(Closed) Metformin but normal blood sugar?

posted 5 years ago in TTC
Post # 2
Member
59 posts
Worker bee
  • Wedding: June 2016

you probably have PCOS and metformin is the most common prescription for it! That’s what I got prescribed! PCOS is polycystic ovary disease, and it commonly causes irregular cycles (i usually have one every 6 months, and the one I’m on now has lasted 3 weeks now.) and difficult conceiving. It has other symptoms such as issues with weight, mood swings, craving for sweets and carbs, unusual hair growth or hair loss, along with many other things. It is a very difficult disease, especially if you want a family. Please read more into it! There ate even a few websites just for cysters, where you can talk to other people with PCOS! Metformin will help balance out your hormones! It typically detected by your levels of progesterone in your blood. I do want to warn you though, you want to eat extremely healthy while on metformin. Definitely no out to eat fast foods! Grease and other unhealthy foods will cause you to have pretty bad diarrhea. Pick up sone anti-diarrhea medicine before you decide to start takone the metformin as this is an extremely common side effect! I hope this helped! If you are trying to conceive, google natural remedies for PCOS and you will find a whole bunch of natural things you can take with your metformin to help! A lot of people have great success with metformin if they can get past the side effects! It will also help you to lose weight if you need to!

Post # 3
Member
1382 posts
Bumble bee
  • Wedding: September 2014

So metformin is recommended for PCOS if you are TTC even if your fasting glucose insulin ratio (insulin resistance test) is normal. It does increase cycle regularity and ovulation rates in PCOS women who are not measurably insulin resistant. But they suspect the reason it helps is because we non-IR PCOS women still have metabolic and hormonal irregularities on a more subtle level, and more pronounced in the follicular fluid than in the blood. So if you don’t have PCOS, metformin won’t help your cycles.

PCOS is the most common cause of long cycles but not the only cause. If your blood work and ultrasound were not indicative of PCOS, I would personally want to consult a reproductive endocrinologist for a thorough diagnosis. 

I’m curious what blood tests your doc did? Did you get AMH? TSH? Day 3/Day 21 tests? Testosterone and DHEA? There are “hard” signs of PCOS but also “soft” signs that don’t make a diagnosis but give more clues. 

Post # 4
Member
467 posts
Helper bee
  • Wedding: January 2016

Metformin works to reduce your blood glucose levels which in turn reduces your insulin levels. This is good if you have PCOS because insulin can exascerbate PCOS by raising the level of a hormone called LH in your body, and also by raising the level of active sex steroids in your body (by inactivating a hormone called SHBG). 

Many of the symptoms of PCOS are related to high LH levels and high levels of active sex steroids, therefore you want to keep your insulin levels down.

You should ask your doctor to explain to you more in depth why she/he is reccommending this treatment. Good luck. 

  • This reply was modified 4 years, 10 months ago by  lamington.
Post # 6
Member
807 posts
Busy bee

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Mrs.Dew:  I have PCOS and have normal blood sugars as well. I was on BC for years, and randomly stopped having my period even on BC. They added in Metformin (started at 500mg 1x day, eventually increased to 2000mg/day when we were TTC), and my periods came back! After I got off BC to start to TTC, I stayed on Metformin. I ovulated on my own, but pretty late (CD 25 to CD 40). I was about to start Femara+trigger (after a MC), when I ended up getting pregnant on my own.

I was diagnosed with PCOS based on blood work, ultrasound, and other signs (severe acne, excess hair). I however am normal BMI (20-21 pre-pregnancy). Luckily Metformin is pretty safe, and I was advised to stay on it until I entered my second trimester.

Post # 7
Member
525 posts
Busy bee
  • Wedding: October 2014

If you want to be extra cautious, you can also consider asking them to rule out Cushings, a differential for PCOS with similar symptoms (often involves 24-hour urine collection and dexamethasone suppression test).A reproductive   endocrinologist is really best equipped IMO, as PPs have mentioned. Good luck!

