Metformin and myo-inositol whilst pregnant

[mrsalice2022]

Hi all,

I was wondering if anyone has been taking Metformin and Myo-inositol whilst pregnant?

I have PCOS and am currently 17 weeks pregnant and don’t know whether I should be continuing with this medication/supplement!

I was told by the fertility nurse to take Inofolic Alpha (Myo-inositol) alongside the Metformin, and fantastically I conceived, however no one seems to know whether I should be continuing to take them together throughout my pregnancy!

From what I’ve been reading about Metformin, it can have very positive effects on preventing late miscarriage?!

Hello 👋 I'm currently 7 weeks pregnant and taking both Metformin (2000mg daily) and Infolic Alpha (Myo-Insitol). I also have PCOS.

My fertility consultant advised I continue to take Metformin at least for my first trimester as it reduces the risk of miscarriage. As for the Infolic Alpha, it says on the box it can be beneficial in pregnancy, so I'm going to keep taking a sachet a day until my stocks run out, then reassess.

Congratulations by the way!

PCOS here too. Who precribed you the metformin? Mine was prescribed by my endocrinologist and so my midwife asked me to book an appt with him for advice. By the time that all got arranged, i think i was about 15weeks? He then said i was fine to stop taking it. The consultant midwife was also very keen for me to stop as obviously it can mess with the gestational diabetes test (which i didnt really understand because surely it would just stop the risk of GD??) But i didnt argue.

Can i ask what dose inositol and metformin you are taking? Im taking 2000mg metformin and pregnacare conception multivitamins but im considering whether i should add inositol as well.

Hi @Kay00!

So lovely to hear from you and congratulations on your pregnancy 🥰

That’s so reassuring to hear that someone else is taking the same combination in pregnancy! My midwife and consultant have both said they don’t know anything about Inofolic Alpha so can’t advise me what to do! And when I’ve asked about Metformin, they’ve just said it’s up to me whether I continue with it.

The fertility nurse had told me to stop the Metformin as soon as I got a positive test but I’m so pleased I continued as there’s a lot of positive information online about it preventing miscarriage. It’s just whether to continue now I’m in the second trimester!

I’ve also been taking Cyclogest progesterone pessaries due to two previous miscarriages, so I feel like my body is fully of medications and I hate to think that I could be harming the baby with all of these drugs! Very anxious as you can tell 🙈 and just wish someone could advise me what to do for the best 🧡

My endocrinologist told me to stop taking metformin at 13 weeks. I wasn't sure about inositol so I stopped taking it when I got pregnant just in case.

I’m on 1,000mg Metformin a day (2 x 500mg) and I take two sachets of Inofolic Alpha a day.

This was the article that I read today… https://www.endocrine.org/news-and-advocacy/news-room/2018/metformin-lowers-risk-of-late-miscarriage-preterm-birth-in-pregnant-women-with-pcos

If Metformin doesn’t pose a danger to baby, it makes me wonder if it’s safer to take it.

That does seem odd to stay to stop taking it so it doesn’t mess with the GTT as surely it would just help prevent gestational diabetes! My GTT has been booked for week 29 of my pregnancy which is still another 12 weeks away.

I notice that article says that late loss and preterm birth was measured. 9 (of 211) from the Metformin group, and 23 (from 223) from the placebo group. 5 and 10% respectively. With these numbers, the vast majority of those will have had a pre-term birth. There's no detail about when these pre-term births occurred, so for all we know they mostly could have been naturally in the 36th week. Given still birth was not reported I guess the only loss(es) in the study were in the second trimester. Still, study numbers are too low to say if that was a sadly incidental occurrence or not.

The article says that Metformin seemingly has zero impact on whether or not you develop gestational diabetes as well.

To me, this is article not enough to go against medical advice.

I stopped Metformin shortly after the end of the first trimester with both. Inositol (only taken with my second) midway through the second trimester. But only because I figured I'd finish the bottle.

@mrsalice2022 apologies for the random revival of the thread! Just wondering how you found taking metformin and any side effects? I’ve been given it and just wondering if worth taking.

I'm currently taking 500mg metformin and 2000-3000mg myo.
Prior to pregnancy I was taking 1000-1500mg metformin.
After reading some studies I personally felt quite uncomfortable taking a high dose but do what feels right for you.

