Metformin

Hi jim48819

I only take 1 Sitagliptin a day with my Metformin, yet I don't eat any sweet products unless I need to. The only thing is that I can't recall as to when I had my last diabetic bloods & health check, I know for a fact that I don't check my own sugars.

Does Metformin give you any problems?

I take Metformin1G/Sitaglip50MG without any problems twice a day at meal times.

I have a combined tablet Metformin 1g with Sitaglip 50mg twice a day without any issues. My local Heath authority don't want me to check my own sugars but call me in once a year to a Diabetic clinic and give me a once over. I had a problem with Ramapril and they swapped that for a Losartin and my problems cleared up within days.

Metformin gave me ulcer like stomach pains about two hours after taking it.

It made no difference if I took it in the morning or in the evening

Hi, no not really, but sometime i get the idea i have  taken them so long, that they are not doing me any good, and the reason i say that is, over a period of time ,and the fact i have more health problems, i am now taking 91 pills a week,which gives me a lot of thirst problems and lots of constipation problems,and every time i go to my GP they just seem to give me more pills,it gets very confusing at times.

Hi Mark,

how long have you been taking Sitagliptin.

My combination of medication taken twice a day is as follows;

sitagliptin 100mg

Metformin 1000mg

I have been talking Sitagliptin for just over a year.

I take it as follows;

sitagliptin 100mg twice a day.

metformin 1000mg twice a day.

Most of the people I know are the very opposite of constipated when taking Metformin.

My neighbour was on a vast amount of pills until she changed doctors.

I could not help but notice you reply to jim and with all of the tables I take per week (161) I am the opposite to the constipation as I can get into difficulties if food is not cooked thoroughly. But I take Loperamide 2mg twice a day and mainly because that one of the ingredients my system disagrees with.

161! That should be a record but no doubt someone will better it. Have you ever worked out the annual cost of them? 

Hi Mark, i take metformin 850mg twice a day and have for 10 years

i take Sitagliptin 100mg once a day, and have for the last three months.but like i said previously the Diabetic nurse does not want me to take 2 Sitagliptin a day,and when i asked her why not, as when i take 2 a day it seems to keep my sugar level down,her answer was, and she was looking in some book, when she was answering me saying thats what it calls for,i said to her but maybe when they put that on the market thats what they prescribed, but maybe that dose does not work for everyone,thats when she came back at me with, it can cause you to have stomach ulsers that can bleed,thats why i say it gets confusing,and also i may add i thought i was taking a lot of pills 91 a week ,and you say your taking 161,,the pharmsutical companys must be making a fortune.

Hi jim48819

I already have stomach ulcers, which I have had for many years and I am taking Omeprazole 20mg and Ranitidine 150mg both are daily. So I take them at opposite ends of the day.

I dread to think. But I am on permanent sick due to CMT (Charcot Marie Tooth Disease) this you will find on the internet if you want as it would take to long to explain.

I am also in remission for bladder cancer. Had a mild heart attack, Both knees replaced and all toe joins fused.

Now I am having to deal with an enlarged prostate.

Apart from that I am in good spirits.

