Met dosage - What's common?

[HeyB]

Hi ladies. I've noticed since browsing on here that most of the women are taking 1000-1500mg of met every day. I am on 2000mg. Is there usually a reason for a higher dose? When I was dx my Ob/Gyn said my testosterone levels were high but said nothing about my LSH or LH numbers. I also never had an u/s. So I'm wondering why he might have given me the higher dosage. Could it be b/c of my weight? I am 5'6 and weigh 240 (down from 250, thank you very much!)

I've asked his nurse to fax me the results of my b/w so I should have that soon.

Any ideas or suggestions?

[maelan]

It is thought that the theuraputic dose is at least 1500mg a day. I was on 2000mg a day. Anything less didn't help with symptoms (and regulating cycles). Every person is different, some on here only need 500mg daily to keep things in check. But it's thought that at least 1500mg. as with all meds, everyone reacts differently.

[lighthouse830]

I'm on 1500mg- it seems to be helping me :)

[stardust1984]

I am on 2000mg a day (1000mg twice a day) my endo consultant built me up to this dose over two weeks to get my body used to the medication to minimise side effects. Didn't realise people could be on lower doses?

[Davelle Parchman]

Is anyone on a higher than 2000mg a day dosage? or is 2000mg the max?

[sweetsunshine72]

I was on 2,000 mg/day for a while. Now, I'm on 1,500 mg/day (I can't afford to have bad gas/upset stomach while performing a massage treatment!!!! :o). My endo said that once you get over 2,000 mg/day, the chance of more serious side effects (like effect on the liver, etc.) start going up faster, and the extra benefit of the higher dosage slows down, so it's not worth it going much higher (in his opinion). I've heard of people on 2,500 mg/day (very rare), but I don't think I've heard of any higher.

[Davelle Parchman]

I'm on 2000mg a day also. My dh says he doesn't understand how anyone that goes to the bathroom (TMI, sorry:)) can be overweight as I am. Ha! I realize that is a side affect of that medicine, but mine never seems to taper off. I just get frustrated with the GI part and give up sometimes. I'll stop it for a while and then pick back up again because I get irregular cycles again.

[HeyB]

Hmmm. I don't really have any GI side effects. I did at first when I was getting used to it and building up the dosage. But now I feel fine. I actually feel a little better, and I'm hoping that in a few more months I'll see even more results. But I just noticed that I was in the minority by taking 2000mg.

[Davelle Parchman]

I'm not sure why, but I've always been on that dosage. But that's what the gyn gave me years ago. I'm just now seeing an endo after being dx with this at least 15 years ago. I'm finding out new information that I just didn't know before thanks to all you wonderful gals here. I am gonna have a follow up with my endo at some point since I got the call from my glucose test today. I may pose that question then.

[jessienevins0314]

davelle, i had the problems too -- big time! im only on 1500mg (3x daily) but still have probs at times. I was going to tell you, my doctor said to use the GI diet (lower Glycemic Index foods) and that would help... :) just refrain from eating as much greasy or fried foods. (i know its hard -- trust me!) but i feel better when i dont eat as much.

[sweetsunshine72]

Davelle, when you start taking your Met again, do you ease into it or jump in "head first"? (Easing in usually means increase by 500 mg/day every week or two until you're at the full dosage.)

If you're going too fast, you might not be giving your body time enough to adjust, and that could make the s/e last longer. Definitely discuss this with your doc, too, when you see him!

[Davelle Parchman]

Great! Thanks for the info. I don't usually eat fried or greasy foods. But I haven't given up the potatoes, bread, rice and pasta. Looks like that's something I need to do. I'm motivated now, so I better get to it while I am. :)

[maelan]

I was on met for yrs and after awhile my tummy just could not handle it anymore. I downed the dose from 2000 to 1000 thinking that may help but that still didn't. Talked with the dr (RE) and he gave me alternative med to met, Actos. I must say there are NO gi issues with Actos. It is suppose to be just as effective as met (the jury is still out on that one with me--my cycles are not as regular as with met but I'm going through a lot of stress right now--so the jury is still out). The bad things are that if your ttc then it is not safe for pg. I was told if I got pg then I would have to stop taking it immediatley. Also the price is awful.. there is no generic and it is considered a name brand drug by ins co. So it is a $40 month co-pay or $20 with mail order.

