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Metformin Hashimoto's

Metformin And Your Thyroid

Metformin And Your Thyroid

Receiving an autoimmune diagnosis can be challenging for the best of us. It can literally take years of searching for answers to seemingly unrelated symptoms to receive a diagnosis to confirm whats wrong. However, conventional treatment of Hashimotos and other autoimmune diseases can leave little hope for improvement. Treatment for secondary conditions like type II diabetes can lead doctors to treat the symptoms and not the underlying root cause. Metformin is one of the most commonly prescribed drugs for regulating blood sugar, but did you know that it can suppress TSH? If your doctor is unaware of the connection, a change in your TSH level can result in him or her wanting to reduce the dose of your thyroid medication. So, if you are taking metformin and thyroid replacement for Hashimotos, the good news is that being informed of this very important detail will allow you to talk with your doctor with the goal in mind to not reduce your thyroid medication simply based a low TSH level that is likely being driven by metformin. Metformin is a popular medication for patients with type II diabetes and polycystic ovary syndrome (PCOS). It is used for gestational diabetes also. It may be called Fortamet, Glucophage, Glucophage XR, Glumetza, and Riomet. Metformin helps regulate blood sugar and has been a favorite prescription in the United States since 1995. While it may be an appropriate medication for patients with Hashimotos and many conditions, its essential to note that it can lower TSH to below-normal levels. Typically, doctors will test TSH only or TSH and Tr only, as opposed to testing TSH, Free T3, Free T4, Reverse T3, and thyroid antibodies. In some cases, the TSH level may detect a thyroid problem, but not always. The TSH is mainly a marker for pituitary function. It Continue reading >>

Potential For Metformin Use In Thyroid Disease

Potential For Metformin Use In Thyroid Disease

An article published in the Journal of Endocrinology reviewed the relationship between the anti-diabetic drug metformin and thyroid disease. Recent evidence suggests that metformin may benefit patients with thyroid disease. The drug metformin is the most common prescription for type II diabetes. It is considered the first-line treatment and acts to decrease blood glucose by inhibiting glucose production in the liver. Over the past decade, several studies have suggested that metformin also affects the thyroid, a small gland in the neck that secretes thyroid hormones (T3 & T4) that regulate metabolism, development, cardiovascular function, sleep, and thought patterns. Thyroid stimulating hormone (TSH), made and released by the pituitary gland, stimulates the thyroid to produce T3 and T4. Disruptions in the production levels of TSH and in turn T3/T4 can result in various thyroid conditions and have detrimental consequences on overall health and wellbeing. Conditions of the thyroid include hyperthyroidism (increased activity), hypothyroidism (decreased activity), goiter (abnormally enlarged thyroid), thyroid nodules (lump of cells within the thyroid), and cancer. published in the Journal of Endocrinology reviewed the current understanding of the relationship between metformin and thyroid disease. It is known that patients with high insulin levels often have larger thyroid volumes and increased incidence of thyroid nodules and cancer. Interestingly, patients taking metformin had decreased thyroid volume and were less likely to develop goiter, thyroid nodules or cancer. Supporting these observations, several non-clinical laboratory studies demonstrate that metformin slows the growth of thyroid nodules and cancers by interfering with certain signaling pathways. In diabetic pa Continue reading >>

Hypothyroidism, Insulin Resistance And Metformin: Read This Brilliant Information!

Hypothyroidism, Insulin Resistance And Metformin: Read This Brilliant Information!

This interesting page has been updated to the present day and time. Enjoy! ***************** The following insightful post was written by UK hypothyroid patient Sarah Wilson. My daughter (25) has epilepsy. What’s that got to do with being hypothyroid and Natural Thyroid Hormones (NTH. also known as Natural Desiccated Thyroid or NDT)? Quite a lot, by the look of things. My daughter’s epilepsy is triggered by unstable blood sugars. And since taking Metformin (medication to improve blood sugar control), she has significantly reduced the number of seizures. Being a good hypothyroid Tiger-mother, I have been doing mega amounts of research and we got to the Metformin approach through reading hundreds of academic medical journals. What I found along the way got me thinking about NTH and Hypothyroidism. I have a strong hunch, backed up by some meaty academic evidence, that when patients develop hypothyroid symptoms, they are actually becoming insulin resistant. There are many symptoms in common between women with PCOS and hypothyroidism–the hair loss, the weight gain, et al. A hypothyroid person’s body thinks it is going into starvation mode and so, to preserve resources and prolong life, the metabolism changes. If hypothyroid is prolonged or pronounced, then it is entirely feasible that even with the reintroduction of thyroid hormones, that chemical preservation mode becomes permanent. To get back to normal, they need a super “jump-start” to kick the metabolism back into action. The super-kick start is effected through something called AMPK, which is known as the “master metabolic regulating enzyme.” Guess what? This is exactly what happens to Diabetes patients when Metformin is introduced. If you are technically minded then you might want to read these article Continue reading >>

