life expectancy

[daybyday]

Can one take met their whole life without it decreasing life expectancy? Does it cause any secondary diseases? I just worry about silly things like that.

[Gen224]

with all candor, what WILL decrease one's life expectancy is diabetes. And if your insulin levels are not controlled adequately, you are at a MUCH higher risk of diabetes than otherwise. Met has been used for decades in the lives of diabetics--I'm not aware of one case where someone has died directly from met. From complications of diabetes, yes--all the time, quite frankly. From complications of lactic acidosis--occasionally, but there's always another factor (kidney disease, liver disease, compromised lung function, etc.) that goes in to that.

So in direct answer to your question, met is much safer than the alternatives of diabetes, stroke, heart disease, and other 'side effects' of PCOS. No one lives forever on this side of eternity, but the point is to maximize our lives here so that they are richer, more fulfilling, happier, and healthier. Controlling insulin levels are key to those goals for cysters. And met is a direct help in that struggle.

HTH

[daybyday]

I am a thin pcos'er and my lab work does not show I have a problem with insulin resistance. There is no diabetes that runs in my family. Heck, I don't know if the met will even induce a period or change anything, but it's worth a try. I have a mild form of pcos. I have a good diet and I exercise. I don't believe I will ever have much of a problem with diabetes in my life if I keep up my lifestyle. So, in other words, I am not worried about diabetes. I was just wondering about the long term effects of the drug. Thanks.

[elsie]

DaybyDay,

It's also worth considering that your diet and exercise efforts may be keeping ir at bay, but that you are still quite young and it may take an event like having a child or being injured and unable to exercise vigorously for a couple of months to reveal an underlying ir problem. I personally had no symptoms whatsoever until I was 27, then overnight: unexplained weight gain, fatigue, acne, excessive sweating, then later on: hirsutism, worse acne, midsection weight gain.

I never would have thought that my (skinny) grandfather's adult-onset diabetes would affect me, but my mother tells me that he was dx'd after experiencing unexplained weight gain and fatigue in his 50s. As time goes on and your metabolism slows due to aging, you may find that healthy habits alone don't cut it -- this would be the time to keep a very close eye on your insulin function. When I was dx'd, I was only 5 pounds over my ideal weight and was exercising 60-90 mins. a day/6 days a week. Despite all that, my symptoms had been getting worse and my fasting glucose was over 100 -- a strong sign of pre-diabetes.

I am very optimistic about life expectancy because my grandfather, who took diabetes meds off and on and also strictly regulated his diet, lived to be 87, and was fairly healthy all his life -- no debilitating conditions. I am only cautioning you to be on the lookout for signs that lifestyle factors alone are not keeping your insulin production under control.

[daybyday]

Thanks for all the info. Now my question is, how could I have insulin resistance if I am so healthy and have been all my life. I have no risk factors for diabetes; I am not overweight, it does not run in my family, my fasting blood sugar was 84, 2 hours after glucola it was 72. My insulin was low. I am seriously scared now that I will get diabetes when I get older. I can't stop worrying about it. Here are some of my symptoms if you are interested:
I have been taking yasmin for 4 years. The first time I went off it 6 months ago I went from 120 lbs to 131 in 1-2 months, I got a lot of acne and some mild hair growth, and some spotting. The gyn just told me it was just my hormones adjusting. The endo decided just to try the met to see if I would get a period off my bc. I haven't gone off my bc yet because I am scared of the symptoms. My appt. is aug. 16th to check my testosterone on the met with no yasmin. I will prob give the met some more time and go off it at the end of july. One time there was a post on here about a website with the 5 types of pcos. I can't remember all of them, but they were like high androgens and no IR, high androgens and IR, just IR etc... Do you think this is true? I just don't want to worry about getting diabetes anymore. Thanks.

[elsie]

Hi Day by Day,

I'm sorry if I worried you unnecessarily about your diabetes risk. It's true that 75% of women with pcos are thought to be ir...you could be one of the 25% that is not. You're also right that there are 5 clinical subtypes of pcos, although I can't remember where in all the research you can find that info, I know that I read about it at one point.

