A comparative study between myo-inositol and metformin in the treatment of insulin-resistant women


Lesley Bludworth
 

https://pubmed.ncbi.nlm.nih.gov/28724173/

Dr. Kellon,
I have already read what has been discussed about inositol in this group.
The above study in humans says metformin and Myo-inositol are comparable in effectiveness as insulin sensitizing agents.
What is the percent effectiveness of metformin in horses?  My vet said metformin is effective in only about 30% of horses (is that the long term effectiveness?) and recommended I stop it in my mare, Im not sure why as her insulin was 25 last we checked, down from 140 with just diet changes but she was in a lot of pain then. 
We will discuss this further when her ACTH and insulin levels are checked in a week or so to see how the pergolide is working.
If this percentage is true, if metformin is only effective in 30% of animals then why wouldn't myo-inositol may have similar effectiveness percentages? 
doesn't mean it wouldn't work or at least have some influence on insulin sensitivity in some percentage of horses like the metformin does.     All the supplements marketed for women trying to conceive are 40:1 myo-inositol to D-Chiro inositol 2000mg to 50 mg. 
Dr Kellon, when you did use the D-chrio inositol in the past how many grams were used?  Was it twice a day dosing? (administer like metformin is administered)
Just a thinking if I wanted to be an N of 1 case example I could do blood work with and without metformin (as I would anyway) and then depending on her insulin levels after coming off Metformin I could do it with and without myo inositol.   
I suspect the myo inositol is more expensive to give than the metformin tho.  Its about $1 a day for metformin.
not attached to this idea, just wondering.
--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Eleanor Kellon, VMD
 

Lesley,

I don't know where that 30% number came from but I certainly wouldn't stop it with the results you have. The myo-inositol and DCI is specifically for women with PCOS. Do you have any indication of ovarian issues?

--
Eleanor in PA

www.drkellon.com 
EC Owner 2001
The first step to wisdom is "I don't know."


Lesley Bludworth
 

Dr. Kellon, 
i don't know about that number either.  Thats what she said, but, if Sophie is in the 30% then that matters here.
I dont think she has ovulation issues, she likes to pee/mark for mares as she does for geldings...   
What would I be looking for in that condition?  Seems infertility and perhaps metabolic issues are symptoms but I've never tried to breed her.

There is evidence for inositol use in other metabolic disorders in humans besides PCOS.
I heard about myo inositol on Dr. Huberman's Pod cast all new studies presented.   He uses it for improved sleep but because it modulates glucose metabolism.  I guess like some non diabetic people take metformin off label for longevity.
Studies start with a question, right?, I wonder if doing x, y or z  makes a difference.   
I will take her off Metformin when I can start exercising her. and then will monitor her insulin levels for a while but that is when I thought I could try adding myo inositol and the other form to her feed to see if it made a difference with her insulin levels, if all other variables stay the same!  

https://www.hindawi.com/journals/ije/2018/1968450/

https://pubmed.ncbi.nlm.nih.gov/29053004/
https://pubmed.ncbi.nlm.nih.gov/34638926/
https://pubmed.ncbi.nlm.nih.gov/27688754/
--

Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Lesley Bludworth
 

oooh, 
here is a small study with women with metabolic syndrome, treated for a year with myo inositol.  Sophie is not post menopausal.
Not a direct correlation but perhaps a reason to try it out with her, not instead of something else just in addition to good management practices.
You said you tried it before and it did work for a few days.  I can imagine you had only a limited number of horses on it to see if some responded and some did not, like the metformin and the myo form is preferred vs the DCI from what I have looked at.

https://pubmed.ncbi.nlm.nih.gov/22192068/
--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Sherry Morse
 

Leslie,

You can do as you like with your own horse, but just a reminder that you can't compare human studies to horses for many things.
--

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response

PA 2014

https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet/Scutch%20Case%20History.pdf

https://ecir.groups.io/g/CaseHistory/album?id=78891

 


Lesley Bludworth
 

Thanks Sherry,
My initial thought was that the use of metformin in horses, which as a human drug, sometimes is very effective for lowering insulin in horses.
So, just interested in possible parallels 
Certainly, better reasoning than using insulinwise or heiro.
I won't be dropping any management practices. But if I'm out of town and cannot get her exercised for a few days or bad weather etc that would limit exercise.
Metformin has been called exercise in a bottle and seems as effective for certain conditions as metformin so...
Can't imagine the dosage or cost, in the human study it was BID dosing.
Someone posted about a European product for metabolic issues in horses...hippo ex or something.
I'll keep you posted in January and February
--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749