seeking advice, long indeed, reply to belle and cate
From: paula (anonymous@obgyn.net)
Thu, 6 Jul 2000 08:46:13 -0500 (CDT)
Belle, i do not take this as a personal insult. i have just been tod
through my own reserarch, but mainly from everydoctor that i have been
to that
1) for women who are obese (like myself) cysts are harder to confirm
without a vaginal ultrasound. while they do not HAVE to be present for
the confirmation of pcos, i was mearly suggesting this was an option if
indeed cate had not had one. i know this to be true because, in a 1
week span, i had a "normal" ultrasound (looking through the tummy
through a full bladder) which showed absoulty no cysts on my ovaries,
and within 6 days later had a vaginal which showed ovaries covered with
cysts. i do not believe the amount of cysts that were on my ovaries the
second time could have formed in that amount of time and asked my doc.
he informed me that while some could have the sheer amount of them would
have cause pain had that happened. i trust him immensily and had had no
pain.
i stand firm by the belief that the igtt is a necessary test, but i also
so not think it should be the first. it is a long, expensive, time
consuming and taxing test that in some women like myself could be
avoided by a simple fasting insulin. i do however realize that some drs
are lothe to perform the igtt after a fasting insulin comes back as
"normal" so do see your point. i just do not let my doctors push me
around. i get the tests i ask for.
i have neither spoken to anyone or heard of anyone (though i believe
you) who has not suffered some digestive problems being on
glucophage/met. i am sure they exist, mainly wanted cate to know there
are side effects, which go away and then you begin to feel better. i am
much more regulated on the glucophage.
finally as to the renal problems associated with kidney function. i
only have this to say. i have been to a diabetic nutritionist, i have
been to a R.E. i have been to a gastronilogist, i have been to many
many many doctors thst have informed me that indeed when you reduce your
amount of carbs below a certain level you will induce ketosis in your
kindey (which for a short time will cause little damage) but long term
will lead to kidney problems. If this were not enough for me, my
grandfather had cronic renal failure, which eventually, which all of his
doctors attributed to his lack of carb intake.
i am not trying to preach a certain level of carbs everyone should be
on, i am simply stating that reducing carbs taxes your kidneys, taking
met/glucophage taxes your kindeys. now me personally i value my
kidneys, i am not going to lower my carbs below a certain point without
the supervision and wisdom of a doctor.that is exactly what i a
recommending for all of you. that if you are doing this on your own, i
would stay around 30% carbs, if you want to go lower, please consult
your doctor.
i do not take others advice as a personal insult. i always research any
and all information i post here, and i do not take advice unless i find
another source to back that advice up. i expect others to do the same
with anything i post.
i believe i gave honest accurate advice to cate, and i wish someone
would have posted the same thing for me when istarted this journey. i
am not willing to go on the hopes that since there has been no reaserch
to prove there are kidney problems resulting from the lack of carbs, i
would rather error on the side of saftey and protect what organs of mine
that i can protect.
love, paula
At Wed, 5 Jul 2000, Belle wrote:
>
>*Cate* Paula has written a response to you that I would like to comment
>on. She is basically correct but I think that it could confuse you
>further.
>
>*Paula*, I would have e-mailed you privately about this but we are not
>supposed to do that so I hope you do not take this to be a personal
>insult. I am just trying to clarify some things.
>
>*Many* women with POCS have insulin resistance (IR), sosme drs think
>that all women would have insulin problems show up if the tests were
>sensitive enough, but as it stands, this is neither proven or proveable.
>
>The primary test that you should ask for is the Gllucose Tolerance Test
>with insulin levels. This test will include the fasting levels as well
>as give you an indication of how your body uses glucose and insulin in
>response to a glucose infusion. Time after time, we have seen on here
>how someone has asked for the fasting insulin and glucose and when it
>returned normal, the dr did not feel that any further testing was
>necessary. That is because many of the drs have dealt with diabetics
>before and a fasting level will usually tell if a problem is necessary.
>IR is a different way of thinking. If you are able to ask for specific
>tests, ask for the right one the first time so that you will not have
>difficulties the next time you go. The 2 hour test should be
>sufficient. I have *never* seen anyone (that I can recall) who did not
>show a problem by the 2nd hour. The 4th and 5th hours are to determine
>hypoglycemia and not IR anyhow. They are almost totally phased out
>because of the danger to the client. The insulin is the hormone that
>enables you to use the glucose (or sugars) in your food.
>
>Ovarian cysts are not necessary for you to have PCOS. The name was
>determined before this was discovered. You do not need to undergo an
>invasive vaginal ultrasound. The dr should be able to diagnose you with
>PCOS (if this is the correct diagnosis for you) by the blood work in
>conjunction with physical apperance (according to the New England
>Journal of Medicine).