The main reason I wrote for you to be extra-vigilant about any symptoms like unexplained weight gain and fatigue is that we are all programmed culturally to think that weight is completely controllable by lifestyle. Normally, it is, but ir/prediabetes is a metabolic problem, and if you have it, you're one of the unlucky ones who can't diet and exercise away your body's failure to use insulin efficiently. It's great that you are so committed to healthy habits (especially at such a young age) but I just wanted you to know that if for any reason you are seeing substantially different weight and energy results for a similar level of exercise and good nutrition, it's important to have new fasting glucose and free insulin tests.

I know that it's very upsetting to find out there's even a potential of diabetes in the future...I was ok with my pcos diagnosis until I found out that the real concern was ir/diabetes. Then, I got very upset. Still, I look at it most days as the best motivation I need to keep healthy, and now it's just a part of me that I accept. I actually find the cosmetic symptoms of pcos much harder mentally to accept most days. So again, I'm sorry if I worried you but I just wanted to make sure that you realize things do change over time and it's important to have a good endo you trust keeping an eye on things. Good luck :)

[Gen224]

Hi DbD--

I think what Elsie wrote is right on the money. I would encourage you to continue to research your diagnosis and turn your fear in to action and motivation to remain healthy. Yes, with PCOS your chance of being diabetic later in life is greater, but it's also greater if you have babies that are over 9# and/or have gestational diabetes. And while diabetes isn't anything any of us strive for, it IS manageable. My grandmother had it (although she wasn't type 2, she had type 1), and it's INFINITELY easier to manage the disease now than it was when she was alive (she died in 1976).

Fear will do nothing productive in your life. Courage is doing something even while afraid--I would encourage you to find your courage and educate yourself. When you do this and see all of the parts of this condition, you will find your strength and courage and you'll not be frozen in place by fear. FEAR is an acronym--False Evidence Appearing Real. Fear can make you inactive and I believe fear can kill--but moving ahead in courage gives you the ability to cope and learn and help others as they learn of their diagnoses and need encouragement from those who have BTDT. :)

So move on in courage, dear cyster! You're worth it and you're infinitely stronger than the fear that has you immobilized right now. :)

[daybyday]

Thanks for your encouragement. I suffer from depression so it is hard for me sometimes to have courage. But, I am working on it and people like you just make it that much easier! I know I may be digging into this a little much, but I just need some answers. It seems I have been researching and researching overload since I was diagnosed, but I still don't have many answers. Maybe you can help me with something. Here are my lab results from when I was off the bc and met:

Insulin Fasting: 6 reference range: 4-27 * this seems low!

Insulin after 120 mins: 23 reference range: 22-79 *this seems very low!

Glucose fasting: 84 reference range: 70-110 *this seems lower too!

2 hour Glucose: 71 reference range: 70-155 *Low too!

** This definately does not show that I have insulin resistance because the numbers are so low, am I right? So maybe I have PCOS without IR? Is this possible? So why then do all the articles say that met may help these women with their PCOS symtoms if they do not test IR? If it helps with the symptoms, then does that mean that I am IR? I am so confused! Also, couldn't the symptoms that I got after I went off the pill (acne, small wt. gain) just be my hormones adjusting? The only symptom that I had before I ever started the pill 4 years ago was a little excess hair, no acne, weight gain etc. So my ultimate question is: Could I have the type of PCOS that includes high androgens and no IR? If so, how can it be treated? If I do not always want to take yasmin, what can I take instead? Another: How long should I wait after I stop my yasmin to supposedly get my hormones back to the way they were before I ever started bc w/out the ance etc? Sorry this is so complicated.

Other lab results:

DHEA: 7.1 reference range: 1.9-7.6 *higher

don't have testosterone #'s with me but were on the higher end

FSH: 5.1

LH: 13

On the yasmin, DHEA, testosterone and FSH/LH ratio are all normal.

THanks for everything!

[elsie]

Hi Day by Day,

You have some really good, quite technical questions that we could try to answer or point you toward the right research, but it sounds like you really need to ask your endo to put your individual situation and treatment in perspective. Don't ever feel that you can't book an appt. with your md, and possibly a nutritionist, just to have your questions answered.

The major long-term health concerns associated with pcos are ir risk (which usually results in difficulty maintaining a healthy weight, along with risk of diabetes), endometriosis/uterine cancer risk from lack of af, and infertility. If for whatever reason you do not seem to suffer from any of these problems with lifestyle efforts alone, no additional treatment may be warranted at all. The annoying cosmetic problems are only symptoms, and may not respond to treatment anyway. The point is, it's important for you to assess your "global risk" and have a treatment plan. It sounds like maybe your endo never explained adequately why s/he rx'd met. I think the solution is to book an appt. or at least a phone call.

