Spiro instead of Met?

amused37 · 05-22-2003, 02:06 PM

Hello all,

This is my first post here, though I've been visiting the forums for the last year on and off, after self-diagnosing.

I'm sure we've all dealt with our fair share of ignorant doctors . . . Well, it took me a year and a half to find one who would actually confirm that I do have PCOS, because, shock of shocks - I am not Insulin Resistant.

The problem, however, is that I am morbidly obese (near 300 lbs.), and I cannot lose weight. I've tried walking, low carbing, any and all fad diets, fasting . . . and still, I continue to gain about a pound a month. But if I'm not IR, why is this happening? (And no, i don't have any thyroid problems.)

I finally managed to wrangle an appointment with an endo last month, and she ordered some insulin tests, saying that even if it was marginally abnormal, she would put me on Metformin right away. If that doesn't work, she said, she would suggest considering GASTRIC BYPASS as an alternative.

Needless to say this saddened me quite a lot, but I was hopeful that the Met would work, despite not being IR.

Well, she called this past weekend and said that my insulin results were fine and that she was putting me on Spiro. I do have thinning hair, acne, and hirsutism, so the Spiro is probably a good idea . . . but will it do anything to help my weight?

Is there any way I can get on Met without being IR? Will it help?

Also, my blood pressure is fine, but I do have very high triglycerides . . . so could that be symptomatic of IR without showing up in my insulin and glucose levels?

If this post is in the wrong forum, please do let me know. And thank you to anybody who can help.

christyz · 05-22-2003, 02:53 PM

I would try to find a Dr to put you on Met, and here is why. IR is directly related to weight. No matter what the labs say, the heavier you are, the more the cells close to insulin. The fat causes a hormone to close the doors of the cells so they don't process sugar properly. So it is this nasty vicious circle.

My labs showed that my fasting glucose was on the high end of normal, but my Dr suspected PCOS since I had a high free androgen. After 21 mos on met and the IR diet, I'm down 40 pounds..which doesn't sound like much, but that is 22% of my body weight! Once you start losing weight (which is near to impossible if your Insulin is even a little out of whack) the more effectively your body processes sugar with insulin and the easier it becomes to lose weight.

So even so called "normal" ranges can be high for you. I would inquire about a 6 month trial of met under your Dr's supervision if he'll allow it. It's just my humble opinion, but i think it is a little irresponsible to reccommend life threatening surgery before even trying a well-studied and relatively safe drug like metformin.

If you want to read some fabulous stuff on IR and how to determine the syptoms (good ammo for your Dr), read this link to a book on Amazon. You can read the fist two chapters and it has enlighted me on how IR and to determine if you are, no matter what the labs say.

http://www.amazon.com/exec/obidos/tg...er#reader-link

Spiro is fine, but be aware that it will wreak havoc with your cycles. It is a dieretic, so drink lots of water with it. I went off spiro because I had set a primary goal of treatment of normal hormones and cycling on my own. And this seemed to defeat that purpose for me. I'm content to shave for the time being.

All the best!

amused37 · 05-22-2003, 06:02 PM

Thank you . . .

Yes, I thought it was rather odd that she would suggest surgery on the first appointment . . . but I am hoping it was just her way of giving me all the options, as she hasn't mentioned it since.

I didn't question not being IR after I tried low-carbing for six weeks last year . . . and ended up gaining 10 pounds. Can somebody still be IR and not succeed in losing weight with low-carb?

My next appointment with my endo is in July, so I will ask to see my results from the insulin test and tell her I'd like to try the metformin anyway . . . I don't mind being closely monitored, I just want as much help as I can get losing the weight.

I'm only 23, it shouldn't be this hard to lead a semi-normal life.

christyz · 05-22-2003, 06:29 PM

Quote:

I didn't question not being IR after I tried low-carbing for six weeks last year . . . and ended up gaining 10 pounds. Can somebody still be IR and not succeed in losing weight with low-carb?

YES!! If you do some reading on the topic, you'll find that there is a reason for this. Insulin is a hormone secreted by the pancreas that processes sugars, carries them to the cells and stores the left overs as fat. Women that are resistant to insulin, their bodies crank out way too much insulin, and since the body doesn't use it all, it is forced to store it all as fat! you can work out and diet until the cows come home, but until you take an insulin inhibitor like Met, your body will be cranking out way too much insulin and storing the excess as fat.

That's why dangerous surgery should be a LAST RESORT.

All the best!

amused37 · 05-22-2003, 06:36 PM

An OB/GYN once said something similar to me . . . but ended it with "you could eat salads and walk five miles a day for the rest of your life and still never lose weight, so you might as well get used to being heavy."

Ha!

Needless to say, I do not see him anymore.

Thanks for straightening me out!

I do have another question, however -- sorry if I am being bothersome. You said that spiro can mess with my cycles . . . is that true even though I'm on birth control to regulate them?

christyz · 05-22-2003, 06:57 PM

You aren't being bothersome at all! But you shouldn't have opened that "bcp" can of worms with me...lol

No, you won't be messing with your cycles on Spiro and the pill, because you aren't cycling on the pill..at least not on your own. The pill synthetically surges your hormones so you will menstruate and not ovulate. I am not big advocate of the pill, because it masks the symptoms (wacky hormones). As soon as you go off (providing you ever want to become pregnant) you will be back to wacked out hormones again. And studies show the pill makes IR worse.

I quote Dr Walt Stoll a lot on this subject. He says ""For the first 10 years of my practice covering the tip of the iceberg with a blanket (BC pills) was the best I knew (for treating PCOS) too....Eventually, the iceberg is going to rise up and your blanket (BC pills) will stop covering that tip. Then, your docs will suggest your increasing the dose--making the "blanket" bigger. Eventually, that dose will stop working and you will have to increase that dose too. The day will soon come when the BC pills will no longer be an answer at all. THEN, you will HAVE TO deal with the actual iceberg (the causes behind this condition). "

Metformin actually treats the *cause* of the hair trouble, the wacky periods and the weight...insulin resistance. So that's my thoughts on the pill.

Don't hesitate to post more questions...I am a metformin and PCOS reading junkie and am happy to answer whatever questions you have.

Angie02 · 05-23-2003, 05:38 PM

FYI, I have to say that I am convinced that my irregular bleeding while I was on the pill was due to an increase in the spiro I was taking. I recently discontinued this med after a miserable month of unexplained bleeding out of the blue. But then again, I am extremely sensistive to this medication, and seemed to have developed an allergy. I agree with Christy--met is a better option. I took spiro and bcp for years and never had the results I have had from the glucophage. My hair loss and bad skin didn't stop with the spiro. Also, you have to take a high dose of spiro for quite some time to get the testosterone-lowering affect. I am not completely convinced that this is safe for all people to do (I had problems with dehydration). The worst thing that the glucophage will do is upset your tummy.

If your gyn won't help you, go back to your gp and ask for a trial of glucophage. I found that my pcp is not a huge fan of spiro and he preferred to have me on glucophage.