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Thread: PAI-1 4G/4G, lovenox, metformin & prednisone

  1. #1
    Join Date
    Sep 2014
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    1

    Default PAI-1 4G/4G, lovenox, metformin & prednisone

    Hi Dr. Coulam,

    I am homozygous for the PAI-1 4G/4G, with low serum PAI-1 in the non-pregnant state. I don't have PCOS but have one ovary that looks "PCO-like" with normal labs, and NO insulin resistance. I understand that Lovenox is a necessary treatment for this mutation, but I'm wondering about the benefit of Metformin in my situation as well. I also take prednisone when I'm cycling, so I'm curious if this might interact to increase blood sugars, and therefore, be another reason to consider adding Metformin to the treatment plan?

    Also, do you recommend re-testing serum PAI-1 when pregnant, and if so, how often?

    Finally, do you consult and prescribe out of state or by phone/skype?

    Thank you very much...I see you are the expert in this field and I value your input greatly as I learn about this new diagnosis!

  2. #2
    Join Date
    Sep 2008
    Posts
    677

    Default

    Quote Originally Posted by niconico View Post
    Hi Dr. Coulam,

    I am homozygous for the PAI-1 4G/4G, with low serum PAI-1 in the non-pregnant state. I don't have PCOS but have one ovary that looks "PCO-like" with normal labs, and NO insulin resistance. I understand that Lovenox is a necessary treatment for this mutation, but I'm wondering about the benefit of Metformin in my situation as well. I also take prednisone when I'm cycling, so I'm curious if this might interact to increase blood sugars, and therefore, be another reason to consider adding Metformin to the treatment plan?

    Also, do you recommend re-testing serum PAI-1 when pregnant, and if so, how often?

    Finally, do you consult and prescribe out of state or by phone/skype?

    Thank you very much...I see you are the expert in this field and I value your input greatly as I learn about this new diagnosis!
    Individual treatment is dependent on medical history as well as laboratory test results. It is therefore difficult to give advice regarding specific patient treatment withough benefit of evaluation and consultation. We do have telephone consultations available for out of town patients. If you are interested just call 847 869 7777 for an appointment. Dr. Coulam

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