3 Things You Need To Know About Metformin

3 Things You Need To Know About Metformin

September 30, 2015 by Dr. Brooke in Be Better , Eat Better , pcos 3 Things You Need To Know About Metformin Metformin is recommended by doctors for women with PCOS that want to loose weight or otherwise manage their PCOS and insulin resistance. But there are 3 very important things that you need to know about it including the fact that it's not the only option! Let me first say, I dont hate Metformin for women with PCOS . For some women it really does help spur ovulation, control blood sugar and help with some weight management but.its not without its share of issues. And its definitely not the magic bullet for weight loss although its usually presented that way. How Metformin (or its generic form: Glucophage) Works Metformin is typically given with meals throughout the day, or more commonly now the extended release version is given once with dinner or at bedtime. While only having to pop a pill one time per day is always appealing, this once a day dosing (especially at bedtime) is where I see the most problems with my patients. It lowers both fasting and post meal glucose levels by decreasing the glucose absorption in your intestines after a meal; as well as decreasing the amount of glucose your liver makes for later use. It also does help improve insulin sensitivity by increasing glucose movement into a cell. All sounds good so far right? Not so fast, here are the most common issues I see in women using Metformin: Metformin is notorious for causing sometimes severe digestive issues including stomach pain or upset, nausea, vomiting, diarrhea and even a sense of body weakness or metallic taste in the mouth in some. And it is touted as not causing low blood sugar as many older blood sugar lowering drugs did, however I see it every day in my practice that Metformin can m Continue reading >>

Thyrotropin Suppression By Metformin

Thyrotropin Suppression By Metformin

The Journal of Clinical Endocrinology & Metabolism Endocrinology Service, Walter Reed Army Medical Center, Washington, DC 20307 Address all correspondence and requests for reprints to: Robert A. Vigersky, M.D., Endocrinology Service, Walter Reed, Army Medical Center, Washington, DC 20307. Search for other works by this author on: Endocrinology Service, Walter Reed Army Medical Center, Washington, DC 20307 Search for other works by this author on: Endocrinology Service, Walter Reed Army Medical Center, Washington, DC 20307 Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 91, Issue 1, 1 January 2006, Pages 225227, Robert A. Vigersky, Amy Filmore-Nassar, Allan R. Glass, Thyrotropin Suppression by Metformin, The Journal of Clinical Endocrinology & Metabolism, Volume 91, Issue 1, 1 January 2006, Pages 225227, Context: Drug-drug interactions are common but often are discovered only long after initial drug release. Metformin has been available in the United States for 9 yr and elsewhere for many years, but as of yet there are no reports that the drug modifies thyroid hormone economy. Objective: The objective of the study was to describe the clinical and biochemical findings of four patients with chronic hypothyroidism, previously euthyroid on fixed doses of l-T4 for several years, in whom the metformin was initiated. Setting: The study was conducted at a tertiary care military hospital providing care to active-duty soldiers, sailors, and marines, retirees of the armed forces, and their eligible dependents. Participants: Four patients with chronic hypothyroidism who were placed on metformin participated in the study. Intervention, Main Outcome Measure: Serum TSH, free T4, and free T3 levels were measured during metformin trea Continue reading >>