No worries at all @Sunandsea13! So I took 500mg at breakfast and 500mg at dinner before and during pregnancy (1000g). They then increased it to 1500mg total towards the end of pregnancy when my fasting sugars were rising. I had no problems taking it and our little girl arrived safely three weeks ago 😊 Good luck with your pregnancy and please ask if you have any other questions!

@mrsalice2022 thanks so much! I’m actually TTC with lean PCOS and have been given metformin. I wondered if you had any insulin issues or were given it without any? I’m just concerned taking it with no insulin issues will make my blood sugar too low?

great to hear you could manage it, I’ve heard a lot of bad side effects!

huge congratulations on your little girl xxx

@MoonIightDreamer thanks so much, what was it that made you concerned?

I took inositol for some of the first trimester and stopped (I was taking it religiously to conceive). I wish I’d continued as I developed gestational diabetes (I have lean PCOS).

I started taking it again in trimester three as it’s actually an ingredient in the pregnacare max supplement and it’s been shown to help with blood sugar management. I emailed the pregnacare manufacturers and they sent me a study which essentially found that up to 4grams a day seems to be safe.

I took much less than that - if I got pregnant again I would take it throughout I think.

@Mushroo thats great advice, thank you! What else did you do for your lean PCOS? I am TTC and taking Inofolic alpha and maybe metformin.

@Sunandsea13 just inositol but I made quite a few lifestyle changes like upping my steps, and focusing on resistance / weight training a few times a week. I also generally tried to eat fewer carbs and had loads of seeds and nuts.

I also had spearmint tea, and took vitamin D, C and zinc daily.

It took about 3 months for me to conceive and I used OPKs on the successful month.

2 week old is currently asleep on me :)

@Mushroo that’s so interesting! So you weren’t prescribed any treatment despite the lean PCOS?

I am taking proceive as well but will add spearmint tea to the mix! I’m very apprehensive about the metformin.

sorry for all the questions, did you have irregular cycles at all? I have no hormone/androgen issues just irregular cycles and polycystic ovaries that has come on in the last few months just as we were TTC (our luck!!).

I am also doing 5k run every other day but not sure what else I can add :/

so glad to hear about your little one 💗

I had lean PCOS also. I took metformin along with Inofolic Alpha and we conceived our daughter within a few months 😊 I was looked after under the gestational diabetes team once pregnant, so I monitored my blood sugars with a kit at home. I managed to avoid insulin and it was just controlled with metformin. Sending you so much luck! I also had acupuncture whilst trying to conceive and I really think it helped.

That’s really helpful to know, thank you! Did you have insulin issues before pregnancy?

what kit did you use? Might get one as I am worried about blood sugar going to low if I don’t have a blood sugar issue to begin with!

@mrsalice2022

I have PCOS and with my last pregnancy 🤰 continued taking my-inositol throughout. I’ve only taken metformin during the early part of one of my pregnancies but I unfortunately miscarried that time and the metformin gave me bad side effects so I never bothered with it again. You continue to take both safely throughout the pregnancy I think.

@Sunandsea13 i had horribly irregular periods as a teen which was when I was diagnosed, but because I wasn’t TTC at that point I just went on the pill for about 10 years.

I came off it about a year before we started trying and my periods were anything from 15 day cycles to over 50. I figured I’d give it a go ‘naturally’ before speaking to GP about metformin.

About 3 months after starting the inositol my cycles became more regular (usually 26 - 38 days and I found the exercise really helped as well. Once we started trying I’d managed to get them around 26 - 35 days so they still weren’t perfect but a definite cycle.

Id really recommend following ‘healthy PCOS’ on instagram, there’s loads of lifestyle tips and I found they did genuinely help.

I never had insulin issues before (that I was aware of!). The hospital gave me the blood testing kit. I too was worried that my blood sugars would go the other way and be too low but this definitely wasn’t the case! I was really lucky and saw a brilliant consultant when I walks 12 weeks (my midwife referred me to the hospital at my booking appointment as I was ‘high risk’ having PCOS). The consultant just put me under the care of the gestational diabetes team from there and they told me to stay on the metformin throughout and gave me the testing kit. I’m glad I did stay on the metformin as my blood sugars were already high whilst in it.

@mrsalice2022 that makes sense! How did you space out the metformin and Inofolic alpha? Did you take any together?

I would take the Inofolic alpha on an empty stomach, 30 minutes before eating, then the metformin with my meal 😊

@mrsalice2022 thank you so much :)