>
>If you are IR, your dr *could* put you on metformin(Glucophage). This
>is not the medical standard yet and it has not been approved for the use
>in women with PCOS. It is actually a diabetic medication that enables
>our bodies to use the insulin more efficiently. Many of us here are on
>metformin and many of us have seen great improvement in our conditions.
>It can cause some abdominal distress but not everyone suffers from it
>and it is a temporary condition.
>
>A low-carb diet does seem to be best for us. I would not worry about
>reducing your carb intake. You do need some but there is no certain
>level at which you should be concerned. There is no research to my
>knowledge that indicates that protein of any kind will affect your
>kidneys. There is research to indicate that when the kidneys of
>vegetarians and those who eat meat were studied, there have been *no*
>difference in the true "age" of the kidneys, meaning that the kidneys
>were no more damaged in one lifestyle over the other. There have been
>dietitians who have come out to say that you should not have a low-carb
>diet but usually these people use one "fits-all" diet for everyone.
>These people are not drs and have been instructed to follow the FDA
>guidelines for diet. This is not scientific, traditional, but not
>scientific. The Adkin's diet has been used for over 20 years and on the
>whole, I suspect (based on case studies) that people lose weight, lower
>their cholesterol, lower their blood pressure and are healthier.
>Personally, I know that I eat too many carbs but the choice is up to
>you. You should not let a dr try to pressure you into a specific diet.
>I have worked with them for 15 years and I would bet that 75% of them
>are over weight.
>
>As far as being in the UK, we have had several women pop in to the board
>and have reported success. I wish I could tell you who they are but I
>am afraid that I cannot remember. In the states, we are probably just a
>little more pushy with the information that we have. We still have
>remarkable difficulties getting PCOS diagnosed and treated.
>
>There is an herbal PCOS board, maybe someone could tell you where it is.
>Many of us use Chromium GTF to help correct the insulin problem. Some
>women have found help with Inositol. This is the basis for the drug
>that is currently being tested for use in women with PCOS. I have not
>found help with this but others have and I would definately try it if I
>had to do it all again. If you go back through the archives, you will
>be able to see other herbal treatments that have been used.
>
>I hope that you get the help you deserve.
>
>At Wed, 5 Jul 2000, paula wrote:
>>
>>First of all dear, your weight is not the cause of pcos, it is the
>>opposite. Your pcos would be the cause of the weight gain. usually
>>women with pcos have a condition called insulin resistance. since there
>>seem to be no cysts on you ovaries, you should ask your doctor to
>>perform some blood tests. Primarily, a fasting glucuse (blood sugar)
>>and a fasting insulin (insulin is the horomone secreted by your pancreas
>>that manages how your body deals with the food you eat).
>>
>>when your body is insulin resistance, the food you eat is not processed
>>by the insulin correctly. this throws off most horomone production in
>>your body, resulting in increased testerone (the male horomone)
>>production, explaining the excess hair. and also causes the spottiness
>>on your body.
>>
>>ok i hope this was not too complicated, because i left out alot of the
>>details to make it more simple. this is not EXACTLY how it works, but
>>it sums it up a bit.
>>
>>now if the fasting insulin and glucose MAY show up normal. if this
>>happens, dont be discouraged, many women with pcos show up as normal.
>>what you show do in this event is request/demand a IGTT test (insulin
>>and glucose tolerance test). you may need to push this issue since
>>often doctors are reluctant to do it. it is a 3-5 hour test. it
>>involves you drinking a glucose liquid and then the docs moniter both
>>your insulin reaction as well as your glucose levels.
>>
>>when you have your ultrasound, was it vaginal? if you are overweight, as
>>many of us are, it can sometimes be difficult for the doctors to see
>>cysts with out a vaginal ultrasound.
>>
>>finally after all then tests, if you come back as having insulin
>>resistance, your doctor should place you on a drug called metformin
>>(also known as glucophage). usually you will start at a 500mg per day
>>level then move up by 500mg per week until you reach a level of
>>1500-2000mg per day. if you go on this expect some nausea and diherria,
>>but the side effects will go away about a week after you meet your
>>maximun dosage.
>>
>>also the best way for women with insulin resistance to lose weight is to
>>begin a low-carb diet. our opinions about which diet vary, but from my
>>research and my particular doctor's recommendation you should start with
>>a diet made up of at least 30% carbohydrates. then if that does not
>>assist your weight loss consult your doctor before lowering your carb
>>consumption.
>>
>>exercise is very important and walking 2-3 miles a day will definately
>>help to get your horomones on track.
>>
>--
>Hope this helps,
>
>Belle
>
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