Blood Sugar Imbalances And Hashimoto’s

Blood Sugar Imbalances And Hashimoto’s

One Thing People with Hashimoto’s Can Do Right Away to Feel Better People often ask me if there was one thing that people with Hashimoto’s could do right away to feel better and that is balancing your blood sugar!! Balancing blood sugar levels should be one of the priorities for anyone who is hoping to overcome autoimmune thyroiditis and adrenal fatigue. Balancing my blood sugar made a big difference for me, helping with my anxiety levels and reducing my thyroid antibodies. Before I balanced my blood sugar, I would get “hangry” (hungry +angry) multiple times per day as the high carbohydrate foods I was eating were making me have huge blood sugar swings. What I didn’t know, is that these swings were also weakening my adrenals and causing a spike in my thyroid antibodies. Blood sugar imbalances have been described as adding “fuel to the fire” in autoimmune thyroid disease by many practitioners who focus on reversing Hashimoto’s. I wasn’t aware that I had blood sugar issues when I was first diagnosed (despite being a self-admitted sugar addict…). I was thin, so, therefore, I thought that it meant that I was healthy. I recently had this conversation with an overweight family member who thought he was in the clear to eat sugar because he did not have diabetes. But you see, diabetes takes many years to develop, and impaired carbohydrate tolerance, insulin resistance, blood sugar swings, and hypoglycemia may be seen for many years before. Researchers in Poland have found that up to 50% of patients with Hashimoto’s have an impaired tolerance to carbohydrates. This means that after consuming carbohydrate-rich foods, their blood sugar goes up too high, too quickly. This leads to a rapid, sometimes excessive release of insulin. These insulin surges can cause Continue reading >>

Hashimotos And Polycystic Ovary Syndrome(pcos)

Hashimotos And Polycystic Ovary Syndrome(pcos)

Hashimotos and PCOS are connected by more than one molecular mechanism and they share certain genetic components. As they have not been extensively studied together, not much is known how their combination can impact our overall health. One condition might trigger the other, and besides genes, can be triggered by the environment. It would be interesting to know more about how or why do Hashimotos and PCOS co-develop, and what can we do to prevent it. What are your experiences? We would love to hear fromyou Thyroid disorders may cause irregular menstrual cycles, problems with ovulation and fertility issues (13). PCOS affects up to 12 in 100 females of reproductive age (4- 7). It is characterised by irregular menstrual cycles, either multiple ovulations in one cycle or no ovulation at all, hyperandrogenism [excessive levels of testosterone] and insulin resistance (6, 8, 9). PCOS can be very different from person to person, and can also cause different grade of metabolic or menstrual cycle irregularities (10, 11). High levels of anti-TPO or anti-Tg antibodies, a hallmark of an autoimmune thyroid condition, are found in 1 in 3 of PCOS patients (12). If a person has either Hashimotos or PCOS, the chance to be diagnosed with the second condition increases up to ten fold (12, 13). Five most commonly mutated genes or molecules in Hashimotos andPCOS Hashimotos is the most common autoimmune disorder in adults, causing a wide range of health complications (14). It is, similar to PCOS, caused by mutations in a specific set of genes (15- 19). Several of these genes are common for both Hashimotos and PCOS: fibrillin 3 gene (FBN3), vitamin D receptor gene (VDR) (20- 22), TGF (23, 24), gonadotropin-releasing hormone receptor (GnRHR) (25) and CYP1B1 (26). Some of these molecules regula Continue reading >>

Metformin For Protection Against Alzheimer's, Cancer And Heart Disease?

Metformin For Protection Against Alzheimer's, Cancer And Heart Disease?

With commentary by Nir Barzilai, MD, director of the Institute for Aging Research, Albert Einstein College of Medicine, and Brian Kennedy, PhD, president and CEO of the Buck Institute for Research on Aging. Metformin may influence fundamental aging factors that underlie many age-related conditions, including cancer, heart disease and Alzheimer's, says Nir Barzilai, MD, director of the Institute for Aging Research at Albert Einstein College of Medicine, the Bronx. "Metformin is generic, and it's cheap," Dr. Barzilai says. And accumulating data suggests that ''it interferes with the biology of aging." Aging, he says, is a primary risk factor for not only diabetes but also most of our big killers, such as Alzheimer's, heart disease and cancer. In animal and human studies, metformin has shown promise in slowing the aging process and halting diseases. To study the potential of metformin further, Dr. Barzilai plans to launch a large-scale study, Targeting Aging with METformin (TAME), to look at the effects of metformin compared to placebo. His team has already completed the MILES study, Metformin in Longevity, and are analyzing the results. In that study, they gave some participants metformin, at 1,700 milligrams a day, and others placebo. The aim was to see if the metformin could restore the gene expression profile of an older person with blood sugar problems known as impaired glucose tolerance (but not yet diabetic), to that of a younger person. Dr. Barzilai knows he has critics of his approach. He brushed them off, saying the people who don't see the value of the research ''don't understand the biology of aging and that it can be changed." He doesn't see the research as testing an anti-aging drug. "Aging is not a disease and we don't want it to be a disease," he says. Howe Continue reading >>

