Why anyone will want to get out of taking metformin?

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Why anyone will want to get out of taking metformin?


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Old 07-15-2012, 13:09   #1
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Default Why anyone will want to get out of taking metformin?

I read some are trying to get out of taking metformin, I donít understand. Maybe there is something I donít know? Why anyone will want to get out of taking metformin? I had to battle my doctor for the prescription because my A1C was only 6.1 even do I was low carb for a few years. It took me a while to get adapted, I needed berberine to control the diarrhea and mint teas for the nausea. Why once adapted will anyone want to stop taking it. It have read so many good thinks about it and has so many health benefits some Drs and Life Extension Magazine recommend them for anyone over 40 as an anti-aging, anti-cancer supplement. They say blood sugar regulation goes down with age and that everyone over 40 years can benefits from metformin, since most are mildly diabetics.

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Old 07-15-2012, 14:42   #2
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http://www.sciencedaily.com/releases...0705172044.htm
Seems the "scientist" of the manufacturer have been working hard.
Sorry just not buying any of it even if I don't use it & just insulin.

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Old 07-15-2012, 15:45   #3
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1. It can block the absorption of vitamin B12. This is very serious. It is not just a "deficiency" but blocking. It is not even known whether supplementing B12 can solve the problem. B12 is an extremely important and vital nutrient.

2. Reduction of testosterone in men. Real deal-breaker!

3. It does nothing useful in the context of my BG management strategy. The only thing Met is known to do is it causes the liver to "hold" and not dump its stores of glucose. Although there is conflicting data and nothing conclusive, it is believed in some quarters that it may reduce insulin resistance.

I have no use for either of these. My objective is to deplete my liver stores of glucose and keep them that way. This requires getting it to "dump" and then not replenishing it. On a ketogenic approach, I want my cells to prefer other fuels over glucose and to accept them. This involves a "physiological" or intentional (diet-induced) insulin resistance. The pathological insulin resistance which is part of my disorder is no longer relevant or a problem.

So, it simply has nothing to offer me let alone something which would make the pssible discomfort and side-effects worth it. Others, using different approaches to control may definitely find it useful but for me it would be counter-productive.

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Old 07-15-2012, 16:16   #4
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Some of us no matter how good we eat still need metformin for various reasons. I am one of the lucky ones and rarely have any GI problems. It has been great for my weight and now I am the thinnest in 42 years. It has also been very good for my skin and it is super clear, now. I had to ask my doctor to increase my dose and had to fight with him about it. If my choice was between insulin and metformin I think metformin would win in my book. When it stops working I will add insulin but until then I am a big fan.

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Old 07-15-2012, 16:25   #5
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The efficacy of this drug is convincing and I would be inclined to listen to your physician rather than pharmacophobes and take this medicine. This is particularly true if you've found through your own testing of bg that it has been helpful. While there is risk in taking any medicine because it is never known in it's entirety what the effects will be, the same can be said for virtually any hard-line treatment strategy. For many type 2's the insulin resistance is severe enough that dietary restriction may be insufficient to reduce bg to safe levels because the liver continues to make its own glucose by a process known as gluconeogenesis. While several therapeutic benefits have been reported for metformin, the most well understood is it's ability to reduce the capacity of the liver to carry out gluconeogenesis.

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Old 07-15-2012, 17:02   #6
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Quote:
Originally Posted by Darbro View Post
The efficacy of this drug is convincing and I would be inclined to listen to your physician rather than pharmacophobes and take this medicine. This is particularly true if you've found through your own testing of bg that it has been helpful. While there is risk in taking any medicine because it is never known in it's entirety what the effects will be, the same can be said for virtually any hard-line treatment strategy. For many type 2's the insulin resistance is severe enough that dietary restriction may be insufficient to reduce bg to safe levels because the liver continues to make its own glucose by a process known as gluconeogenesis. While several therapeutic benefits have been reported for metformin, the most well understood is it's ability to reduce the capacity of the liver to carry out gluconeogenesis.

First, if this is in response to my message, please don't engage in "straw man" arguments. Your implication that any of the things I said came from "pharmacaphopic" sources is the straw man. Everything I said comes from verified scientific sources.

Second, all that is known about Met is that it reduces glucose "output" by the liver. As far as I know, I don't believe the exact mechanism is known. Is it at the "front end" as in suppressing the storing of glcogen and/or gluconeogenesis or at the "back end" by suppressing its release into the bloodstream. If it works at the front end, what would prevent the liver from releasing whatever it has. From what I've read, I think it is more llikely that it works at the back end - by suppressing the RELEASE of the glycogen. This in turn reduces storage from direct dietary sources and/of gluconeogenesis because of signalling that it is "full".

In either case, the liver remains "full" of glycogen, what is reduced is "throughput". That's the part that makes it of no use to me although others may find it a great help.

jwags: One thing I'm curious about is the relationship between Met and ketosis. It seems plausible that since liver glycogen depletion is generally regarded as a prerequisite to ketosis and Met prevents that, does it also prevent true ketosis? Have you considered getting hold of the free blood ketone meter so we could find out?

