The One with the Mets
This post is brought to you by paleo banana bread with chocolate chips, lentil pasta, the fact that sportsball is back, watermelon, burritos, Amazon Prime Agatha Christie specials, Adam Driver, and sitting on the floor when you have a perfectly good desk to write at.
So, when I say 'mets', do we think of the Cincy-based sausage? Or do we think of the New York sports team? I think the former is spelled differently. Whatever.
We're talking pills, baby.
Specifically, Metformin: A drug generally associated with diabetics, now in my medicine drawer. Yay! I'm not diabetic, so, what's up with that?
One of Metformin's off-label uses is to help women with PCOS. To understand why, let's revisit the biochemical roots of this disorder:
The Underlying Causes of PCOS
According to Healthy PCOS, there are five usual hormonal culprits that lead to this disorder. Basically, if any of the following are out of whack, it's gonna lead to PCOS-ish trouble:
- Insulin: Regulates your body's response to sugar
- Androgens: Typically a male sex hormone
- Cortisol: Modulates your body's stress levels
- Progesterone: As our FCP deftly put it, "pro"=before, "gest"=birth; hormone that gets your bod ready for alien invasion
- Thyroid (and related hormones): Gland that does a crapload of stuff in your body, from governing metabolism and digestion to contributing to brain and bone development
I think we've discussed all of those in a decent amount of detail here, already - except, perhaps, for insulin. (We're also going to continue talking about the above fab five, so, get pumped.) Insulin, however, is gonna be today's focus.
Of the hormones above, it's still unclear which linked imbalances lead to PCOS, and which result from it; in other words, which are causative and which are correlative. (Despite the fact that PCOS is affecting a growing number of women, it's still not super being studied, which, what.) However, it's widely assumed that an insulin imbalance or a high amount of androgens is typically at least associated with a root (genetic?) cause.
[Brief plug for Healthy PCOS: Dude who runs the FB account owns a supplement company and is obvi trying to sell women on his product. However, his marketing strategy seems to be 90% genuine, interesting, science-backed info about PCOS, and 10% testimonials to buy stuff, which...is a marketing strategy I can respect. I'm not a customer, so I can't speak to his stuff, but I highly recommend an FB follow if you're interested in learning more.]
What Up, Insulin?
Let's take a literal second to go over how insulin normally works in a healthy body: Basically, insulin helps shovel sugar from your blood into your cells, where it can be used as energy...instead of sugar just floatin' around in your blood where it's not doing much, except for causing a lot of harm.
But wait! Here's a (really short, helpful) video:
Natural Ways to Manage Insulin or a Sugar Imbalance
Easy; you can eat well and exercise more. Problem solved. However, for a woman with PCOS, it's not always that simple. (Tbh, for a normal human being, it's not always that simple.) Anyway, I'm writing this section last, and this post is already freaky long -- we'll talk more about natural ways to manage sugar next week, when we talk about what it's like to randomly go vegan for a month YAY.
What Metformin Does
Basically, three things, courtesy source, source:
- It makes your body more sensitive to insulin...artificially increasing insulin's efficacy. This means that insulin can do a better job of taking sugar out of your blood so your cells have energy to do things.
- It decreases your body's ability to absorb sugar...so! One of the ways that sugar enters your system is via your diet, obvi. When sugary foods slosh through your intestines, sugar gets slorped into your bloodstream. Metformin makes that happen less.
- Metformin inhibits glucose production by the liver. Less, sugar, less problems, right? In addition to stopping external absorption of sugar, the drug blocks internal production, too.
Trifold attack: Metformin boosts the way your body deals with sugar, and makes sure that there's less sugar in your system to begin with.
Of course, if you're able to control your body's sugar levels naturally, that's probably a better long-term solution.
In my specific scenario, sugar was never my problem. (In fact, if forced to guess between insulin resistance and high androgens as a root cause for my PCOS, I'd suspect androgens, first.) HOWEVER, women with PCOS are SUPER SUPER SUPER WAY LIKELY to be at risk for diabetes if they don't take care of themselves. Without sounding the alarum/being too paranoid, I was gaining weight and starting to collect symptoms that could have started to sound like prediabetes. Stopping that train way the eff in its tracks now = something I'm not sad about.
Okay, so that's what Metformin does...re: insulin resistance and diabetes. I'm on it as a fertility aid. How's that supposed to work?
PCOS = weird hormonal ish = you don't ovulate, or, at least, that's how it's worked out for me. Insulin's one of the hormones that often misbehaves in a PCOS situation. At the very least, if you're taking Metformin, you're ruling out one of the usual suspects.
There are some studies or reviews (here's one) which show that Metformin can be compared favorably to Clomid in re-establishment of normal ovulation (where Metformin works slowly, because it attacks root causes, and Clomid jumpstarts the system to get things going *that cycle*). There's also some evidence (same source) that shows using the two together has an additive effect for better ovulation.
In some women, the insulin resistance leads to increased androgens, making an insulin sensitivity drug a one-two-punch for hormonal...betterness.
Lastly (for now), there is some cause to believe that if you've got PCOS, taking Metformin can reduce super-early miscarriage, probably due to the overall improved hormonal profile associated with the drug. We suspect that that's one of our issues, so we signed up fast. As with most things for PCOS, it's controversial and not super studied, unfortunately: but my doctor has seen anecdotal success, so we're trusting him for now. Also, it's cheap, which helps.
