Thyrotropin Suppression by Metformin

Vigersky, Robert A.; Filmore-Nassar, Amy; Glass, Allan R.

doi:10.1210/jc.2005-1210

Cited by 154 publications

(164 citation statements)

References 10 publications

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“…While three studies in patients with hypothyroidism and/or levothyroxine treatment showed a reduction of serum TSH levels under metformin treatment (9,10,11), a retrospective study demonstrated significantly higher serum TSH levels in euthyroid patients with T2DM treated with metformin compared with those treated with other diabetic agents (12). However, in that study, metformin use was not associated with serum TSH levels after adjustment for several potential confounding factors of which goiter was the only significant one (12).…”

Section: Introductionmentioning

confidence: 82%

Metformin inhibits goitrogenous effects of type 2 diabetes

Ittermann

Markus

Schipf

et al. 2013

European Journal of Endocrinology

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Objective: Data on the association between type 2 diabetes mellitus (T2DM) and thyroid volume are sparse. An experimental study demonstrated an inhibitory effect of metformin on the growth of human thyroid cells. So far no study on humans has investigated potentially modulating effects of metformin on the association between T2DM and thyroid volume. Therefore, we investigated these effects in a population-based cohort study. Design and methods: We used data from the Study of Health in Pomerania and included 2570 individuals for cross-sectional and 1088 individuals for longitudinal analyses. T2DM was defined by physician-diagnosed self-report or intake of antidiabetic medication. Results: In the cross-sectional data, females with T2DM treated with antidiabetic medication other than metformin had a larger thyroid volume (bZ4.69; 95% CI 1.87 to 7.50) and a higher odds ratio (OR) for goiter (ORZ1.71; 95% CI 1.05 to 2.79) than females without T2DM, whereas in males, no such association was detected. In females or males treated with metformin, T2DM was not associated with thyroid volume or goiter. In longitudinal analyses, incident T2DM not treated with metformin was significantly associated with a higher risk for incident goiter in the total population (incidence rate ratio (IRR)Z1.70; 95% CI 1.10 to 2.91). Individuals with T2DM having changed from metformin to other antidiabetic agents during follow-up also had a higher risk for incident goiter than individuals without T2DM (IRRZ2.71; 95% CI 1.74 to 4.20). Conclusions: We demonstrate an inhibitory effect of metformin on prevalent and incident goiter. Antigoitrogenous effects of metformin add to the general benefits of metformin treatment of T2DM.European Journal of Endocrinology 169 9-15

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Section: Introductionmentioning

confidence: 82%

Metformin inhibits goitrogenous effects of type 2 diabetes

Ittermann

Markus

Schipf

et al. 2013

European Journal of Endocrinology

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“…Surprisingly, a few years ago, it has been reported that serum TSH level in hypothyroid patients decreased in response to metformin therapy and increased again when metformin was discontinued (Vigersky et al 2006). Later, this finding has been confirmed by several studies.…”

Section: Introductionmentioning

confidence: 87%

“…Metformin is hypothesized to change the affinity and/or quantity of thyroid hormone receptors, increase the central dopaminergic tone or induce activation of the TSH receptor, thus enhancing the effects of thyroid hormones in the pituitary (Vigersky et al 2006). In a case report of a 28-year-old male with resistance to thyroid hormone, metformin-induced hyperthyroidism, normalized altered circulating levels of peripheral markers of thyroid hormone action and required a temporary reduction in the levothyroxine dose (Krysiak & Okopien 2011).…”

Section: Mechanism Of Action On Thyroid Functionmentioning

confidence: 99%

Metformin and thyroid disease

Meng

Chen

et al. 2017

Journal of Endocrinology

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An intriguing area of research in thyroidology is the recently discovered association of insulin resistance with thyroid functional and morphological abnormalities. Individuals with hyperinsulinemia have larger thyroid gland and a higher prevalence of thyroid nodules and cancer. Accordingly, patients treated with metformin have a smaller thyroid volume and a lower risk of incident goiter, thyroid nodule and cancer. Multiple studies in vitro and in vivo have demonstrated that metformin can inhibit the growth of thyroid cells and different types of thyroid cancer cells by affecting the insulin/IGF1 and mTOR pathways. Besides, metformin treatment was associated with a decrease in the levels of serum thyroid-stimulating hormone (TSH) in diabetic patients possibly by enhancing the effects of thyroid hormones in the pituitary and activating the adenosine monophosphate-activated protein kinase (AMPK). Based on this evidence, metformin appears to be a promising therapeutic tool in patients with thyroid disease. More clinical studies are necessary to evaluate the clinical significance of metformin for the treatment of thyroid diseases.

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“…Many other literatures have also documented an association of thyroid abnormalities, notably overt and subclinical hypothyroidism as well as autoimmune thyroiditis with GDM [56][57][58][59][60] . This correlation has been substantiated by depiction of an inverse association between Metforfin and TSH level 61,62,63 . Hence, screening for thyroid dysfunction in diabetes patients, ät-risk" patients for GDM, with anti-TPO antibody positivity, or with TSH concentrations in the upper limits of normal range has been advised by many studies.…”

Section: Discussionmentioning

confidence: 75%

Subclinical Hypothyroidism in Pregnancy - A Case Series

Sahu

Dash

Ray

2017

Bangladesh J Med Sci

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Background: Effects of overt hypothyroidism on pregnancy outcomes and foetal development are well established and treatment protocol is reputable. Method and material: The prevalence and effects of subclinical hypothyroidism (SCH) on pregnancy are not yet clear. Hence, universal screening of all pregnant women is still debatable and treatment of detected sub clinical hypothyroidism is yet to have general consensus as data regarding beneficial effects of treatment to mother and foetus in SCH cases is inadequate. Result: Odisha is a known endemic area of Iodine deficiency and reports of occurrences of SCH in Odisha are very limited. This study is a case series, done to detect the prevalence of SCH in pregnancy in the ante-natal unit of a medical college and hospital catering to a large population of Odisha. Conclusion: This prospective study included screening of the pregnant women for thyroid function and follow -up of the cases with SCH till confinement to record any adverse effects of the thyroid dysfunction on obstetric outcome.

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Thyrotropin Suppression by Metformin

Cited by 154 publications

References 10 publications

Metformin inhibits goitrogenous effects of type 2 diabetes

Metformin inhibits goitrogenous effects of type 2 diabetes

Metformin and thyroid disease

Subclinical Hypothyroidism in Pregnancy - A Case Series

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