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Old 07-15-2012, 17:42   #7
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I stopped met 4 days ago but my numbers are up. I'm in ketosis, not deep, but ketones hovering around 1.4. This morning my fasting was 116, something I've not seen for over a year.

So - I just took 500 mg to see if that can get me back down. I'm also trying to get my ketones >2. Once I'm deeper in ketosis, I'll try dropping it again.

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Old 07-15-2012, 18:04   #8
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Quote:
Originally Posted by moon View Post
I stopped met 4 days ago but my numbers are up. I'm in ketosis, not deep, but ketones hovering around 1.4. This morning my fasting was 116, something I've not seen for over a year.

So - I just took 500 mg to see if that can get me back down. I'm also trying to get my ketones >2. Once I'm deeper in ketosis, I'll try dropping it again.
I'm not suggesting you follow my ideas, just expressing them. I think something important about doing LC/HF is that standards for morning numbers needs to change. As far as I'm concerned, anything acceptable as a post-meal number is acceptable as a morning number as long as overall averages and A1C are in a good range.

Think of it as a "delayed" meal. Because of all the changes in metabolism, this glucose was stored and dumped in the AM. Dumping liver glycogen on a ketogenic diet is a GOOD thing, not a bad one. I want it dumped, gone and kept as low as possible.

Peter of Hyperlipid has an A1C in the 4's and average waking numbers of 120. I think this is pretty clearly a non-issue.

Quote:
I've been thinking about this for some time as my own FBG is usually five point something mmol/l whole blood. Converting my whole blood values to Mark's USA plasma values, this works out at about 100-120mg/dl. Normal to prediabetic in modern parlance. However my HbA1c is only 4.4%, well toward the lower end of normality and healthy. That's always assuming that I don't have some horrible problem resulting in very rapid red blood cell turnover. I don't think so...

I spend rather a lot of my life in mild ketosis, despite the 50g of carbs I eat per day. So I can run a moderate ketonuric urine sample with a random post-chocolate blood glucose value of 6.5mmol/l.

What is happening? Well, the first thing is that LC eating rapidly induces insulin resistance. This is a completely and utterly normal physiological response to carbohydrate restriction. Carbohydrate restriction drops insulin levels. Low insulin levels activate hormone sensitive lipase. Fatty tissue breaks down and releases non esterified fatty acids. These are mostly taken up by muscle cells as fuel and automatically induce insulin resistance in those muscles. There are a couple of nice summaries by Brand Miller (from back in the days when she used her brain for thinking) here and here and Wolever has some grasp of the problem too.

This is patently logical as muscle runs well on lipids and so glucose can be left for tissues such as brain, which really need it. Neuronal tissue varies in its use of insulin to uptake glucose but doesn't accumulate lipid in the way muscle does, so physiological insulin resistance is not an issue for brain cells.

However, while muscles are in "refusal mode" for glucose the least input, from food or gluconeogenesis, will rapidly spike blood glucose out of all proportion. This is fine if you stick to LC in your eating. It also means that if you take an oral glucose tolerance test you will fail and be labelled diabetic. In fact, even a single high fat meal can do this, extending insulin resistance in to the next day. Here's a reference for this.
When attempting to go down a LC/HF or ketogenic path, I wouldn't make any decisions based on mornings readings as long as they are under 130 and A1C is OK. Certainly not returning to Met as it could work against the strategy as a whole.

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Old 07-15-2012, 18:21   #9
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I am super happy that some people can achieve ketosis and get great bgs at the same time. I have no problem losing weight and at 120 pounds I am very happy with the way I look. So I don't need to be in Ketosis to lose weight. Many of us seem to have higher bg set points and even with ketosis never get below 90 or so. Every diabetic is different and some of us need metformin or insulin to help out a pooped out pancreas. It is the same with DP, some don't ever experience it and others of us who sleep in an extra 15 or 20 minutes get it with a vengence. I don't think every diabetic needs metformin but for those of us who it helps, it is great. I don't think we should be made to feel guilty because we can't get lower bgs with just diet. There is way too much guilt with diabetes as it is. If you need a certain medication for diabetes, blood pressure or whatever you use it. Now, if something has severe side effects of course I wouldn't use it but sometimes it is a judgement call.
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Old 07-15-2012, 18:43   #10
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I've been on a HF/LC/ketogenic path for quite a while, and while blood ketone testing is new, I've used the strips and always gotten color, typically medium-dark. So my last A1C of 5.8 was in that environment.

I've been so glad not to be cursed with fasting issues, so it's hard seeing >100 numbers. I'm also not convinced that A1C value is more important that blood glucose testing because I'm =still= not clear what it's actually measuring for me.

Food for thought though - thanks Salim.

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5/23/11 .. 6.2 . . . . . . . Low-carb/high healthy-fat diet
9/8/11 .... 5.6 . . . . . . . No meds, No statin
2/24/16 .... basal/bolus insulin 2-3 days/wk due to steroids

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