Increase Metformin?

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Increase Metformin?


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Old 11-21-2013, 03:44   #1
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Default Increase Metformin?

I have been taking metformin now since September 3rd. When I started my A1c was 9.1 and fasting was 250. I have been sticking to the lchf diet and it is working. I think I am starting to have more better days but still suffer on and off with nausea. It seems like a vicious cycle. I try and eat more but get a sick feeling sometimes an hour after I eat. I then am not hungry for the next meal, but I think that makes me feel sick too. Plus I think with my bg levels being lower I feel queezy too.

My fasting BS is now between 85-95 in the morning. Mostly between 90-100 pre meals and 110-125 post meals (other than last week-ends wine and dinner fiasco!). Right now I am taking 500 mg of Metformin a day, sometimes 750. I cut the pills in half as my pharmacist told me there is no extended release metformin in Canada? My Dr. would like me to increase my metformin to at least 1000 mg a day. I have lost almost 30 lbs and hope to lose another 10.

My question is do you think there is any benefit to raising the metformin? Will it give me any benefits with my post meal bg readings? Are there other benefits? Will it help overall to lower my numbers further? I am asking as I have read different points of view.

I should add that I am only eating about 40g of carbs a day at the most.

Thanks!
Judy


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Old 11-21-2013, 06:31   #2
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Judy I can't help you with your questions about Metformin, just wanted to say congrats on your better numbers and weight loss - way to go!

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Old 11-21-2013, 07:16   #3
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Usually drug dosage is based on body weight. A 1000 mg/day for metformin is not a very heavy (strong) dose, if that is your concern. However in my personal opinion since you have lost 30 lbs you might as well continue with 500 mg/day.

The other symptoms that you have described could be attributable to Atkin's Flu. When you start the LCHF way of eating your body takes 2-3 weeks to keto-adapt. In this period such symptoms do appear, but they will go away soon as your body adapts to your "new normal" sugar levels.

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Old 11-21-2013, 11:44   #4
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My opinion (and it's just that!) is a bit different. I agree that most medications are given based on body weight. Metformin, however, is based on blood sugar control. Personally, I found that anything below the maximum dose of metformin did nothing for me. I had to be at the maximum dose, where I still am, in order for there to be a good blood sugar effect. I stay in good ranges now most of the time (about 98%).

The one question I have, you say that you're taking 500 a day and sometimes 750. Why does your dose switch? The metformin needs to be maintained at a certain level (whichever dose level), and then usually a doctor would go from there, seeing how that specific dose affects you. Your blood sugar numbers look really good on your dose. It's a shame that the extended release isn't available, as it tends to cut down on the side effects, including stomach upset.

As far as raising it, I would be one that would always say, only take the amount of medication that you need in order to get where you want to be. You're not seeing anything over the range you listed? At all?

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Old 11-21-2013, 15:38   #5
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Judy - mega congratulations on getting your BG under control. You've really done a great job with your diet.

You had really high BG levels when dx'd and I don't doubt the doctor having put you on metformin. However, doctors are used to diabetics that don't change their diet much, or follow ADA guidelines, and never really get their BG down as far as you have. So the routine would definitely be to increase the met until one is on the higher dosage.

But (here's my opinion) since diet has been successful for you and your BG, if it were me, I'd drop the met and see if I could continue good control with diet only. It may mean you'd need to reduce daily carb intake a bit, maybe down to 30g a day. Then, if you find this works well with BG and you are satisfied with the diet, then you may not need to be on met.

With your low BG level, you have some wiggle room to experiment a bit.

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Old 11-21-2013, 18:30   #6
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There is too extended release Metformin in Canada. It's called Glumetza XR. I was on it for a few months as my body adapted to Metformin, now I'm on 2000mg regular metformin a day. It was a bit more expensive though.

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Old 11-21-2013, 22:16   #7
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Quote:
Originally Posted by Freyagirl View Post
Judy I can't help you with your questions about Metformin, just wanted to say congrats on your better numbers and weight loss - way to go!
Thanks Freyagirl, It certainly is a journey isn't it!

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Old 11-21-2013, 22:20   #8
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Quote:
Originally Posted by skb View Post
Usually drug dosage is based on body weight. A 1000 mg/day for metformin is not a very heavy (strong) dose, if that is your concern. However in my personal opinion since you have lost 30 lbs you might as well continue with 500 mg/day.

The other symptoms that you have described could be attributable to Atkin's Flu. When you start the LCHF way of eating your body takes 2-3 weeks to keto-adapt. In this period such symptoms do appear, but they will go away soon as your body adapts to your "new normal" sugar levels.
Thanks skb, I agree that it could be the Atkin flu combined with everything else. I have been eating lchf for about 12 weeks so I thought it would be gone by now. I do think I may be having more good than bad days though!

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Old 11-21-2013, 22:27   #9
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Quote:
Originally Posted by Mary0110 View Post
My opinion (and it's just that!) is a bit different. I agree that most medications are given based on body weight. Metformin, however, is based on blood sugar control. Personally, I found that anything below the maximum dose of metformin did nothing for me. I had to be at the maximum dose, where I still am, in order for there to be a good blood sugar effect. I stay in good ranges now most of the time (about 98%).

The one question I have, you say that you're taking 500 a day and sometimes 750. Why does your dose switch? The metformin needs to be maintained at a certain level (whichever dose level), and then usually a doctor would go from there, seeing how that specific dose affects you. Your blood sugar numbers look really good on your dose. It's a shame that the extended release isn't available, as it tends to cut down on the side effects, including stomach upset.

As far as raising it, I would be one that would always say, only take the amount of medication that you need in order to get where you want to be. You're not seeing anything over the range you listed? At all?
Hi Mary, I say that sometimes I take the 750 as I am trying to build to the 1000. Trying to take it slow because of the nausea. My numbers are always great now if I stay away from the carbs. I do not eat any rice, pasta or potatoes. I have a low carb bread that I eat once in a while. It is 9g of carbs for one slice and that is all that I have. It always varys and sometimes I am at 120 after but today after a half sandwich with ham and cheese I was at 140 one and a half hours later. At 2 hours it was at 120.

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Old 11-21-2013, 22:33   #10
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Quote:
Originally Posted by VeeJay View Post
Judy - mega congratulations on getting your BG under control. You've really done a great job with your diet.

You had really high BG levels when dx'd and I don't doubt the doctor having put you on metformin. However, doctors are used to diabetics that don't change their diet much, or follow ADA guidelines, and never really get their BG down as far as you have. So the routine would definitely be to increase the met until one is on the higher dosage.

But (here's my opinion) since diet has been successful for you and your BG, if it were me, I'd drop the met and see if I could continue good control with diet only. It may mean you'd need to reduce daily carb intake a bit, maybe down to 30g a day. Then, if you find this works well with BG and you are satisfied with the diet, then you may not need to be on met.

With your low BG level, you have some wiggle room to experiment a bit.
Hi VeeJay, It's funny but I have become crazy about testing and my numbers. I have a meter that tracks my averages and highs and lows. It really bugs me when a higher number is recorded. Because of this I have been slow at adding new foods to try as I don't want to wreck my good results. I know I have to as I am getting frustrated with almonds, chicken and salad! haha.

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