LF doctor opinion

[sylke]

Something didn't sound right to me.

http://community.livejournal.com/pcosupport/578106.html?nc=1

The commenter writes that she takes breaks from Metformin to "detox for [her] liver's sake". Now, what I thought about how Metformin works is that it actually decreases the stress on your liver. Met changes liver function so it's not producing as much glucose, reducing overall blood sugar which eases the strain on the insulin-producing pancreas. Now, you shouldn't drink very much while on Met, because the liver won't process it as well or correctly, and having liver disease is a definite contraindication for taking it. But is there any medical advantage at all to taking a break to "detox" from Met? Personally, I take a break from time to time, but that's simply an aversion to swallowing large pills and it being so easy to get out of the habit of taking them daily.

bluekitsune? jvinocur? jfrands? Feel free to chime in, I'm looking at you folks for commentary. (vetgirlbeth, your input would also be valued if you care to comment on diabetes medications in non-humans :)) My apologies if I forgot any other members of the medical community.

Comments

[jvinocur.livejournal.com]

I generally agree with Beth. There can be important adverse effects from metformin, and people may need bloodwork for monitoring, but I'm not sure we really do drug holidays with metformin.

Regardless, it's pretty much never the right idea to take a drug holiday on a whim. I mean, the whole point of going to a specialist is because they know more about this...and if you don't trust your doc, you should find a new one, not start doing things behind his back :-)

[sylke.livejournal.com]

So, there are other drugs that do indicate a drug holiday from time to time? It makes sense, given the variety of side effects that some drugs have and the inevitable strain on various parts of the body, but I don't believe I'd heard of a prescribed holiday before. Then again, I'm a little young and a little too healthy to be taking anything particularly hard core.

I am completely open and honest with my specialist. I told him up front that I was taking a break because I don't like the big pills. ;) 4 pills at night is right at my borderline, and my understanding of *why* I'm taking the Met is that it makes my body work a bit better (extraordinarily layman terms here) and reduces my chances of getting Type II diabetes later in life, which is also manageable by diet. So honestly they feel kinda optional. What's the word for people like me? Noncompliant? ;)

[jvinocur.livejournal.com]

There certainly are drugs where holidays are even recommended (see what google scholar finds for "drug holiday").

And you really don't want to make it any closer to frank diabetes than you can manage, btw. It puts you at substantially increased risk for heart disease, kidney disease, blindness, leg ulcers, and probably other stuff I thankfully don't have to deal with any more.

Incidentally, we're supposed to say "nonadherent" instead of "noncompliant" now, for some reason.

EDIT: fix broken formatting, *sigh*