was 2 i choked on some hard rock xmas candy, the kind that has ribbon shapes and stars etc. ever seen it? I started choking when it got lodged in my throat and my father was tipping me ipside down to dislodge it and my mom and dad were both panicking cause i turned blue and they went out front with me and started pounding on their neigbor's door, (he was a nurse i think) and he did the ole heimlich manouever and was able to dislodge the candy.

Now get this. I had never heard that story until i was 12. When I was 12, i had swallowed a hard candy. it was a jolly rancher. it was LARGE. I felt that thing every millimeter as it slowly slid and moved through my throat etc. I even felt it as it moved into my chest. It seemed to take hours for that thing to dissolve. the pain was pretty intense.

Nobimbo, it had never occurred to me that this could actually be a real fear/phobia until you pointed it out. i know i sound a bit like a bimbo myself, :-) but i just never thought to put 2 and 2 together befoe. but after you made me think about it from all angles, it makes pefect sense now. this whole thing is a real pain in the butt! I wish i could just put it out of my sub conscious mind and get on with it!

i am going to try your techniques above and will let you know which works best! Iwill not give up. I will also not beat a dead horse either! If the tiem release really isn't going down then i will admit defeat and go for the twice a day regular met.

THANK YOU so much! Say hello to the Cardinals for me! Best team on the planet! I hope the Rams do better this year for ya....

[Storm8]

I have managed to successfully take the pills...but i cheated. I called the Doc's office and told them that I had tried all weekend to get those suckers to go down but to no avail. So now I am on the regular metformin 500mg. Just one a day. I took it after dinner lastnight. Is it just me or does this dose seem really small? I have been reading about others out there taking at least 1500 to 2000mg a day. Will i not see a difference with 500mg?

[nobimbo]

You need to start off with a small dose so your body gets used to it and to limit the side effects. Your doc should have given you a schedule for taking it (something like 500 mg for 1-2 weeks, then 1000 mg for 1-2 weeks, then 1500 mg, which is considered the minimum effective dose).

Linda