Metformin, vitex, inositol questions

[Roobear]

Brief background...

Been ttc for 7 months with no success yet. Have incredibly light and somewhat irregular periods so doctor has put me on 1500mg a day of metformin to help regulate ovulation - got a pos OPK for the first time last month so hopefully that’s helping. Bmi is 22-23 (weight fluctuates quite easily by half a stone).

I’ve been reading up on other things that may help to conceive and regulate cycles but may also help sway pink as I’m hesitant to load up on loads of multivitamins.

I’ve read positive things about Vitex/Agnus Castus and also about inositol. Went to Holland and Barrett yesterday and got some. The inositol is inositol and choline though (I couldn’t find any without the choline). My question is dosage and when to take as I’ve read some things saying to take daily, some saying take from O to AF, some saying from AF to O and some saying only on CD 3-7?!!

Now quite confused so any advice welcome!

[atomic sagebrush]

PLEASE do not take vitex and inositol in addition to the Metformin. Metformin does what those things do, only about 1000 times better and more effectively. You're on quite a high dose of Met already (I"m actually surprised they started you off at that high a dose! did they test your blood sugar and insulin response?)

So to answer your question, none of the above. I don't think you should take either of those two things and you need to allow the Metformin time to work.

[Roobear]

Thanks atomic.
I didn’t start on 1500; I started on 500mg and gradually worked my way up with bloods checking various things along the way. I ended the last cycle on 1000mg and gp advised to move up to 1500mg this cycle as no real adverse side effects (one day of a slightly funny tummy and feeling nauseous after a very high fat high carb takeaway! Lesson learned!).

Out of interest, would the vitex or inositol actually do anything then as I’m taking the metformin?

[atomic sagebrush]

Oh good ok in that case then it's all legit. Sometimes we run across doctors who will throw higher doses of meds at people without taking the steps needed to get them there.

Yes, taking vitex and inositol can delay or stop your ovulation and also may make it much harder for you to conceive. I really cannot state strongly enough how important it is that you stay well away from those two supplements. They will not help your sway, and will very likely make it much harder for you to conceive.

[Roobear]

My fault - I probably should have explained better but was trying to avoid an essay 😉😂

Yes all legit. My GP is great and really on it (and has a cracking reputation in women’s health and fertility in the locality). I think I’m just tryjng to throw everything at it! However, if the vitex and inositol are likely to have an adverse effect then I will be staying well clear!

Just so I’m better educated (and for the benefit of others trawling the web for useful knowledge) would you mind explaining why they would negatively impact on ttc as I’ve read so many positive things about both of them, especially with irregular cycles and PCOS.

[atomic sagebrush]

No not at all you explained it perfectly - just wanted to be sure you were being well-looked after!!

Think of PCOS as being a state of "too much". Too high blood sugar, which makes too much testosterone, which your body makes at the expense of progesterone and in some cases estrogen (some PCOSers have quite a lot of estrogen, others not enough). Metformin rectifies this by lowering blood sugar and testosterone; it also lowers cholesterol levels and your body uses cholesterol to make testosterone, estrogen, and progesterone and so can cause lower levels of these things (which for some people can be good, because as the body stops making too much testosterone and estrogen, it can make more progesterone which is often in short supply for PCOSers. It also helps you lose weight which in turn can lower estrogen levels further.

The trouble is, that is what inositol and vitex also do, only less effectively than Met and with some other side effects that are irritating. Vitex can lower estrogen substantially for quite a lot of people and even though it's ~said~ to raise progesterone, I've seen SO many people develop a short LP while on vitex (possibly due to low estrogen, but possibly due to low progesterone as well) and we saw such poor results with conception for women over 35 that I dropped it several years ago for that age group. And as for inositol, we have had some people on inositol whose egg quality mysteriously tanked and others who just did not conceive for ages until I had them stop taking it and then they got pregnant. 2 separate women were even told by their doctors (while taking inositol) that they were menopausal and had no chance of pregnancy based on their FSH and AMH numbers but both of them went on to have not one, but TWO more babies with no trouble at all after dropping the inositol. I know it feels like these things are well studied but honestly they really aren't at all tested and many, many people will show up on here after having TTC for year(s) while taking these herbs and don't conceive till they drop them.

So not only are you taking on the risks of the potential side effects, but you're basically doubling up on the effects of the Metformin. Since Metformin can lower blood sugar, cholesterol, and hormone levels, you toss things onto that that do the same thing, and you end up (even with PCOS!) too LOW in hormones. You end up not being able to conceive not because of your PCOS, but because your estrogen is super low, your CM dries up, your lining gets poor, your ovulation gets really delayed (You can also have delayed ovulation due to low estrogen, it's not always due to high testosterone!) and your

To sum up: Vitex and inositol are like a low-rent version of Metformin but they are NOT metformin and have different (not always positive) qualities in addition to doing more of the same. You don't want to a)get the potential side effects of them or b) end up getting too much of what the Met is already doing for you.