Metformin prescription?

sandilee

For those of you who are not diabetic but have Metformin as part of your treatment, how did you get your prescription?  Being still in the experimental stages, many oncologists don't prescribe it unless your glucose readings are abnormal, or you are over their recommended weight.

  I'd love to hear how you came to be prescribed the drug, for those of you who take it.  It certainly seems promising, given all of the information out there.

AlaskaAngel

sandilee,

Western medicine hasn't provided as much emphasis on diet, exercise and the metabolic actions in regard to the effects of menopause and treatments like OA or chemopause, so in general, doctors are mostly way behind the curve in trying to use drugs like it in responsible ways. They just aren't educated with that focus.

I had no other chronic health problems. The metabolic limitations as a postmenopausal breast cancer patient were getting worse and worse for me to try to deal with day-to-day over time as a long-term survivor. I have credibility with my PCP, but instead I first demonstrated that I was doing everything "right" that I "should" be doing as a postmenopausal patient in terms of diet and exercise -- and it wasn't working, and I was continuing to struggle with weight issues. (EDIT: I saw the cancer center dietitian at considerable expense for 2 years, without improvement.) I then went to an endocrinologist, who then did thorough blood testing and verified that my diet was exactly what it should be. He then recommended that in order to compensate for my miserably slow metabolism and maybe to speed it up a bit, that I exercise 2 full hours a day 7 days a week instead of an hour a day 7 days a week.

That probably would have worked, except that at my age, with the extreme drop in testosterone (which maintains and builds muscle), I was not willing to put my joints and the rest of me through that. I decided I hadn't worked all my life just to devote the rest of it to exercise.

I knew about the various benefits of metformin and its long history of use, and the research being done with it. I explained to the endocrinologist  that there were various trials for cancer patients being done using metformin, and asked him for a prescription. He prescribed it to me. My PCP continued it. I maintain my daily exercise and a healthy diet that is about half what I ate pre-cancer treatment, and I use occasional low-dose metformin. I do believe in the careful monitored use of it.

A.A.

lintrollerderby

I had a history of Polycystic Ovarian Syndrome (PCOS). Metformin is widely-used for this condition, but I had never been on it. I read about the clinical trials and brought the info to my PCP and mentioned that if she didn't want to prescribe it for my TNBC, it was indicated for my PCOS. She heartily agreed.

JAN69

After reading about Metformin on some bco threads, I asked my PCP about it.  He wrote up a script right away, saying it is a long proven drug with few (or no) side effects.  I don't know how to tell if it has done any good, but I'm pretty sure it hasn't done any harm.  I'll be watching for other replies here.  Jan

sandilee

Thank you for your replies, all.

Jan-Did your PCP give you the prescription with no weight or health issues other than being a BC survivor?

If I were having problems with my weight, or had PCOS in my history, I think either my oncologist or GP would have no problems with prescribing it.  I'm actually of normal to below normal weight, and have no other endocrine issues, so I would need to an MD  who appreciates that it might be helpful for breast cancer and is open to writing a scrip off-label for potential tumor regression.

jenjenl

I can't answer only to say i am preparing to go to bat for it in July with my MO and he's a total pain in the ass!

SpecialK

What I have noticed is that many MO will not prescribe it because it is still in trials for use for BC and will recommend that people get it from their primary care docs, in part because those docs have much  more experience prescribing it for their patients with legitimate blood sugar issues. I have seen some MO prescribe it in a limited way for their patients who have high blood sugar from steroids taken during chemo. My MO suggested in speak to my primary care about Metformin. My glucose has hovered just over 100 since chemo, and I was on a statin for several years, high blood sugar can be a SE from them. I have discontinued the statin and have been fairly successful keeping my cholesterol numbers under control. My PC was on the fence about prescribing Metformin, if I had pushed it he would have done it. He was aware of the study and I provided him with a copy to read   I have a MO appt tomorrow and will discuss again.

AlaskaAngel

SpecialK, that is where I think we (and maybe MO's) need more input and/or research from some kind of specialist like endocrinologists. Again, we each tend to think of our own questions mostly in reflection upon our own diagnosis. What I wonder is whether premenopausal patients who are not overweight and/or don't have PCOS type situations or high blood sugars would be candidates, or not, because of the way in which metformin does its stuff. (Not saying they wouldn't, but just that I don't know.)

JAN69

Sandilee  I claim chemo brain.  It's been at least 3 years since that conversation with PCP.  I am overweight, but that wasn't discussed as I recall. I was also 69 years old.  I do remember him saying that Metformin is an old safe drug and it reduces inflamation....(that's what I would really like to know what he said.)  I think he's pretty much up on diabetes because there are always posters  about the disease in the exam rooms.  But I don't think we've ever discussed it since that one conversation.  I'm just happy to have it.  And it is a very cheap drug.  Jan  Oh, now I remember that he ran an A1C test along with other blood tests and it was normal.

honeybair

I have been on Meformin for years because of elevated blood sugars.  I am considered pre-diabetic. When I cut the carbs, my blood sugar reads in the normal range.  I have tolerated this drug really well and it has enabled me to lose around 28 pounds.  I still need to lose more weight and am working on it.  I did not realize that it is sometimes used for the prevention of BC.  It truly is one of the old tried and true and safe drugs.

KDLodge

Just for everyone's consideration. I have been taking 1000mg of Metformin in the morning and 1000mg with dinner for three years since I was diagnosed as a diabetic type 2. I had a 2cm breast cancer removed last month so I'm not sure about the prophylatic uses for Metformin to prevent cancer. Certainly didn't work for me but I certainly won't quit taking it because of the tumor.

sandilee

 Thanks for your input, KD.  Sometimes you can do everything right and still get cancer. I know that Metformin isn't a cure-all or guarantee of no recurrence, or in my case, progression.  Who knows-maybe it kept your cancer from progressing beyond the breast.  

  There's so much we don't know about how it works, but so much research has shown it can have a positive effect in some people, with some types of cancer.  It does reduce overall inflammation, and lowers circulating glucose. If someone tolerates it well and is looking for ways to boost our odds, it seems like it might make sense. 

dwill

 Got a call from my PCP yesterday saying that my blood sugar levels has risen and I am now at the prediabetic stage.   She wants to start me on a med that will prevent me from getting diabetes.   I am still waiting on her to send the medicine to the pharmacist but I believe the med is going to metformin.   Will find out tomorrow!  I have had so many changes since I have been on anastrozole (arimidex).  My blood pressure spiked, depression , exhaustion, bone pain, IBS issues have caused my PCP to try to get ahead  by issuing me at least 5 new meds in the last 6 months. I was shocked yesterday when I got the call about the new meds to prevent diabetes.  It is somewhat frightening to me to deal with diabetes as well as cancer.  Will write back tomorrow to confirm her treatment plan. Would like to know more about metformin.  I am at least 70 lbs overweight.