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Re: cently diagnosed with PCOS... not sure which advice to take!

From: Natasha (anonymous@obgyn.net)
Thu, 22 May 2003 17:16:28 -0500 (CDT)

Celeste,

I have only been on metformin for a little more than 2 months. I have already had one blood test taken recently, and it didn't seem to improve my insulin level by much (28.5 to 25), so my doctor decided to increase the doseage from 500mg 2x day to 1000mg 2x day. That was probably a mistake, as it was giving me lots of side-effects as is. The bloating was unbelievable, and I had to run to the bathroom like every half hour. I was also stupid, and went out drinking with a friend a week and a half ago, and after that got so sick that I couldn't get out of bed for a week. I think my blood sugar level must have gone down, because I got a huge craving for sweets. Anyway, I went back to see my doctor, and she brought the dose down to 500mg 3x day. That's probably best anyway.

As far as my testosterone goes, I don't have the test results in front of me at the moment, and can't recall the exact number, but I think it's more like 18. It's strange, because I have always had a sex drive probably worse than a guy's. If that's not a sign of high testosterone, I don't know what is! I've also had severe skin problems with my face, back, chest, arms for over a decade now. A cosmetologist once looked at my face, gasped, and exclaimed, "I've never seen anything like it! There is not one clear pore on your face!" This is with me taking VERY good care of it, i.e. cleasing twice a day, using toner, cream where needed, night treatments.. So this has been just MILDLY frustrating, as you can imagine. And as of late, all this hair on my neck started growing and growing. I'm not sure if the spironolactone has anything to do with it, but the hair seems to have gotten progressively worse since I started taking it.

To answer your question about Atkins, YES! I followed the diet in the strictest sense of the word. I did read the book from cover to cover, and signed up on atkinsfriends.com. I also had a couple of friends online who went on it, and I used to go into a chatroom on that site to discuss what else I should do. If all of that wasn't enough, I have a store near me that sells all types of Atkins products. Trust me, I knew exactly what I was doing. I stayed on the induction phase the entire year and a half, because when I tried to increase my carbs from 20 grams (I think that's what it was, been a while now), I started putting on weight. I don't have a problem committing to something if it actually works, but once I hit that plateau after 2 months and 20 lbs, I never moved on from it. I was exercising at the time (getting up early 6 days a week and doing an hour & 20 mins of fast-paced walking/jogging around my complex religiously all spring, summer and most of the fall). All I got to show for it was a slight increase in my weight, and big bulky muscles, as has been the case from all the other exercise routines I've ever done. None of the fat seemed to want to budge at all.

Most of the people I've spoken to have been quite successful on Atkins, so I was pretty surprised about my own results. All I know is that I gave it my all..

Right now, I am feeling very weak and barely have enough energy to get up in the morning, so exercising has been pretty much impossible. At minimum though, I still try to do stretching in the morning and before bed.. I'm thinking of trying pilates, and maybe add the walking back in in a while. Maybe that will counter the bulk. And even though I've gotten off Atkins, I am still very conscious of what I eat. I majorly control my carbs and sweets, and I also try not to combine meat and carbs. Really, mostly it's like veggies and some chicken and turkey and fish. No pasta, no white flour, no refined sugar. If I ever have cravings for something sweet, I usually just drop by my local low-carb store, and get a bar or something. Oh! And of course, I don't eat fast food EVER. Like 99% of what I eat is something I've made myself from scratch. So tell me, what am I doing wrong?!#$? I don't get it.

I'm not trying to conceive at ALL right now. That is not something I can afford to do as of yet. I still don't like that I have all this hair growing, so my doc said it's ok to stop the spiro and see if it makes any difference. Thanks for your suggestion, I will definitely look into Avandia. I was seeing an endo who wasn't much help at all, and went to another doc who sat me down and said, "no amount of exercise or dieting you do will ever help you. The only chance you have of losing this weight is to get your stomach stapled. If you don't, your weight will just keep climbing." And she is supposed to be top of her field. So, this is why I have been considering it. I did just get my period after not having it since december '02, and I'm not sure if it's due to the spiro, or because I just dropped about 8 pounds.

But anyway, thank you for all your advice, and for all the info on spiro. I'm still pretty scared about not being able to control this weight, so please feel free to give me some more suggestions.