Hi Mark,

You have a good attiude,and im sure it will help you,especially with the condition of your health,and between both of us, we seem to have our fair share,i myself three years ago went in to hospital for a small simple operation on my eyes,from there everything went wrong,and from someone who never took pills in there life,i am now as as i have already said am taking 91 a week,after my operation, they were suppose to keep me in for the day,and if everything was ok i was to be released the next day,i think  they needed the bed, so i was released the same day as they said i was fine and i could go home,but funnily enough 3 hours after i was released,i was doubled up on the floor in my house with pain as i could not urinate,even though i had a real sensation to empty my bladder,i was back in the hospital immediatly after calling them,now even after going back they checked my bladder with one of these scanners,and said what we think is your system has kicked out as you had a general annaseticand it will probably kick back in with in a couple days,as it often happens,so you stay here to night and have an uncomfotable night, or you can go home and have an uncomfertable night,so it was almost 10 o clock, so i said, ah well if its only for a couple of days i think i can handle that, i will go home,big mistake,as i had to go to my GP 3 days later, as i was still having problems trying to empty my bladder,he gave me some strong pain killers,end result was i went 10 days could not empty my bladder, with out difficulty, i could not eat, i could not emty my bowels, and in that 10 days i lost close to 2 stone in weight,after i was rushed to hospital in an emergency right from my GP office, as i was just about ready to collapse,they finnaly in serted a catheter,in to me and i released one and a half litre of urine,my bladder had be stretched for 10 days ,my kidneys was not functioning properly and i lost 2 stone,they kept me in for a couple of days and had to put me on a drip as my water levels were a way low,they had me caterize my self for 6 weeks,after they took the bag off and asked to urinate i could not do it ,thats when my trouble started,they said the fact that i cant urinate we will have to go in and see what is going on,so they checked my prostate,and said your protate is enlarged, so we will have to take a biopsy which they did,they found cancer cells,and i had to go for 1 month of radiothearphy everyday for a month, and they said i should go fo some hormone treatmentwhich i did and have done once every 3 months for the last 3 years i go for a needle in my stomach,and i finnished up with nearve damage ,which i believe was through the lazer treatment i got when i was getting the radiothearphy,the only advice i could give you Mark is,if you are not haveing any problems with your water works,and before you let them take biopsies,make sure you know what you are doing ,and the reason i say this if you give them permissinn to take a biopsie there is a very good chance with your age they will fined cancer cells,but just remember this Mark even if they do find cancer cells ,they cant tell if they are fast growing cells or slow growing cells and if they are slow growing cells they can take decades to flare up,so in other words if you give them the ok to do the biopsie, and they come back and tell you they have found some cancer cells,then you dont have a choice ,if i knew what i know now Mark ,i would have went on the wait and watch program,that way if your not haveing prob;ems with your water works,you dont have to take a chance of getting all these horrendous side effect,on the wait and watch the DR CHECKS YOUR psa, you go back in 3 months he checks it again, and if it has not went up, he will see you again in 3 months or 6 months whatever,there is guys doing that, its worth looking into Mark,because the side effects i got were horrendous thats why i am on morphine every day .

Hi jim48819

I am not worried at the moment, just concerned that nothing has happened yet. As the hospital is aware that I have had cancer twice now. While I was in hospital having surgery on my ankle, I had noticed that after the surgery, my fluid intake was around 1750ml and my urine output was close to 3000ml. So after being discharged from one hospital, then by luck my appointment came through for the next set of cancer test to be done. The consultant said that he was not surprised as my prostate had enlarged and was pushing against the bladder, I will arrange some test he said and start you on some medication. End of June I started the medication and my original appointment was March. Surly after four months I should have heard of the hospital by now...

Check on the latest prostate procedure Urolift.

Hi Mark,

i would have thought the same,you should have heard by now ,,and i did not realize Mark you had cancer twice already,i have to say, you have had more, than your share,lets hope you here soon, as the waiting can be a real pain.

Hi jim48819

It's the not knowing, that is the worst of it all. Each time I have had cancer, it has gone to the next stage each time.

stage 1: not a big threat.

stage 2: started to grow bigger and a threat to get into the connective tissue.

stage 3: in the connective tissue and can spread to other parts of the body.

stage 4: nothing that can be done (fatal)

As I have said, I have been through stages 1 & 2 and I don't want to see 3 or 4

Will do and thank you derek76.

Hi again derek76

If they could do that procedure urolift, it would be of great benefit and if it means that I can get rid of one of my tablets, I am all for that as well.

My concern about Urolift is that while it relives pressure on the bladdee it cannot stop the prostate from growing. So what happens then?

Hi Mark, you say each time you have had cancer it has gone to the next stage,if you dont mid me asking Mark, what is the higest PSA level you have shown,im curious as mine is creeping up, and i have no idea how high they can go ,  thank you .

Mine has been as high as 9.8 and my biopsy was negative.

I've often heard of readings of over 400 but this oncology artice is interesting:

" It is possible for the PSA to go to very high levels. There is no absolute maximum value. In fact, I have seen PSA values over 2000 ng/mL. As a rule of thumb, the higher the serum PSA, the more extensive the tumor, but this is not an absolute rule or a direct relationship. It varies from individual to individual. For example, a man with a PSA of 40 ng/mL does not have twice as much tumor as a man with a PSA of 20 ng/mL. It IS generally true, however, that a man's PSA will go from 20 to 40 when the tumor roughly doubles in size. Each person's tumor makes and leaks PSA at its own rate. Similarly, I have patients with PSAs over 300, yet who are alive without tumor 10 years after receiving radiation and hormones. Having said that, a smaller fraction of that group is alive than out of the group of men with PSAs of 10.