Different Effects Of Metformin On The Hypothalamic-pituitary-thyroid Axis Inbromocriptine- And Cabergoline-treated Patients With Hashimoto's Thyroiditis And Glucose Metabolism Abnormalities.

Different Effects Of Metformin On The Hypothalamic-pituitary-thyroid Axis Inbromocriptine- And Cabergoline-treated Patients With Hashimoto's Thyroiditis And Glucose Metabolism Abnormalities.

1. Exp Clin Endocrinol Diabetes. 2015 Oct;123(9):561-6. doi: 10.1055/s-0035-1564073.Epub 2015 Sep 15. Different Effects of Metformin on the Hypothalamic-Pituitary-Thyroid Axis inBromocriptine- and Cabergoline-treated Patients with Hashimoto's Thyroiditis and Glucose Metabolism Abnormalities. Krysiak R(1), Okrzesik J(1), Okopien B(1). (1)Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medykw, Katowice, Poland. Metformin was found to reduce serum thyrotropin levels in patients withhypothyroidism. This effect was less pronounced if patients were additionallytreated with bromocriptine. The study included 39 premenopausal women withautoimmune thyroiditis and thyrotropin levels exceeding 3.0 mU/L. All patientshad been treated for at least 6 months with bromocriptine (5.0-7.5 mg daily) orcabergoline (0.5-1.0 mg weekly). Because of coexisting type 2 diabetes orimpaired glucose tolerance, they were then given metformin (1.7-2.55 g daily).Glucose homeostasis markers, thyroid antibody titers, as well as serum levels of thyrotropin, total and free thyroid hormones and prolactin were determined beforeand after 6 months of metformin treatment. At baseline, cabergoline-treatedpatients were less insulin resistant as well as tended to have lower levels ofprolactin than bromocriptine-treated patients. Although in both treatment groups,metformin decreased plasma levels of fasting and post-challenge plasma glucoseand improved insulin receptor sensitivity, this effect was more prominent inpatients receiving cabergoline. However, only in bromocriptine-treated patients, metformin decreased serum thyrotropin and this effect reached the level ofsignificance in a subgroup of patients with subclinical hypothyroidism. Neitherin cabergoline- nor in bromocr Continue reading >>

Diabetes Drug May Affect Thyroid In Some Patients

Diabetes Drug May Affect Thyroid In Some Patients

HealthDay Reporter MONDAY, Sept. 22, 2014 (HealthDay News) -- Metformin, a drug commonly used to treat diabetes, may raise the risk of low levels of thyroid-stimulating hormone (TSH) among patients with an underactive thyroid, a new study suggests. The researchers cautioned that low TSH levels may be associated with heart problems and broken bones, although a cause-and-effect link was not established in this study. Among those in the study with an underactive thyroid (hypothyroidism), there were 495 incidences of low levels of thyroid-stimulating hormone per year compared with 322 in the normal thyroid group, the report published Sept. 22 in the CMAJ concluded. Among patients treated for an underactive thyroid, metformin was linked with a 55 percent higher risk for low TSH levels, compared to those who were taking sulfonylurea for their diabetes. "The results of this longitudinal study confirmed that the use of metformin was associated with an increased risk of low TSH levels in patients with treated hypothyroidism," Dr. Laurent Azoulay, with the department of oncology at McGill University in Montreal, said in a journal news release. "Given the relatively high incidence of low TSH levels in patients taking metformin, it is imperative that future studies assess the clinical consequences of this effect," Azoulay added. Two experts agreed that the finding requires further research. "The question this study poses is: does the suppressed TSH have clinical significance?" said Dr. Gerald Bernstein, director of the diabetes management program at the Friedman Diabetes Institute at Mount Sinai Beth Israel, in New York City. "The answer is as follows, millions of people have type 2 diabetes and millions of people have low thyroid and take thyroid pills. And given the multiple mill Continue reading >>

