Re: To Dr. Jwang
From: j wang,MD (anonymous@obgyn.net)
Sun, 1 Oct 2000 20:38:00 -0500 (CDT)
I don't know. I am not aware of any studies using avandia for pco,
though they're probably out there. Theoretically, avandia should work
on pco the same as metformin because they have esentially the same
mechanism of action. Your RE would know better than I.
At Sun, 1 Oct 2000, Eileen wrote:
>
>Dr. Jwang, I feel real yucky on 1000 mg. of metformin, like I have
>constant indigestion or a stomach ache. Do you know if maybe I took 500
>mg. metformin only, combined with Avandia, if that would work? Thanks
>so much again. Eileen.
>
>At Sun, 1 Oct 2000, jwang,MD wrote:
>>
>>The newer information about PCOS suggests that metformin is a better
>>physiologic treatment for this condition. THere are those in who feel
>>that patients should show definite signs of insuylin resistance on lab
>>tests. There have been a number of complaints with patients on
>>metformin with GI side effects. The issue then becomes - do you feel
>>want to feel lousy as long as you're taking the pill? I have several
>>patients that have stopped the met. because of the side effects.
>>Although weight loss is more difficult off of met.. it still can occur.
>>Birth control pills can at least regulate cycles.
>>
>>At Sun, 1 Oct 2000, Eileen wrote:
>>>
>>>Dr. Jwang, Thanks for your reply. I think I need to see my RE about
>>>this. I know that metformin has been studied more than others meds for
>>>PCOS, but so far, the side effects have been hard to deal with, if I
>>>take more than 500 mg. My doctor thinks that 500 mg. will do nothing
>>>for me, but I just don't see how I can gradually work up to 2000 mg. I
>>>have one good friend whose teenage daughter has a severe case of PCOS,
>>>and it took 6 months to see ANY results from the metformin, but since
>>>then she lost a lot of weight. Stories like that make me think I should
>>>hang in there with it, but since I have been taking it since January,
>>>that seems like a long enough trial. I have also noticed more heartburn
>>>since I increased my dose to 1000 mg., so in general, I just don't feel
>>>that well on it. I am just afraid that maybe there are no other
>>>alternatives. And I think that both Actos and Avandia are in the same
>>>chemical family as Rezulin was, and we know that was taken off the
>>>market. Have you known of any patients who got good results in treating
>>>PCOS with something other than metformin? I know that everybody is
>>>different, but I need to find something that will work for me. Thanks
>>>so much again for responding. Eileen.
>>>
>>>At Sun, 1 Oct 2000, jwang,MD wrote:
>>>>
>>>>The primary rule of practice is "do no harm". It sounds like you have
>>>>had a siginificant problenm with side efects form metformin, and
>>>>therefore, I would recommend you try a different aproach to managemong
>>>>your PCO. Check with your doc or an endocrine specialist.
>>>>
>>>>At Sat, 30 Sep 2000, Eileen wrote:
>>>>>
>>>>>Hi, I have been taking Metformin since January of 2000. I am a little
>>>>>discouraged. I started at 1000 mg. a day, but quit it entirely for a
>>>>>month due to elevated liver enzymes. This later checked out, so I went
>>>>>back on it, but this time at 500 mg. a day. I have tolerated the 500
>>>>>mg. just fine since July, but in the last week have been trying to
>>>>>increase my dose back up to 1000 mg. I am having a tough time. I have
>>>>>to take immodium now with the 1000 mg per day dose, so I won't be in the
>>>>>bathroom too much. I also have an upset stomach even without diaherra
>>>>>at the 1000 mg. dose, but even more discouraging is that my doctor
>>>>>wants me to work up to 2000 mg. per day! I don't know if I can make it!
>>>>>
>>>>>By the way, I have PCOS, not diabetes, but have several diabetics in the
>>>>>family. I need to lose at least 30 lbs. But I wonder if I would be
>>>>>better to switch to Avandia or another medication, or to combine a low
>>>>>dose of metformin with Avandia. It seems like I have been on met a long
>>>>>time--about 8 months, and should see some results which I have not. I
>>>>>also take Diane 35 to help control PCOS, and this is a great medication
>>>>>for me; and I take generic Spironolactone, 50 mg daily. Any medical
>>>>>suggestions from a knowledgable doctor about this would be greatly
>>>>>appreciated. My email is: r_eileenhunter@hotmail.com
>>>>>
>>>>>Thanks very much.
>>>>
>>>>--
>>>>J Wang, M.D
>>>>Assitant Clinical Prof.
>>>>Tufts University School of Medicine
>>>>
>>>>>**Note: Opinions expressed here are for educational purposes only
>>>>>and, as such, do not constitute a physician-patient relationship.
>>>>>This information is not intended to supplant the need for you to
>>>>>consult with your physician prior to choosing therapeutic options
>>>>>and/or interventions.>
>>>>
>>--
>>J Wang, M.D
>>Assitant Clinical Prof.
>>Tufts University School of Medicine
>>
>>>**Note: Opinions expressed here are for educational purposes only
>>>and, as such, do not constitute a physician-patient relationship.
>>>This information is not intended to supplant the need for you to
>>>consult with your physician prior to choosing therapeutic options
>>>and/or interventions.>
>>
--
James Wang, M.D
Assitant Clinical Prof.
Tufts University School of Medicine
>**Note: Opinions expressed here are for educational purposes only
>and, as such, do not constitute a physician-patient relationship.
>This information is not intended to supplant the need for you to
>consult with your physician prior to choosing therapeutic options
>and/or interventions.>
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