Another factor is that other things can make PSA rise. The first two abnormal PSAs I saw were before the test was approved, and both patients had bad cases of gonorrhea. These men's PSAs were about 100. A bladder infection will make it go up by 4 to 10 points. An injury to the prostate will make it go up. I had one patient who was a long-distance cyclist who told me that his PSA could be elevated by a long bicycle ride. Ischemia (lack of blood flow to tissue) of the prostate can make it go up. It is thought that this may be the cause of the "PSA bounce" (PSA goes up, then back down) that is sometimes seen after radiation, as a result of local scarring caused by the radiation.

One other thing to keep in mind is that tumor that recurs after being treated with hormones generally tends to make less PSA than that same tumor before exposure to hormones. So in a man who has a PSA of 20 and goes on hormones, if the tumor becomes hormone-refractory, it may have the same tumor burden but with a PSA of only between 5 and 15"

Hi Derek, thanks for your reply,it has kind of give me some hope, as i go to see my oncoligist to morrow,and i had no idea what she could say,

How big is your prostate? When mine was 35grms my PSA was 5.1 and gradually rose as my prostate grew to 75grms when it went to 9.8. Big prostate equals high PSA. After laser surgery on my prostate it went back down to 5.0 but most peoples  went down to just over 1.00. As my prostate regrew my PSA went up to around 7.6.

When I had my second biopsy it caused a lot of bleeding and I was kept in overnight. A passing urologist in seeing a patient late at night asked why I was  there. After telling him he said, PSA terrorism quouting a Norwegian paper that blamed high PSA's results for unnecessary biopsies and treatment of low grade cancers that would never spread.

Hi Derek,

i have no idea how big my prostate was,as all i was told when they first checked, was that i had an enlarged prostate,and said they should take some biopsies to see what was going on in there,they did that and that is when they found some cancer cells,and there reconmendation was that i had one month of radio thearphy, and one year of hormone treatment, which i did ,but no one has ever mentioned the size of my prostate,anyway as i have said i have an appointment to morrow with my oncoligist and i will have a few questions to ask her,just have to wait and see how i make out .

In your case prostate size probably does not matter.They should have given you information on the stage or grade of your cancer:

"Knowing the stage of your cancer helps doctors decide the best treatment for you.There are a few different staging systems for prostate cancer. Two of the most commonly used systems are a number staging system and the TNM staging system|.

The simplified number system is described below:

Stage 1

The cancer is very small and confined to the prostate. It can’t be felt during a rectal examination.

Stage 2

The cancer can be felt as a hard lump during a rectal examination, but it’s still within the prostate gland.

Stage 3

The cancer has started to break through the outer capsule of the prostate gland and may be in the nearby tubes that transport semen (seminal vesicles|).

Stage 4

The cancer has spread beyond the prostate gland to nearby structures such as the bladder or back passage (rectum), or to more distant organs such as the bones or liver.

If the cancer has spread to other parts of the body this is known as metastatic, secondary, or advanced prostate cancer.

If your doctors did a biopsy of your prostate, they will look at a sample of the cancer cells under a microscope to find out the grade of your cancer. Prostate cancer is graded according to the appearance of the cancer cells.

There are several grading systems, but the Gleason system is the most commonly used. This system can help doctors decide which treatment might be best, as it gives them more information about the cancer.

The Gleason system looks at the pattern of cancer cells within the prostate. There are five patterns, which are graded from 1-5. 1 appears very similar to normal prostate tissue whereas 5 appears very different to normal tissue.

The biopsy samples are each graded and then the two most commonly occurring patterns are added together to get a Gleason score of between 2-10. The lower the Gleason score, the lower the grade of the cancer. Low-grade cancers (6 or under) are usually slow-growing and less likely to spread.

A score of 7 is a moderate grade. High-grade tumours (8-10) are likely to grow more quickly and are more likely to spread. High-grade tumours are sometimes called aggressive tumours.

Prostate biopsies with a Gleason score of 2 are rare. It’s more common to get scores from 6-10.