But if met is not working for you after diet changes and dialing in the right dose and if you are not planning to ttc then maybe ask the dr about alternatives to met (there are others out there as well). There is no need to suffer.

[Davelle Parchman]

Thanks Maelan. I've been taking it for a while, and Sweetsunshine is right, I just jump right back into it when I take a break. I just keep figuring it will taper of the s/e. But I do have to go back to the endo from the test anyway, so this may be a question that I pose to her. It's been such a long time since I took 1500 mg that I don't remember if it helped my cycles or not. That may have been why it got bumped up to 2000mg. I don't remember doing this so much when I took it while I was pg a couple years ago. Maybe your body is just different then. Thanks for all the advice ladies.

[Nikicat]

I'm on 2000mg per day, but my mom is on 2550mg per day. Yep PCOS does run in families (haha).

[Davelle Parchman]

Thanks Jess, I"ll see what I can find on that. Right now I've just cut out as much sugar and/or substitutes as possible. No potatoes, no white bread, no rice, and I've changed the pasta that I've bought. I've only had regular pasta once lately. But I'm sure there is so much more that I need to cut out or change. Thanks again!

[JessicaAnn]

I have been on 1000mg for about a year and a half (give or take a few months when I quit taking it). Does that seem like a low dose? I take 2 500mg a day, and when I asked my gyno if I should go up to 3 pills she said I only needed to do that if I was trying to get pregnant (which I'm not).

Just wondering why everyone else is on a higher dose.

[Davelle Parchman]

Personally I thought they put you on whatever dosage that your symptoms were under control at. I've had my tubes tied so there are going to be no more children for me and I'm still on 2000mg a day. If you haven't seen an endo that might be something you want to look in to. I've just had an appt last month for the first time ever.

[sweetsunshine72]

It's a difference in attitude and training. Gyno's only have basic training in managing metabolic issues, so they are more cautious about using Met. They are "treating" you for PCOS from the point of view of a gyno condition, so it's more like "well, other gyno's do this, and I know that this helps" rather than full education on the whole thing. An endo, on the other hand, is treating a metabolic issue, and knows that the standard therapeutic dosage starts at 1,500 mg/day to be truely effective metabolically, so that's what they work you up to.

Some of us are lucky enough to be able to "get away" with a lower dosage, especially if we do really well with the lifestyle changes. Some of us are just genetically more disposed toward diabetes and will need a higher dosage for the rest of our lives to slow down or stop the progression to diabetes.

I would keep an eye on your symptoms (especially weight gain, dark skin patches, and mood/energy issues), and if you don't feel that they are controlled properly with your current dosage, then I would see an endo for sure! Oh, and if you are on BCP, be aware that it will cover up symptoms, but it doesn't actually "treat" PCOS, and long-term usage of BCP has been linked to worsening metabolic issues.

HTH! :)

[JessicaAnn]

Thanks so much for the replies. I was diagnosed in December 2007 and have not really taken the condition seriously until now. I took the meds my gyno prescribed... and that was it. I didn't ask any questions or do any research. I am just now starting to do what I should have done then, and I am now realizing that my gyno probably should have run a few more tests and followed up with me. After I was diagnosed I didn't even have another appt until my next annual a full year later, and then I didn't even see her because she wasn't available (I saw another doctor who didn't even bring up PCOS in my appt). So there are a lot of things I need to check into, apparently!

I made my first appt with an endo at Vanderbilt for 8/11 (first avail) and I'm really excited to get all of this stuff figured out. I have wasted so much time!

Thanks again for all the help.

[sweetsunshine72]

You're very welcome!

I'm glad that I was able to help! :)

[Davelle Parchman]

Hey Jess, I understand completely. I was in the same boat. I thought if I took the medicine I was given and didn't eat a bunch of fried stuff and didn't gorge on sweets that I'd be doing what I needed to do. There is so much more to it than that. In fact I just saw an endo in June and I've been taking met for years that my gyno prescribed. Keep us updated on what the endo says.