Post # 8
Member
525 posts
Busy bee
  • Wedding: October 2014

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ADiamondInTheRough:Hey I don’t want to hijack the thread but just curious when exactly your OB took you off the Met and did you wean slowly? Mine is recommending I start ramping down at 13+3, be off completely by 14, immediately followed by an early glucose tolerance test to decide next step. This seems pretty standard but I need to research it a bit…

Post # 9
Member
660 posts
Busy bee

i was diagnosed with PCOS about 5 years ago and was given 1000mg metformin a day. basically i went on BC when i was 16 because my period would last weeks! it was awful. also have lovely hair growth (sally hansen wax strips + me= best buds), and a really hard time losing weight. when diagnosed i was overweight by 15/20lbs. insulin and blood sugar have always been good.

i was put on the depo shot after years of pill birth control after diagnosed with high blood pressure at 26ish. i’m 29 now, have been off depo (it was horrible) and birth control free for 2 years and FINALLY have a normal, almost trackable cycle. i average 25-31 day cycles. i also work out regularly and try to maintain a healthy diet. i’ve lost almost 20lbs in the past 2 years so while it’s been slow and steady, it actually helped with my period (and i’m off blood pressure meds!). if i stress (or eat too much sugar) the week or so before i’m expected to get a period, it’s late. it’s crazy how much diet can effect your body!

i’ve kept on the metformin and when we TTC this summer, my obgyn will have me on it through the 1st trimester.i did notice a few months ago with some additional weight loss, when i take it it makes me a little lightheaded, even if i take it with food. wondering if my blood sugar gets low or something. my doc told me i can do an every other day 500mg dose instead.

PCOS sucks. like, really sucks. but it’s manageable!

Post # 10
Member
217 posts
Helper bee
  • Wedding: March 2015

I don’t have much experience taking metformin since I only just started about a month ago. DH and I have been TTC for a year now with no luck. I first went to my GYN who wanted to start me on progesterone to induce withdrawal bleeds and then clomid to force ovulation. I asked about metformin because I had read up on how it’s supposed to help with everything mentioned above, weightloss (I’ve always suffered from obesity and lost 85lbs about 4 years ago but then when I met DH I gained 15lbs back and can’t seem to shake it) and help regulate your cycle. However, he said metformin could take up to 6 months to kick in and work. Since my main goal was to get pregnant ASAP we did the progesterone/clomid route first. We did this for about 4-5 months with only 1 successful ovulation, but it didn’t stick and I got my period. This was back in the summer. Then after seeing an RE, an acupuncturist and an endocringologist, I was finally put on metformin 500mg 1x a day (what I wanted to be on from the start!!!) even though all my test results came back fine. I had a glucose intolerance test done, I had a full work up for my thyroid done. Everything came back fine, but my endocrinologist put me on the meds and after a MONTH of being on it I got my period after a year of not having my period on my own. I’m in the middle of my cycle right now and have been trying to track ovulation with temp charting, but that’s not working because my temps are psychotic and all over the place. I’ve been doing OPKs to try and detect any surge but so far I haven’t had an obvious positive OPK. 

I know this probably isn’t much help since I don’t have any definite “oh yeah it’s definitely helped/oh no it hasn’t” but I’ve read a lot of back and forth on whether metformin works. I think it really just depends on your body and your situation. There are so many women who have said it works and they got pregnant on their 1-3rd try of TTC after being on metformin. I’ve also read of women who say they didn’t respond to the drug at all. PCOS is seriously an extremely frustrating diagnosis to deal with in terms of TTC because there is no standard, no set X + Y= Z.

 

  • This reply was modified 4 years, 10 months ago by  KatEmmaMarie.
Post # 11
Member
512 posts
Busy bee
  • Wedding: October 2014

I have PCOS and am on 1500mg metformin/day. Clomid worked for me first cycle (it made me ovulate), but then nothing. So I’m onto injections, still with the Metformin. Last cycle I was able to ovulate on my own again (no trigger shot required), we’ll see what happens this cycle! I think I’ll ovulate again myself 🙂 (although it’s not really myself since its meds lol but I digress…) 

Can’t really say whether it’s working or not yet but it can’t hurt! Good luck.