All my best! -Natasha

At Thu, 22 May 2003, Celeste wrote: >At Thu, 22 May 2003, Natasha wrote:
>>
>Natasha, I have some questions. How long have you been on Metformin? It
>can take some time to help things get under control or even to find out
>if you need a higher dose or to add another medication.
>
>Second, if you have high testosterone (over 30) then Avandia in
>combination with Metformin may help you a LOT.
>
>You say you did not have success with the Atkins diet, but I have to ask
>if you followed it strictly from the book or if you dieted according to
>what you had heard the Atkins diet was all about. In any case,
>restricting carbohyrdates helps ANY insulin sensitizer therapy work
>better because it can address your baseline insulin levels instead of
>what elevation is a result of food you just ate.
>
>I can recommend http://www.atkinsfriends.com for support and help with the
>Atkins diet. It also has boards for other lowcarb plans. At
>http://www.holdthetoast.com they have an FAQ about all of the other lowcarb
>plans. It may be that a different one is one you can live with. I
>personally think that Protein Power is easiest for most people to live
>with; there is more info at http://www.eatprotein.com. I hope you can find
>something you can stick to because diet and medication can help you
>avoid full blown diabetes, which is important.
>
>If you are not exercising, you should be. It is incredibly good for
>your pancreas and will also help meds work better. Aerobics are not as
>useful in combination with carb restriction as weightlifting is, but
>adding any activity can only help.
>
>I lost 60 lbs on lowcarb diet and exercise and NO WAY would I get
>stomach stapling over this. For one thing you are put on a lowcarb diet
>for the rest of your life anyhow, so, why not just go on it and skip the
>surgery?
>
>I have used spironolactone and it did cause "irregular bleeding"--for me
>this meant spotting 3 weeks out of the month. It slowed down hair
>growth, but I felt like Avandia did an even better job. Spiro blocks
>the effect of testosterone on your tissues, but it doesn't reduce
>testosterone. Avandia helps to lower the testosterone. Are you trying
>to conceive? If so, then you should not be on spiro. It is alright if
>you got pregnant on it and stopped taking it soon but prolonged use of
>it in pregnancy can cause malformation of little boy parts by blocking
>the effects of testosterone on a boy. You can ttc on Met and Avandia.
>Some docs let you stay on Met throughout pg and breastfeeding, others do
>not, it just depends. Avandia is too new to allow it in pg or bf, but
>it's safe for ttc. It was this combo that helped me get my daughter. If
>you can get your testosterone under control, then you can use
>electrolysis or laser hair removal to get permanently rid of any hairs
>that were changed into whiskers by high testosterone. However it
>doesn't make any sense to spend on that until you get control. JMHO.
>
>However if you are not ttc, there is no reason you should fear Spiro. I
>liked its diuretic effect. I'm your size almost exactly, too. ;o)
>
>I hope this helps!!!!
>
>>I am 24. In August of 2002 I went to see an endo, and after several
>>tests, was diagnosed with PCOS. I have always had a regular period,
>>although a very painful and heavy one, up until just a year before that,
>>when it just stopped for 8 months. Other than that I have most of the
>>classic signs - the skin problems which never got better and followed me
>>into my 20's, the extra weight which never wanted to come off, despite
>>all the different diet and exercise routines I've been through, constant
>>fatigue, etc. etc... I also found out that my thyroid was barely
>>functioning, that my testosterone levels were three times what they
>>should be, and that my insulin levels are high (although sugar is still
>>ok), which makes me pre-diabetic.
>>
>>Anyway, I've been on medication for my thyroid (synthroid), and was put
>>on metformin (500mg 3x day), as well as spironolactone. After doing
>>some research on spironolactone, I found all sorts of forums stating
>>that it has proven to cause tumours, and that you can't get pregnant
>>while being on it, as it causes birth defects. It also needs to be
>>taken in very large doses to be effective, but then it messes up your
>>period. This really scares me! But lately, the hair on my upper
>>neck/chin region has been growing out of control!! It won't stop. No
>>matter how much I tweeze, I find a whole bunch more the next day. It's
>>so frustrating!
>>
>>I have been to several different doctors, and two of them have mentioned
>>that I should have stomach stapling surgery. I carry the weight pretty
>>well at 5'8, and noone thinks I'm THAT overweight, but the fact of the
>>matter is I have like 110lbs to lose or so. I have tried all sorts of
>>diets, including Atkins. I stayed on it for 1.5 years, but it only
>>worked the first 2 months. Any sort of exercise, even just walking,
>>gave me bulky muscles, but no fat loss whatsoever. I am sooo scared of
>>this surgery. I heard all sorts of horrible things about it from people
>>who had it done, and it seems like it's such an extreme thing to do.
>>
>>Do you guys havc any advice on the surgery, and the spironolactone? I
>>would really appreciate some feedback.
>>
>>--
>>Thanks,
>>-Natasha
>>
>--
>Celeste
>

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