And again at the risk of scaring you unnecessarily, I want to re-emphasize that while your numbers are all excellent now, things can change over time -- particularly after having children. Many of us probably had similarly healthy scores at a younger age, but have found over time that we cannot sustain them with the normal lifestyle changes everyone has to make as they age and their metabolism slows. The great news is that the right treatment can return our numbers to ideal levels -- I had my annual endo appt. recently and my glucose numbers are almost identical to yours. Granted, I take 1500mg of met daily, but I was exercising far more than this when I was dx'd and had scores in the pre-diabetic range. I had thought I was in the best shape of my life, but am now grateful that I found out what was wrong on a cellular level. My endo reminds me at every appt that we pcos'ers are very lucky to have such strong motivation for healthy habits at a young age. So take heart and book an appt. with an endo asap. Good luck :)

[Gen224]

Hi DbD--

I am so glad that we can encourage you in the right direction. :) That makes what this board is all about worthwhile to me....

Anyhow, a few thoughts for you:

1) You mentioned that your fasting insulin level was 6 after being off of met and bcp. Did you continue to watch your carbs after going off the medication? Did you carb-load before your test? While this can skew results in the pro-pcos direction (specifically towards IR), if you're not IR on your own, carb-loading won't make a difference. If you are IR, then you'll see a measurable difference. I would recommend asking for a repeat of the test in a few weeks/months and carb-loading for 72 hours before the test.

2) If you have the androgen-based pcos, it's possible, but your RE really needs to make that determination. The honest thought is that pcos is insulin-based and that androgen-based symptoms are "something else" (but they often don't know what that 'something else' is). Because the symptoms mimick insulin-disorders, it tends to get categorized as such. I think another fasting insulin (or GTT) would be in order to rule out IR and potentially rule-in an androgen-based difficulty.

That's what I've got for now....I hope you're having a good day and you're able to make heads or tails of your health-struggles. It's safe to say that this whole board is pulling for you! :)

[daybyday]

Thank you for all your encouragment and information ladies. It is very helpful. Genn224, I don't believe that I carb loaded before my GTT, heck I didn't even know what to do at the time. Now I have a better understading. The endo put me on met about 3 months after I got my GTT. I got the GTT at the obgyn that I work at and I just went to see the endo to get met to see if it would help. I did and he put me on 1500 mg recently To see if it would induce a period. I go back in a month. I do feel better on it. I am not as tired all the time, I can concentrate better, I do not get cranky if I'm hungary etc.. He is not a reproductive endo btw but is very knowledgable. So are you suggesting that I go off the met now and get another GTT and eat lots of carbs for 72 hours before my fasting GTT to get a true reading? I think that may be a good idea but I hate to ruin the progress that I've made with the met so far. Tough decision I guess. Thanks for everything again ladies. This board is so helpful and supportive through my struggle for answers!

[Gen224]

DbD--

if when you return to your E s/he determines that the met is not effective (enough) for your system and suspects an androgen overload (from whatever cause) and wants to take you off the met, then yes, I would ask for another GTT or fasting insulin test and carb-load prior to it. That's simply to rule out an insulin-disorder once and for all.

Honestly, if you're having success with the met (and with the tiredness, hunger, etc., it sounds like you are), then that alone suggests that you *are* IR and that you're on the right track.

One final word about test results--doctors talk about "normal" and "ranges of normal" when looking at empirical results on a page. But everyone's body is different and what may be "normal" for the general population may *not* be "normal" for your body. It's incredibly important for you to know your body and when these strange reactions started. If you can compose a timeline, all the better. But most people don't have that sort of memory-ability. ;) I had it before I had our son--now my memory isn't that good! :o Anyhow, if you know how your body reacted to food, exercise, and other factors in your life before the symptoms started, then even if your test results are "normal," they not "normal" for YOU. And that's what is important. ;)

[daybyday]

Thanks :D

[Leslie8007]

insulin ressistance is a common side effect of the disease the people who study this have now found........... so having the disease is the casue not really family history or anything else that could be a precursor to diabetis