Post # 12
Member
807 posts
Busy bee

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rjay:  I met with two OB’s (was switching clinics) who basically said the same thing to me. My Metformin was to help me ovulate, thus once pregnant, being on Metformin was not necessary (as my insulin levels were normal prior to going on to Met, there was no real medical reason for me to stay on it). They presented research saying that it may help reduce MC risk in women with PCOS (which I also found), but also noted there was some research that mentioned there was no change in MC risk with staying on Metformin vs coming off Metformin during pregnancy. Ultimately they said it was my choice, and it if made me feel better to wait till 2nd trimester, they had no problem with it. I decided I didn’t want to make any drastic changes during the early stages of pregnancy, as whatever I was on wasn’t causing any issues. I went from 2000mg, down to 1500mg around 6 weeks since the 2000 was killing my stomach, and stayed on the 1500 until my 13th week. They mentioned I could either stop taking it all together, or titrate myself down if I was more comfortable with that. I think I just stopped all together at 13 weeks.

Post # 13
Member
1001 posts
Bumble bee

I was on Metformin for several years in my teens, due to PCOS.  I titrated up to 2000mg/day by the end of the first year.  It never did help with my PCOS symptoms, but I did have to closely monitor my blood glucose.  Something to keep in mind if you’re on high doses of Metformin and you’re not diabetic – you should be monitoring your blood sugar, because the Metformin can throw it out of whack.

Post # 14
Member
660 posts
Busy bee

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Polyphemus:  thanks for the suggestion – i noticed that sometimes i feel a little loopy/lightheaded after taking it and have normal blood sugar levels. maybe the med is making it too low. will check in with my dr!

Post # 15
Member
1382 posts
Bumble bee
  • Wedding: September 2014

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Mrs.Dew:  So as long as you were in the follicular phase, LH:FSH doesn’t have to be cd3 for PCOS testing, it’s just short hand for those tests. That’s considered a “soft sign,” but only because in obese women, LH gets modulated down, not because of false positives. You do sound like you fit the official diagnostic criteria. Because with long, irregular cycles and over-expression of androgens (hirstutism) you don’t need the polycystic looking ovaries. Just 2/3. I have polycystic ovaries and long cycles but not the androgens, so with 2/3 I have PCOS. But about a quarter of normal women have polycystic-looking ovaries (PCOM) and not all PCOS women have that. So hirstutism can be tricky because of ethnic variations in what’s normal, but because hormones are weird, they can be in the normal (usually upper-normal) range on a blood test and still cause issues. Especially because these phenomena can be much more intense on your ovaries where they are being made, but surgery to sample that is not at all worth it & never done except in experiments.

From your first post it sounded like your doc made the diagnosis with only long cycles and I assumed normal LH:FSH since you said your labs were normal. With the high LH and the hirstutism, it sounds like a good diagnosis. Often PCOS diagnoses are not clear cut.  If you want to be more sure, you can ask for two things if you haven’t had them yet: AMH and TSH. TSH will check for  hypothyroidism which can also cause long irregular cycles. AMH is a hormone that is made in the little preantral follicles on the ovaries which are too small to see on ultrasound. People with PCOS have high AMH, though it can still technically be in the normal range. Normal range is up to 5 or 6, but my RE said he doesn’t usually see women above a 4 unless they are under 20. It naturally decreases with age as you use your eggs. So a 30 year old woman at the top of the normal range would still be suspected of PCOS because the top of the normal range is there to include normal for teenagers. Mine was an 8.5 at 30 years old. Severe cases of PCOS can be like 15 or more. AMH is a fairly new and specialized test so it will probably need to be sent away to a special lab. My RE thinks it will soon become an official diagnostic criterium for PCOS but it was too new at the last meeting where they decided the criteria so it wasn’t included. 

Now, as for metformin when you don’t show signs of insulin resistance on your blood test. My RE told me that though my glucose:insulin ratio looked great, I would probably show mild insulin resistance if they did the intensive test where they pump glucose into one arm and insulin into the other. It’s not the safest test and intensive so they don’t do it for PCOS except for in experiments. The glucose:insulin ratio is good for showing if you are IR in a way that is affecting you systemically. But, as I said before, these things are magnified on the ovarian level where the hormones are interacting and being made, and where it matters most for ovulation. That’s why they think metformin works even for non-IR PCOS women. I was faced with the same choice to take metformin without being IR. My parents are doctors, my husband is a med student, so we read through the studies and found that they pretty unanimously supported taking metformin. If you like to read studies yourself I can share links. Clomid made me ovulate, but my lining wasn’t great with it so it didn’t work for me. So I’m now gearing up for a cycle of injectable gonadotropins and IUI. 

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