This will be cross posted to the PCOS forum and general discussion.

I am writing with a heavy heart today because the PCOS I struggle with is fighting back and now my hormonal battle just got more complex.

Prior to surgery, I took Metformin and hormones to help with PCOS. I got WLS because beyond the ~20 lb loss from the metformin, I was unable to lose weight despite a low carb diet and exercising hard at the gym. 

I went off the meds and hormones for over 1 year 7 months.  Around March 2015, my endocrinologist declared my labs were normal and congratulated me for beating PCOS. I was happy but kind of had to wonder as I was still having acne, darkened skin, and hair issues..but maybe it really was something in my heritage/family tree (i.e. just being a hairy woman).

Unfortunately, despite eating low carb and a low GI diet, my Hb A1C is 5.5 (it is in the upper limit of normal; the upper threshold is 5.6). Thank god for the vets that tell people to eat protein forward/ low carb. Had I NOT been eating this way, I would certainly have been in the pre-diabetic range or at least in the "monitor closely stage".

My free and bound testerone is also high.

So now I am back on metformin.  Interestingly, Metformin seems to absorb better and have a better bioavailablity AFTER RNY as compared to non-RNY patients. So this may be the ONE drug on the planet that does better after WLS.

 

http://www.diabetes.org/research-and-practice/patient-access-to-research/gastric-bypass-surgery-can.html?referrer=https://www.google.com/

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114332/

Effect of Gastric Bypass Surgery on the Absorption and Bioavailability of Metformin

Raj S. Padwal, MD, MSC,1 Raniah Q. Gabr, MSC,2 Arya M. Sharma, MD, PHD,1 Lee-Ann Langkaas, LPN,3 Dan W. Birch, MD,4 Shahzeer Karmali, MD,4 and Dion R. Brocks, PHD2     What I am most worried about is the progesterone and other hormones I am going to have to take. Prior to surgery, an oral birth control would have handled it. NOw, my endo is referring me to a gynocologist to get it all figured out (along with preventing pregnancy ).   It would have been easier to have a "remedy" (there is no remedy for this) to combat these symptoms had I had the slee***** WLS. To be clear, I do not regret RNY. I Love my surgery. But alternatively, it makes the treatment "landscape" so much more complicated and limiting.   While resolution of PCOS MAY occur, I knew going in it wasn't 100% thing.  I was really pleased to be PCOS free for a few months.   But I am scared and disappointed too.  I WI**** could have gone away forever, hence the disappointment.  I am scared because the last time I had a flare up, I could gain 7 lbs a week WHILE on a diet. I am afraid that I will regain my weight and have no mechanism to get it off. LIke I used my one nuke (WLS), I dont have anymore weapons in my arsenal beyond anorexia, but anorexia isn't a sane, normal option is it.   Sometimes, I really really hate my body and how it turns against me.   That is it. -SS

We are sorry to hear all you are going through.  Hopefully things will get better soon

I am sorry.  I am glad that the Metformin works better post- RNY.  Just keep taking care of yourself.

Nothing more heart breaking than to see a diabetic 5yr old with an insulin pump hooked up to his waist - testing his own blood sugar at a party so that he could maybe select one party goody this past weekend.

Best,

Layla

 

I am not sure where did you find out that 5.5 is really bad. .. 

because our body processes the sugars and proteins in a very special way- our A1C could be higher than a normal, non RN person. I have to be on steroids -and mine A1C of 5.6 is consider "normal". 

Just make sure the benefits of metformin out do the possible side effects. 

 

PCOS is NO fun! My doctor many times told me that "Once you have the expected weight loss then hopefully your PCOS will be manageable." Never once did he say it would be cured. Cured would be what I was dreaming of! Its wonderful that you're so proactive! Just dont let this get you down! 

Thank you so much for posting this! Talk about perfect timing. I am only 10 weeks post op and am struggling for every ounce I lose. My PCP immediately took me off of Metformin after my VGS. I went back in this morning they've put me back on. I'm really hoping this will help.

Ok... scratch that.. I'm PRAYING this will help. lol

WereYorkie,

So far, no weight loss for me. I have had to use the toilet 3-4 times a day though for a BM.  COnsidering that I used to go only once every three days, this COULD be seen as an improvement (but i dont think so).

Stay strong, stick to your surgeons plan, workout when you can, and make good food decisions and just know that you did the best you could.

My heroine (spelling?) Midori Ito (the first woman to land the triple axel in figure skating has a great quote that kind of puts into perspective and gives me relief:

 

" I have no regrets because I know I did my best -- all I could do...."- Midori Ito

 

For me to lose and get down to a "normal" weight, I pretty much had to eat meat and non starchy veg and that was it.  I also had coffee and tea with cream. NO sugar ..and if it needed sweetening SF sweeteners

For example, chicken with a side of cucumber (salt and peppered..or maybe some tazaki).

Good luck.

I am praying for both of us!