The Connection Between Thyroid Disease And Diabetes

The Connection Between Thyroid Disease And Diabetes

It's not uncommon for someone to have both thyroid disease and diabetes. In fact, if you have type 1 diabetes , type 2 diabetes , insulin resistance , or metabolic syndrome , this doubles your risk of developing thyroid disease. And thyroid disease increases your risk of developing metabolic syndrome or type 2 diabetes. This association is even stronger if you are overweight or obese. It's important, then, to make sure you undergo routine screening for diabetes if you have thyroid disease, and vice versa, to ensure early detection and timely treatment. When one of the conditions is poorly controlled, it can make management of the other condition and reducing your risk of complications more difficult. There are also few steps you can take to help reduce your risk of this double diagnosis. Your thyroid gland and thyroid hormones play a major role in regulating many of your body's biological processes, such as growth, development, and metabolism. Because thyroid disease interferes with metabolism, it can alter your blood sugar. This increases your risk of developing diabetes, and it makes it harder to manage your blood sugar if you already have diabetes. Hyperthyroidism, which is overactive thyroid hormone, and hypothyroidism, which is underactive thyroid hormone, are both associated with mild hyperglycemia (elevated glucose levels). You might not experience obvious symptoms of thyroid-induced hyperglycemia if you do not have diabetes because your insulin can regulate your blood sugar to get it near optimal levels. It is believed that the chronically high blood sugar that can be induced by thyroid disease may contribute to the development of metabolic syndrome, a pre-diabetic state. Untreated metabolic syndrome can progress to type 2 diabetes. Diabetes can cause alteratio Continue reading >>

There Is High Likelihood Of Having Both Polycystic Ovary Syndrome And Autoimmune Hypothyroid Disease.

There Is High Likelihood Of Having Both Polycystic Ovary Syndrome And Autoimmune Hypothyroid Disease.

PCOS Treatment: Use of Combination Therapy More Effective Long-Term Hashimotos Thyroiditis is Common in Women with PCOS According to their analysis, published in Experimental and Clinical Endocrinology & Diabetes,2 the researchers found that many women with polycystic ovary syndrome may also have problems with their thyroid, a gland that helps to maintain metabolic processes in the body.3 More specifically, this form of thyroid disease Hashimotos thyroiditis , an autoimmune hypothyroid condition in which the bodys immune system attacks the thyroidis three times more common in women with PCOS than in women without it.2 Besides assessing the prevalence of Hashimotos thyroid disease in women who have been diagnosed with PCOS, Jan Ulrich, MD, and his team also studied the impact that autoimmune thyroiditis may have on hormonal changes.2 If you are a woman with PCOS, your body may be producing too much androgen. Androgens are a class of male sex hormones, in particular, testosterone, that are found in smaller but necessary levels in women too.4 Higher levels of androgen may interfere with a womans ability to get pregnant; for this reason, many women with PCOS struggle with infertility.1 Surprisingly, the researchers found that high levels of androgen are less common in patients who have both conditions: Hashimotos thyroiditis and PCOS. This hormone pattern was confirmed even when looking at testosterone alonean increased testosterone level is not found in patients with both conditions.2 Dr. Ulrich and his co-authors speculate that thyroid autoimmunity suppresses androgen production but they do not have a clear reason as to why it happens.2 Metabolic Complications Similar in PCOS and Thyroiditis The researchers assessed the impact of having both Hashimotos thyroiditis and PC Continue reading >>

Metformin Inhibits Thyroid Cell Growth And Improves The Treatment Of Thyroid Cancer In Patients With Diabetes

Metformin Inhibits Thyroid Cell Growth And Improves The Treatment Of Thyroid Cancer In Patients With Diabetes

