Metformin Questions:) Help so confused

Pure

I really want to consider taking this but my doctor did my blood sugar and said noway. I know I can buy it myself or get my primary to do it but I am scared it would interfere with the pathway that metabolizes my antihormonal. Has anyone looked into this? Also, does anyone have any of the latest research showing its promise. I really appreciate your feedback!

TectonicShift

My pcp gave metformin to me when I asked.

She also gave me simvastatin because of this: http://www.dailymail.co.uk/health/article-2055372/Daily-dose-statins-cut-risk-breast-cancer-30.html

(My onc wouldn't give me either.)

clariceak

Here's some reading for you.  Obviously, there are different opinions and trials are ongoing.

http://community.breastcancer.org/topic_post?forum_id=79&id=757520&page=7

hopefour

If you go to the  "Metformin and Breast Cancer" thread Nattygroves posted a link that shows an interveiw with the doctor who is behind the trails for Metformin. It is informative and may help with the info you seek. 

Joyfully, Hopefour

geewhiz

I take it and have low blood sugar( it stays in the 50-60 range...I am vegetarian and steer clear of processed foods) .

It does not effect me in the least. It operates on the insulin pathways. LOTS of amazing stuff going on with it. It is a 30 year old drug with minimal side effects across the board.

My pcp initiall wasnt going to give it to me, but then researched it a bit and now prescribes it off label for ALL her cancer patients...it's that promising.

Timbuktu

I got metformin because my sugar was slightly elevated and I asked for it because of the cancer study.

One warning.  The other day i just had a piece of fruit for breakfast and went shopping.  I nearly passed out.

I felt as though I was going to die right there in the store.  My knees were buckling, my heart felt strange.

i ate a little something and my strength returned.  

I told my dr about this and it turns out that you have to eat when you take metformin.  Even though my sugar is high, if I take metformin and don't eat regularly, my sugar can drop and i can pass out!  Thought I'd pass this on

because I had no idea. No dr warned me.

Momine

I am planning to discuss it with my onc next month. My fasting blood sugar has hovered around 95 since my DX. It is not diabetes, nor pre-diabetes, but it is danged close at this point. When I tried to discuss it with my surgeon, he just waved me off, told me not to worry and that if I became diabetic we would deal with it then. 

Type 2 diabetes is rampant in Greece, and Greek doctors still use 110-120 as the cut-off for "normal," so it is hard to get them to think proactively about this. My onc is US-trained, so I am going to see what he thinks.

RosesToeses

Pure, I don't know about AI's, but I'm on tamoxifen and in the metformin trial.  So, just confirming that my onc doesn't see an interaction problem there.

Also, because of my inner mother hen I wanted to add a link to the American College of Radiology's guidelines for Metformin here: http://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/Contrast Manual/Metformin.pdf  since on the other thread some people were talking about getting the drug without a perscription.  There's a risk of deadly interaction with IV contrast for CTs under the right conditions, so please be careful especially with the scans!

Pure

This is all really good info! I really appreciate it. I started taking the Green Tea supplements that is suppose to do something similar to Metformin. And yes if I don't eat I get a little lightheated. Thank you so very much!

Momine

Even if you are not on metformin, it is a really good idea to stick to regular meal times and eat properly at all meals. It will help keep your blood sugar staple.

SelenaWolf

I am, also, taking tamoxifen and am in the Metformin trial.  There is nothing in Metformin that will contraindicate the tamoxifen.  Metformin stabilizes blood insulin levels; tamoxifen is an oestrogen-binding agent.  They operate very differently.

Outfield

Rosestoeses, there's actually no interaction with CT constrast.  The issue is that CT contrast can cause kidney failure (almost always in people with some predisposing factor), and in the situation of kidney failure levels of metformin can build up in the body to toxic levels.  

Pure's question about drug interactions is a very good one.  Drug interactions often don't have anything at all to do with what the drugs are for.  Think of Paxil (an antidepressant) and tamoxifen, or clopidogrel and omeprazole (an platelet inhibiting drug and a drug that reduces stomach acid).  Most drugs are processed through a set of enzymes in the liver.  Some drugs cause the liver to make more of a particular enzyme, other drugs can sit on an enzyme and basically take up its time, making it less generally active.  If there is a second drug that is processed by that enzyme, changesin enzyme activity levels caused by the first drug can change levels of the second drug.  A slightly more complicated interaction is if action by the liver is needed to make a drug active in the body.  Tamoxifen itself doesn't do much.  It's what is called a "prodrug," and the active form is actually produced by the action of the liver enzymes on the tamoxifen.  Paxil slows down those enzymes, so they don't turn the tamoxifen into its useful form at the rate they should.

Metformin in general doesn't have a lot of drug interactions because it's not a drug that has much effect on liver enzyme activity.

Pure

These are great responses.. Does anyone know what phase of trials they are in and what the prelimary results are showing?

Timbuktu

My onco said that the results are very promising and if I can stay on it I should.  My surgeon said it will still be a couple of years before the study is done.

Sometimes, when the results are stunning, they will stop studies.  It seems that hasn't happened yet.

RosesToeses

Outfield, thanks for clarifying about interaction vs. what ever you call the "one-two punch" effect you're discribing--good to have someone with your knowledge around!

SelenaWolf

I was notified about the Canadian leg trial in May 2012 and was told that I qualified for it because I had had breast cancer surgery within the previous 12-months.  I'm not sure how long its been going on, but I would assume that it is still within the first few years.

TectonicShift

There are more than 300 different open trials going on right now involving metformin if you look at clinicaltrials.gov. The big breast cancer recurrence trial is a phase III trial. It's only been going on for a year or two though, so it will probably be several years before preliminary results are published.