(Okay, one last thing: if you google 'metformin success stories pregnancy', you'll find 2985u9832 testimonials of women a) struggling to conceive for a billion years, b) going on Met, and c) getting knocked up three days later (basically). Obviously this is a skewed sample selection, obviously I'm looking for the data I want -- but it's comforting nonetheless.)
My experience thus far with Metformin
I mean, spoilers, I've been on it for almost two months and we haven't seen success...yet. But that would have been...a lot to expect. All in all? Nothing super crazy. My doctor started me on a low dose (500mg/day) with the idea to ramp up to 3x that, eventually.
Cons: Nausea. If you don't take it with food, you feel like crap. Not to be dramatic, but this doesn't help with two-week-wait confusion, when literally everything that happens is like OH MY LAWDY IT'S FINALLY HAPPENING; pseudo-pregnancy-nausea because of infertility meds = double not-fun.
Side note: My first cycle on Metformin was slightly elongated, but we'd also done a ton of travel that month, so it could have been stress, too.
Pros: I mean, as with everything, just knowing that I'm doing anything to get myself healthier reduces my stress levels and gives me some hope.
With this cycle, we're noticing an interesting trend, though...
My temps are up!!! (Remember, they used to be at ~96.6 pre-ovulation.) Literally no idea what's causing this, because we're throwing a million things at my body at once. But this is fun to see.
Why are we so excited about this???? Because, at its root, I'm pretty sure my infertility issue is a hormonal one (see everything above, and in past blogs). Hormones aren't something that you can measure easily at home. However, hormones do have their figurative fingers in just about every pot...in a woman's body; I regret that metaphor. I was pretty sure my weight gain was hormonal. So was my insomnia. And other things.
Seeing as we can't easily measure hormone levels at home, scrutinizing these secondary effects can give us an idea that something is changing...likely for the better. It gives us hope that next time we go in to do a hormone panel, it won't be really bad news.
Which, like, future not-bad news: Isn't that what all of us could use a lil bit more of in 2020?
Our drug-related plans
I should note, to end this post for today, that it's the opposite of my plan to be on a chronic medication for keeps...starting at age 28. We're simply adding Metformin to the kitchen-sink-arsenal of things we're investing in *for now*. Later this year, when we formalize/unveil our [CUE TRUMPET SOUND EFFECT] Project Waterbear Battle Plan, we'll have a better idea of just how long I'm gonna plan to be on the med.
For right now, we're investing in it because we're trusting our doctor and we're seeing some fun results. Tentatively, I'd think that I'll continue to take it as long as it doesn't suck to do so...and as long as we continue to work with our Napro towards a healthy pregnancy. Stay tuned, though.
What else we're up to:
- I just realized that our German Shepherd might actually have some basic herding instinct!!! ...For herding me. I'd been wondering why Wilhelm would, when hungry, decide to bumble along behind me, helpfully booping the back of my knees with his noggin en route to the food drawer. Literally just today we put two and two together. It's adorable! I hate it. (Wilhelm does *not* herd Ted in this way, which raises some questions about what Wilhelm thinks the hierarchy in this home is.)
- Want to know a ridiculously effective way to feel better about politics season and election-related gloom and doom? Watch Parks and Rec, season 4. You know, when Amy Poehler and Paul Rudd are duking it out for a city council seat? It's beautiful and fantastic and all things good. Basically therapy, at this point.
- Another way to feel less down about the next six weeks? Ted and I have joined the Biden TextTeam; we're pulling our first (non-hard, non-invasive, actually-kinda-fun, only-an-hour) shift today. We watched a documentary last night that reminded us (again) that the majority party in 2016 was non-voters. Guys. Um. Vote? So, we're texting people to remind them, basically regardless of their affiliation, but also, #BlueWave.
- You know when you find a cheap product that actually makes your life a lot better? This week, I found two: these AmazonBasics silicone muffin things, and this pill organizer. Cleaning out muffin tins is *the worst*, to the extent that I'd stopped making muffins. These silicone things are ridiculously easy to use, and basically don't require cleaning (note: I do clean them). The pill organizer? It's probably saved me like an hour a week...and a lot of mental energy. I take 25320943890 supplements, and I'd been laboriously counting out each of them multiple times a day. Hilariously/worse, I (like a ridiculous problematic goon) have toted these 909324809385 *glass bottles of pills* with me to each of the 01293128447 trips we've taken this summer. Things are ... better now.
- Also also, cool thing alert, Verily Magazine - a pub I've been writing for for about two years - asked me to write a thing about infertility!! My lovely editor read a PWB piece and reached out; and, as a result, I have a piece running on Tuesday - I'll share it then (and link it next week).
NEXT UP, we're gonna talk about how goin' vegan has been. (It's been okay.) But! We'll discuss the meat substitutes that don't suck, the plant-based recipes that have actually been really great, and how this has affected the whole weight loss game.
AFTER THAT, buckle in, guys, because I'm handing the keyboard over to Ted. He's going to delve into the paperwork and price of infertility thus far...as well as what we're anticipating going forward. (This is not our Battle Plan. The arrival of our Battle Plan will be heralded by majestic fanfares for weeks in advance. It will be very obvious. And exciting. I can't wait.) As a heads up, this post will likely be wayyyyyy more intelligently researched than anything I hastily throw together, so it's definitely worth clicking over for!!!
WEIGHT STUFF:
'Tis all. Ted's got a game to watch, I've got some tapping on a keyboard to do for the next several hours, and then it'll be Monday again (and October later this week!!?)
Stay safe out there!