Metformin for weight

[Bubble56]

Has anyone been given the drug Metformin to help the Cushing syndrome when on steroids? I know that at the moment it is trivial when life is as it is but I am bi polar and the weight gain is having a massive psychological effect on me. I exercise, walking and cycling as much as I can and I have consulted a nutritionist and my diet is excellent so I really don’t know what to do next. I am tapering down to 10 mg having been diagnosed in October with pmr.

Thank goodness for this site- you are all fantastic. Thank you.

[PMRpro Ambassador]

Your diet may be excellent - but is it also low in carbohydrates? Many of us lost weight having gained it or avoided it to start with by going low carb. Some of us are unlucky and need to be very low carb - Snazzy and I only lose weight at some 20g carb a day but we do manage to maintain our weight OK. Others manage simply by cutting processed carbs and added sugar. Cutting processed carbs also leads to a much lower salt intake - that is also important in weight management when on steroids.

[Bubble56 in reply to PMRpro]

Yes it is very low carb- I am meticulous about that because I have been utterly determined to keep my weight down and I discussed all that with the nutritionist. Have you had experience of Metformin because I have a call with my doctor this afternoon and was going to ask her about it.

[Hidden in reply to Bubble56]

It is not a recommended weight loss drug as yet. Why would you want to put a drug in that isn't needed?? If it's so hard to lose weight on the diet the nutrisionist is recommending I would change that aspect. It says that metformin does not often cause hypoglycemia, but it can and does. A hypo is not a pleasant experience at all and hypo can lower your mental mood and cause physical pain afterwards like a short flu dose.

[PMRpro Ambassador in reply to Bubble56]

Not at all - it is something I would never countenance to be honest. For all the reasons the others have already quoted so I won't repeat them.

The Diabetes Care study says that the average weight loss after a year is a mere 6lbs - and once you stop taking it the weight is likely to return. And like any drug metformin has adverse effects. There has been - as far as I know at least - no clinical trial done and the mechanism and potential risks haven't been looked at.

[Hidden]

I have taken it for 20yrs for diabetes. It is not a weight loss drug. It is a drug to reduce the glucose in your system for an illness and is not to be trifled with. If you have diabetes, fair enough. But I would say for weight loss a low carb, high fat diet (unless fat is not allowed...gallbladder). I lost over 2 st doing that rather than the Metformin which did not stop pred weight gain when I didn't eat fewer carbs. I would never trust a Dr who would prescribe it for weight loss.

[Bubble56 in reply to Hidden]

Ok thank you very much for your helpful advice. I had been reading about research that had been done on it and maybe I just got a bit optimistic!

[Hidden in reply to Bubble56]

Just a tad. It's basically a very harsh laxative for some.

[Bubble56 in reply to Hidden]

🙀

[SnazzyD]

Unless you are showing signs of actual diabetes (consistently high HbAlc results) I’d be very wary of taking a drug that is designed to keep your blood sugar down for fear of becoming hypoglycaemic and the other potential side effects. It won’t save you from fluid retention (that’s salt) or the Pred face because that is a different cause.

When I started on 60mg Pred I could only keep my weight stable by having next to NO carbs, low was still too high. So no 1 small potato on the side, absolutely no rice, pasta, potato, maize, flours, no hidden glucose or starches etc. My carb came from a bit of carrot and fructose in a little fruit. My desserts were two small pieces of 85% choc or berries and plain yoghurt, and dairy free for me. Can’t face it now but it did the job! I had plenty of fats, mostly plant based and protein. I’ve have not yet met any clinician who hasn’t seen weight gain on Pred as an inevitability and one seemed be surprised when I didn’t put on weight. He even thought I wasn’t absorbing the Pred at one point. I have found through others, that dieticians also often have a blank spot here too, most thinking the normal excellent diet will do the trick. Once I got to under 5mg I could be a bit more lenient and now on 0.5mg it’s even better but I still don’t have the usual carb on my plate and to be honest I don’t miss it. I’m gluten free so that does help because most carbs are not the same, but chips......

[SheffieldJane]

You really don’t have to apologise for this response. The weight gain is the most demoralising aspect of all this, as far as I’m concerned. I’d just started to like myself again when I had to move to GCA doses. I puffed up almost immediately.

As for Metformin. Well if you have type 2 diabetes it is advertised as not making you gain weight like other diabetes drugs. It gives you diarrhoea and kills the appetite. Doesn’t sound much fun. The disciplined amongst us cut out all the carbs and apparently win the battle. The rest of us avoid the mirrors and cameras for the duration. It does go, mine had, alas.

[tangocharlie in reply to SheffieldJane]

A friend is on it for T2D, it doesn't seem to have curbed her appetite, she eats anything and everything and I've always been surprised she's not fatter than she is, though she is by no means skinny. She does have to dash for the loo quickly an hour or so after taking it in the morning! For years I kept telling her about low carbs and even bought her The Blood Sugar diet book, she wasn't interested. Then she's seen my progress and since cutting down on bread and a lot of sugars her bs levels are coming down and she's starting to believe me.

[Rimmy in reply to SheffieldJane]

I know how you feel SJ - most of mine had dissolved - especially around the torso and again needing more Pred for a 'relapse' - guess what !!??

XX

[tangocharlie]

Interesting, I thought Metformin was only prescribed to contol diabetes. Are Doctors prescribing it for weight loss now then?

