Well let's summarize IR first for those reading and confused...
What is IR? IR stands for Insulin resistance. This is a condition in which our base cells become resistant to the hormone, insulin and do not process sugar in the blood efficiently.
What causes IR? Here is the tricky no straight answer explaination.
Insulin resistance may be part of the metabolic syndrome, and associated with the development of heart disease. Insulin resistance precedes the development of type 2 diabetes and is considered a pre-diabetic state. Insulin resistance is alsoassociated with many other medical conditions including fatty liver, arteriosclerosis, acanthosis nigricans, skin tags, and reproductive abnormalities in women (PCOS).
Factors that make IR worse. IR is aggravated in obese people and the medical conditions above. Certain ethnic groups are at higher risk as well: Latino, African-American, Native American, and Asian-American. My Great grand fathers were Cherokee and 1/2 Apache maybe that is a factor. I look scotch-irish though.
Management and treatment: There is a genetic component so some people may not be able to win out with a life-style change. You may however be able to stave off diabetes by managing your insulin resistance with diet, exercise, and medication.
Aw crap...there goes my fav coffee......Would IR throw off my adrenals as well as T4/T3 conversion???
So what is your favorite coffee? Coffee is too bitter for me. Sodas are my evil caffeine source. IR can have a big effect on you metabolic processing power, over all energy level and more. If you can not process you sugar effectively your cells and muscles live in a state of energy deprivation. Now I would think that your PCOS is having a higher impact on your adrenal function. By PCOS causing a shunt in the adrenal processing system and pushing toward excess estrogen and testosterone synthesis the rest is short changed. You can manage this some with progesterone supplementation. Some do well with this others have to take cortisol and treat the source. Many can get by with a half dose this way. 10 mg of HC versus a full 20-25. What about what is really bugging me....horrible fatigue, no motivation, no libido (both of these not decreased...NONE... zilch nada) is that related to IR?
This sounds more like low cortisol too me. I started my cortisol and with in a couple of days my husband was getting nervous. I had the look that I get when I stalk someone during martial arts... I was thinking about wrestling.. just the home behind closed door kind. Treating the adrenal issue helped cure all you listed completely except for fatigue. Adding the glucophage helped resolve the lingering fatigue issues and stopped my serious muscle cramping issues. my potassium levels are up in normal range again as well. But this is me.. my body chemistry is in its own class. I thought that there were specific formulas to determine IR (HOMA and QUICKI) that is used when you take the oggt with insulin. I couldn't figure them out with my numbers. I am just too dang tired! I also thought that the insulin numbers had to be at a certain level within that test before calling it IR. Also, I thought that IR can be related to adrenal probs too?
There is no simple test or check list that can be followed to determine IR beyond a doubt. You have to look at symptoms and trends. The fact that you have PCOS and have shown a reactive hypoglycemic trait in your GTT is one of the strong indicators of IR. Adding that you have had an elevated IGF documented and you have all you need to get an IR diagnosis.
So when trying to diagnose IR in a perfect world your MD may/should suspect the IR syndrome before you and then test you accordingly.
If you have some of the following you are at risk:
1) Family history: parents or siblings who have type 2 diabetes, hypertension, or cardiovascular disease. (Grandmother and Aunts)
2) Health: Obesity or overweight (BMI - body mass index- above 25). Concentration of fat around the waist than around the hips (an apple shape) - (All me despite exercise and dieting)
3) Age: greater than 40 years (I am 33 so I don't factor here)
4) Pregnancy issues: Gestational diabetes (I had borderline liver and kidney failure during my Pregnancy.. my blood sugar was supposedly fine)
5) polycystic ovary syndrome (PCOS) (ME!)
6) Pre-diabetes (This can be AI diabetic trait or blood glucose level trend determined, once IR is established you are a pre-diabetes candidate)
7) Heritage: Latino, African-American, Native American.
So if you have certain factors it should be looked into. Your PCOS is the biggest factor for you. I also run really low bp....I've been eating some salt a few times a day to try and keep bp higher.
These are signs of electrolyte imbalance which is closely tied to adrenal imbalance.. low cortisol. I am not overweight...would the glucophage cause me to lose too much? Sorry...I am just tired of being tired and want to be like my normal self...I miss myself
i am not sure. I lost a whooping 2 pounds on my Metformin. It did stop the gain. Now I have to lose the rest by getting my thyroid hormones up and being more active. Some people lose weight on a glucophage others do not. It will depend on your body chemistry. Treating the IR will allow you to eat more normally and give you added energy.
Besides Metformin (Glucophage) there are other medications that people use successfully. Actos and Avandia are both FDA approved to treat the insulin resistance that occurs with type 2 diabetes as well. You do have options and you will have to wwait and see what your MD recommends you try. I have done well on metformin XR, and have not had the nasty diarrhea side effects that I was warned about. My weight also hasn't melted off either.. soooo maybe I should try one of the others. I am giving the MF a chance since my muscle and energy issues have improved. I am pretty sure it is a low thyroid hormone issue that is the last nail in my hypoT tummy tub.