Metformin and Keto...?

(Nina S. ) #1

Hello, I started a slight keto diet on July 30th (I say slight because I started eating between 30-60g per day of carbs- a significant reduction compared to the hundreds of grams of carbs I would normally consume per meal) and I did that for 2 weeks and lost 16lbs. On 8/20/18 I got serious and changed my numbers to 20g of carbs per day. I felt sick on days 2 and 3 but completely better by day 5. I tested for ketones at home that week and was between 1.5 and 4 mmol/L up until 4 days ago.

4 days ago my Endo decided to put me back on Metformin for PCOS (Polycystic Ovarian Syndrome). I’ve been on Metformin for 4 days now and surprisingly it hasn’t made me sick with nausea and diarrhea as is has in the past (when I was eating crazy large amounts of carbs) but when I tested my ketone levels this morning I was at 8 mmol/L. Should I be worried??

From what I’ve read, Metformin desensitizes you and makes you more sensitive to insulin but, I’ve also read that eating a low carb diet will make you produce less insulin so I am confused because I am on a medication that makes me more sensitive to insulin but I also on a low carb diet which makes me produce less insulin?

Can I be on Metformin and still stick to under 20g of carbs or should I slightly increase my carb intake to get my ketone levels back down to optimal ketosis levels??? I don’t feel sick or anything just worried that my ketone levels are so high and I’m not sure why.They weren’t as high prior to me starting the Metformin and I’m wondering if it has anything to do with it. I also haven’t lost any more weight but I haven’t gained either.

Please help!

(Omar) #2

There is no issue in being even zc and take metformin. Actually I do that.

If you have any side effects from metformin ,then you should stop taking metformin not start taking carbs.

If your doctor is well informed about keto, then you may ask him why you need the metformin.

The first step to restore the hormonal balance is the low carbs and that is the most effective for PCOS

(Nina S. ) #3

@Alpha thanks for the help. My doctor is well aware that I am eating keto and already in ketosis and actually said that was a good idea but he placed me on the Metformin for my PCOS. I have used Metformin XR in the past (prior to doing keto) and it made me really sick so I stopped. He has now put me on regular Metformin which I started a week after I went into ketosis and seemed to be handling it well with no side effects. I think maybe it’s because I have low insulin levels? I am worried because of my high ketone levels now that I’m back on Metformin. My eating habits have not changed, I’m still on 5% carbs, 15% protein and 75% fat.

(Drew Schmidt) #4

So I am tracking a few things. First, I actually got my blood work done and asked for A1C and Insulin levels. At first he didn’t test my insulin. When that came back my insulin was the same (actually .1 higher) than it was about six months ago when I was eating like crap.

So then I found out about HOMO-IR that is another measure of how insulin resistant you are. My previous HOMO-IR was 4.4 and now it’s 3.4. So it’s going the right way.

Dr. Benjamin Bikman says he likes to see an Insulin in these ranges:
Normal Insulin uU/ml

  • Diabetic - 17 or above
  • Pre - 7-17
  • Normal - Up to 6

HOMO-IR

So I noticed my A1C is going down, but my morning blood sugar is usually higher. Almost always higher than when I went to bed. So just glucose I don’t think it enough. I’m checking that, and A1c, and Insulin and Homo-IR to see if I’m going in the right direction.

I hope that helps.