[Bubble56 in reply to tangocharlie]

I understood research had been done to help prevent Cushing syndrome and effects such as moon face and bloating but having read more about it just now it is only research!

[PMRpro Ambassador in reply to Bubble56]

I doubt it prevents Cushings per se - just might possibly help with the weight. Maybe ...

[Hidden in reply to tangocharlie]

It started being seen as a weight loss drug after a study in the US. I have not yet heard of anyone who has been prescribed it purely as weight loss. I lost weight initially in 2001 when dx with diabetes but I think my diet changed significantly then in terms of quantity. All Drs seemed to still recommend carbs loaded diet then. The effect doesn't last, or didn't in my case even though my diet pretty much stayed as it was at the start in 2001. The only way is a good diet you can stick with forever or for at least the majority of time,non terms of diabetes and pred ...the low carb approach ....as far as you can take it and remain with it. Of course some drs outside the UK may prescribe it. But I remember in the early days having several hypos. Another woman I know actually dx with diabetes ended up in hospital with a hypo. So if your hba1c is "normal" , it's not a drug that in its current form should be messed with.

[ali5son]

Managed to lose weight after 10mg pred using a well known low carb diet bars and shakes

[Bubble56]

That’s encouraging and I needed to hear that ali5son

[Hidden in reply to Bubble56]

You can do it bubble. Sit down for 5mins and just relax. We all struggle with it but have to find a way that works. Most of us that try low carb, replacing all or most the carbs with good fats for satisfying appetite find it works. But low carb does not work for everyone. To be honest. I always do better when I am focussing on other things. Lockdown and a limited life that is dictated by ensuring you get shopping isn't the best environment!!! I normally shop every other day and get fresh stuff. Getting a delivery every couple of weeks is not good for me!!! Good luck. 🌻

[Bubble56 in reply to Hidden]

No, luckily my husband has started doing the shopping 😂 and we are eating lots of good quality fresh veg!

[Hidden in reply to Bubble56]

You are sooo lucky. I do get a veg box every week so lucky that way but there's nothing like picking up your own veg. ....shopping wise I mean. 😂🤣😂

[Constance13 in reply to Hidden]

If you can bend there are quite a few things you can pick up over here. Just remember to ask the farmer first.😂😂

[Hidden in reply to Constance13]

🤣😂🤣

[Koalajane in reply to Bubble56]

Please remember that a lot of veg and fruit has a fair few carbs in them

[Rimmy in reply to Koalajane]

Yes and 'ridiculously unfair' I reckon !!

[Hidden in reply to Koalajane]

Yep....stick to the green ones where poss.

[PMRpro Ambassador in reply to Hidden]

This time of year is great - asparagus time! And cheap as chips this year so far with all the restaurants being shut! Otherwise it is a funny selection of veg in May - all the sort-of-winter veg gone, summer ones not in full swing yet.

[Hidden in reply to PMRpro]

Except I got it in veg box and it took up 3.50. it wasn't a very full box that week. It's one of my faves. And people forget about the wonder that is black kale...my best kale. It can be stir fried, creamed like spinach or torn , seasoned and crisped up in the oven like crisps. ...of such things...parmesan grated the put in the oven and allowed to bake so crispy....yum. Not even 10am and thinking about food...again. 😵

[PMRpro Ambassador in reply to Hidden]

Give me details of the kale - can't get my head around it somehow but available here, Everything is seasonal here so they have loads of asparagus for people to go out to eat. Mainly white but there is green too. White is better ...

[Hidden in reply to PMRpro]

It's Italian..cavolo nero...from Tuscany apparently. It's more robust and can be seasoned and oiled for crisps. I like salt, pepper, paprika and a bit of chilli. Yum.

bbcgoodfood.com/recipes/spi...

[PMRpro Ambassador in reply to Hidden]

I know what it is!!! That's why I asked how YOU do it!!!!

[Hidden in reply to PMRpro]

I am off my head this morning. Did the family quiz at 9am ...thought I hadn't at 11am so answered tomorrow's. 🤦‍♀️

Salt pepper and paprika and cayenne it chilli, I prefer groundnut oil. Then around 120 in my fan oven which seems to run hot. I start at 20mins and see what happens with a shake. If you can take salt without blowing up then a nice sprinkle of finger crushed sea salt. .....I did have some nice ones with cashew butter from marks once but never saw them again. When I can go shopping I may try it...probs this time next year as I couldn't get black kale this year to grow....yet.

[PMRpro Ambassador in reply to Hidden]

Do you use it as a vegetable too?

[Hidden in reply to PMRpro]

Yes. In stir fries just shredded. And I steam it or fry it shredded like spinach or cabbage with some cream, but I bet marscapone good too. Lots of white pepper good with all green leafy veg I find. Kalettes are good roasted too. It's the tender tops of green kale.

When I grew black kale last year I kept picking the really tender baby leaves for salads too. I have 3 different kale seedling growing at the moment and Swiss and rainbow chard too. I made some lovely chard gratin. Greens in general just steamed then buttered and nutmegged nice too.

[jaycee444]

Started a low carb diet as soon as was put on Prednisolone and my weight has stayed stable. I thought I would really miss the carbs - especially bread which I love but in truth I havent. I really love my low carb diet now and intend to stay on it even when I no longer need steroids.