|
Re: maybe Dr. Sam can help - On Glucophage and weight loss (very long reply to Muriel)
From: Dona (anonymous@obgyn.net)
Wed, 7 Nov 2001 11:31:09 -0600 (CST)
Thank You Suzie!
You explained that so beautifully!I have read many of those abstracts
you are talking about,unfortunately I have a hard time saying things in
my own words in writing.You said everything I have been thinking since
all these posts started!
I am Dyslexic and sometimes it's hard for me to relate things in
writing.I do much better verbally one to one.=)
Thanks again,Dona
>At Wed, 7 Nov 2001, SusieQ wrote:
>Hello Muriel,
>
>I realize now that your problem isn't really with us. It's with your
>husband. His attitude is will certainly destroy any emotional or
>medical advances you make. An unsupportive partner, much less one who
>doesn't believe in pcos, will kill anyone's enthusiasm. I hope the two
>of you find some serious marital counseling before you get pregnant.
>Pregnancy will not reverse or cure his poor attitude. You sound very
>young. While it is very altruistic of you to be a philosopher, we are
>your best source for medical information. Even local doctors are not as
>knowledgeable about pcos, as many of the ladies on this board are. We
>appreciate each and every post from Dr. Sam, because his education and
>knowledge far exceeds many of the answers we find in our own docs
>office.
>
>Your doctor, inappropriately, prescribed met for weight loss. That is
>an irresponsible and unsubstantiated reason for prescribing met. Most
>studies show that some women lose on met, but the majority do not. JAMA
>and NEJM both have abstracts available for your use online that show
>this. Why does it not cause weight loss? Because it does not directly
>effect blood sugar levels. Metformin is used to increase sensitivity to
>blood glucose in the liver and muscles. It does not work in the
>pancreas (which puts out the excess insulin). Metformin will not lower
>the free-flowing glucose/insulin in the blood. Metformin is designed to
>enhance insulin sensitivity, it does not directly affect the pancreas,
>and it's insulin action.
>
>Some women respond to metformin quickly...when the liver processes
>insulin more efficiently, it reduces the signal to the pancreas to
>create more insulin. Thus, hopefully, reducing the free flowing insulin
>in the body. While this seems like it should then reduce weight, it is
>only a side effect for under 33% of pcos sufferers. See NEJM for these
>statistics.
>
>The excess insulin in our system throws off more than just the pancreas
>or liver function. Obviously the ovaries are affected, but so can the
>pituitary and adrenal glands. The entire endocrine system is connected
>together, and all those glands are affected by the excess
>insulin/insulin sensitivity. This is the reason many women do not lose
>weight on metformin. Other glands, like the adrenals or pituitary, can
>still be malfunctioning. Excess estrogen and testosterone are also
>common factors, which can exacerbate weight gain. There are unlimited
>numbers of acids and lipids in the body that may be affected by the
>insulin problems.
>
>So, why take met? Increased insulin sensitivity can reverse many of the
>affects of pcos, but not all of them. Some women don't ovulate on met,
>others do. Met has worked wonders for me. But I have not lost one
>pound, despite strict diet and exercise. My theory about the weight
>problem, is that time is of the essence. I suffered for 20 years with
>no dx, while the excess insulin and IR ravaged my body and disturbed all
>those delicate balances our endocrine system tries to maintain. Those
>of us who have been undx'd for a longer period of time, seem to have
>more trouble reversing the problems of pcos...our endocrine systems are
>just going to need more time to repair.
>
>I take met to feel better - I have more energy, clearer skin, fewer
>migraines, and a better overall quality of life. I am also trying to
>prevent diabetes later in life. While weight loss would benefit all
>those things, my body just won't let loose of those extra pounds. And,
>unfortunately, there are many thin diabetics and pcos cysters too.
>
>I am glad you are being proactive, we need as many women as possible to
>get the word out. But you are missing a big piece of the picture. The
>entire endocrine system must be addressed if we are to successfully
>treat all the symptoms of pcos. So, what comes first the excess insulin
>or the IR? That's like asking the chicken/egg question...the docs are
>working on it. Fight for PCOS research all you like, but please don't
>fight with us.
>
>I hope you find what you're looking for, SusieQ
>
>>Hello Kimberly and anyone else who wants to chew my ass for asking
>>questions. I will respond to Kimberlys post, given she sumed up everyones
>>complaints with me very well.
|
|
![[ PCOS Discussion Forums ]](../../images/pcos_at_obgyn.gif)