Friday Chronic Roundup: August 1, 2008

PCOS/Insulin Resistance/Diabetes/Infertility

• The "fat gene" talk again
• One nutritionist's approach to PCOS treatment
• Another hint that tumeric might help Type 2 diabetes
• Can metformin or glyburide help prevent Alzheimer's in Type 2 diabetics
• The heredity/genetic link of PCOS
• Researchers have identified the functional role of the Lrh1 gene in regulating ovulation.
  

Interstitial Cystitis/Pelvic Floor Dysfunction/Vulvodynia/IBS

• What treatments for IC reduce healthcare costs?
• Another IBS drug trial moves forward.
  

Asthma/Allergies/Celiac Disease

• Results from heart research to be applied to asthma research
• Research on alternative allergy therapies is promising
• Does the consumption of nuts during pregnancy contribute to childhood asthma
• I guess this is supposed to be grand: people with long term asthma, hay fever or allergies are up to 25% less likely to get the most common type of Non-Hodgkin Lymphoma.
  

Chronic Fatigue Syndrome/Fibromyalgia/Lyme Disease

• Caution: Lyme disease rates are up this summer.
  

Mental Health

• Depression is shown to abate with constant electrical stimulation
• Does spanking lead to depressed toddlers?
• The work of proteins in DNA that cause depression
• Scientists have found the mechanism that causes postpartum depression in mice
  

Met is a Good Bet

Turns out Metformin is a good bet for those with PCOS, regardless of whether they have the often-accompanying Insulin Resistance.

A study in the Irish Medical Journal evaluated the use of Metformin in PCOS patients. The study abstract states:

This study evaluated the use of metformin as first line treatment for patients with polycystic ovary syndrome. A retrospective review of patients’ files diagnosed with PCOS over 16 months in Department of obstetrics and gynaecology of a Regional hospital. The outcome was the response to metformin treatment regardless of the main complaint. Treatment response was measured by change in LH/FSH ratio, fasting insulin, testosterone, day 21 progesterone and/or pregnancy. A day 21 progesterone greater than 25.5 nmol/l and/or pregnancy were the parameter of ovulation. Thirty-four patients were diagnosed with PCOS. Twenty-five complained of infertility (14 primary and 11 secondary), six patients had oligomenorrhoea or amenorrhoea and three presented with hirsutisim. Seventeen patients received metformin as first line treatment. Eight received it with other treatment (5 clomiphene citrate and 3 ant androgens). Nine patients did not receive metformin. This study justifies the use of metformin as an appropriate first line treatment for PCOS.

(the bold is mine)

For those of us with PCOS, we can tell you the Met can do wonders. Maybe some more skeptical practitioners will now think twice when bashing Met as a PCOS-only treatment.

The Body Chronic Strikes Back

I've been meaning to blog about my Day o' Doctors on Tuesday, but I haven't had the time nor the energy. It's an important story to tell, though, because it compacts a lot of what I've been going through into one stressful day.

9 a.m.
I go to see the nurse practitioner about my PFD/IC/VV. Last time I was there she gave me a prescription for Lyrica and a prescription for lidocane ointment. Neither have worked well. The Lyrica has cause me to gain about 15 pounds in a month and my clothes are much tighter. Not to mention, I have issues with weight gain/loss anyhow, I don't need any more uncertainty in that department. The lidocane wasn't not working but it wasn't working either. I'd have bouts of stinging and burning for 10-15 minutes after applying it that would cause me to flare up. The numbing properties were totally outweighed by this.
Now, instead, I'm on Neurotonin, which is like Lyrica only allegedly devoid of some of the side effects. I've only been on it for two days really, so I can't tell. I also have a small dose of Flexirill to take for muscle spasms. And the lidocane has been replaced by a compounded medecine cream with elavil in it (and other things). I still have to get the last one filled.

10 a.m.
Enjoy breakfast at a coney island. Go to the pet supply store to get cat food.

11 a.m.
Go to physical therapy.

1:30 p.m.
Go to new endocrinologist. Not surprisingly he bumps up my Metformin from 1000 mg to 2000 mg per day, orders blood tests and actually switches the Metformin to Glumetza, which has fewer side-effects (allegedly). I asked about Byetta after reading about people's success with it on the Soulcysters board. He says it might be a possibility but we should get the blood results first. He brought up the dreaded "obesity" word and the idea of bariatric surgery. He told me to keep an open mind but I've pretty much already made up my mind in the negative on that subject.

5:30 p.m.
Go to therapy...and definitely need it after having such a hectic day of doctors and medical professionals.

Net gain of medications: 1
Net gain of pills to take per day: 3 (Glumetza only comes in 500 mg)

So far, I haven't been able to tell anything except the following:
1. The Glumetza while not as harsh as the Met still has some side effects. I've had a couple bouts of nasty afternoon-nausea at work from it. I've decided to split it up--1000 mg in the morning, 1000 mg at night.
2. The Neurotonin/Flexirill makes it really hard to get up in the morning.

The one thing I have simply GOT to do is to change my eating habits. But I know what it requires and it's not easy. I've had much success before with a low-carb lifestyle and exercise, but my circumstances have changed a lot since then. But more than that I know how hard it was for the first month especially. And I'm not sure I currently have the inclination to put myself through that.

So we'll see. As all things medical go, we shall see.

Pumping Iron

I've had trouble with multivitamins in the past. So I consulted my father in law (who is a retired pharmacist and also has Type II diabetes) about what vitamins to take with metformin. In a car-problem-induced trip to the mall, I stopped by GNC and picked up the following:

B-50 Complex (as metformin blocks B vitamin absorption)
B-12 Tablets (see above)
Chromium 400 mcg tablets (helps insulin levels)
Cinnamon capsules (helps insulin/glucose levels)

I've taken cinnamon before, but the others are new. I keep telling my husband that I'm going to get all tough like metal from the chromium. I took them yesterday and forgot this morning. But then i thought that it might be good to take them at bed time anyhow as they may cause some nausea.

I was thinking about adding Vitamin D as Vitamin D deficiency could be the cause of some of my exhaustion. We'll see how this goes.

I didn't know until this weekend that cinnamon is an "oriental herb" (according to the GNC bottle). Apparently it's true. Who knew? I never associated cinnamon with anything Asian. Well, I'll be damned.

Bear this in mind

Chomium can be helpful for insulin resistance. I've actually heard this somewhere before, but it's nice to hear a personal perspective.

So this weekend my goal is to get started on cinnamon (500 mg) and chromium (300 mg) and possibly a B complex vitamin. I've been told by my retired pharmacist father in law that I need B vitamins to supplement my diet with the metformin.

Onward and upward!