Metformin inhibits thyroid cell growth and improves the treatment of thyroid cancer in patients with diabetes Metformin: a diabetes drug that helps the body become more sensitive to insulin. Radioactive iodine (RAI): this plays a valuable role in diagnosing and treating thyroid problems since it is taken up only by the thyroid gland. I-131 is the destructive form used to destroy thyroid tissue in the treatment of thyroid cancer and with an overactive thyroid. Obesity and type 2 diabetes have both been associated with an increased risk for some types of cancer. Metformin is a diabetes drug that helps the body become more sensitive to insulin. Metformin has also been shown to have beneficial effects in various cancers, suggesting there may be a role for this drug as an additional cancer treatment in some cases. In a prior study, these authors found that metformin decreased the growth of some types of thyroid cancer cells when grown in a lab. This study examined the effects of metformin on the response of thyroid cancer to treatment in patients with diabetes. Klubo-Gwiezdzinska J et al. Treatment with metformin is associated with higher remission rate in diabetic patients with thyroid cancer. J Clin Endocrinol Metab 2013;98:3269-79. Epub May 24, 2013. The authors reviewed the records of 240 patients with thyroid cancer who had been treated with surgery and radioactive iodine and who had previously been diagnosed with type 2 diabetes mellitus. There patients were followed for an average of 6.9 years. They divided the patients into three groups: group 1 had been treated with metformin, group 2 had not received metformin and group 3 had not received metformin and did not have a history of diabetes. The patients in group 1 and 2 were similar in age, sex, weight and use of dia Continue reading >>

Hypothyroidism, Metformin & Weight Loss

Hypothyroidism, Metformin & Weight Loss

Metformin, sold under the brand name Glucophage, is a diabetes drug that can improve insulin sensitivity and promote weight loss by helping lower glucose levels and prevent hunger. It works as a weight-loss aid, but may not be suitable for people with hypothyroidism because it can interact with levothyroxine -- thyroid replacement hormone -- and lead to high blood sugars. Video of the Day Your thyroid gland is located at the base of your throat, in front of your vocal chords. Part of your endocrine system, your thyroid produces T4 and T3 hormones which control the speed your body uses oxygen and energy -- your metabolism. Low thyroid function results in a slower metabolism; one of the first signs of hypothyroidism is weight gain. Other symptoms include brittle or weak nails and hair, fatigue and a sensitivity to cold. Hypothyroidism is treated with supplemental thyroid hormone; which your body can also convert to T3 hormone. Rarely do you need to supplement both hormones. Levothyroxine is the most common treatment and replaces T4 hormone, boosting metabolism Weight Loss and Hypothyroidism Until your hypothyroidism is controlled and your metabolic function returns to normal, it will be difficult for you to lose weight. It can take three months or longer to find the correct dose of levothyroxine and buildup enough thyroid hormone in your body. You can try to boost your metabolism by changing your body composition and increasing muscle mass. The more muscle tissue you have in comparison to fat, the higher your metabolism will be -- and the more calories you will burn, even at rest. Weight loss requires you to burn more calories than your consume, so that your body will break down stored fat to use for energy. Metformin and Levothyroxine Metformin decreases the amount of gl Continue reading >>

Metformin And Thyroid: An Update

Metformin And Thyroid: An Update

aEndocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, Athens University School of Medicine, Athens, Greece bDepartment of Endocrinology, Metabolism and Diabetes, Evgenideion Hospital, Athens University School of Medicine, Athens, Greece aEndocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, Athens University School of Medicine, Athens, Greece bDepartment of Endocrinology, Metabolism and Diabetes, Evgenideion Hospital, Athens University School of Medicine, Athens, Greece *Theodora Pappa, MD, PhD, Endocrine Unit, Department of Clinical Therapeutics, Athens University School of Medicine, ALEXANDRA Hospital, 80 Vassilissis Sofias Avenue, GR-11528 Athens (Greece), E-Mail [email protected] Copyright 2013 European Thyroid Association Published by S. Karger AG, Basel This article has been cited by other articles in PMC. Metformin is one of the most widely prescribed antidiabetic medications with a favorable safety profile. In the last decade, several studies have reported a TSH-lowering effect of metformin in patients with diabetes mellitus. To review literature data on the role of metformin use on thyroid function tests and the course of thyroid cancer. We performed a search in the PubMed database using the terms: metformin, thyroid, TSH, diabetes, polycystic ovarian syndrome (PCOS) and thyroid cancer. The majority of available evidence suggests that metformin therapy results in a modest reduction of TSH levels in diabetic and/or PCOS patients with thyroid disorder, while thyroid hormone levels remain unaltered. It appears that this effect is independent of thyroid autoimmunity and thyroxine treatment. However, metformin use in subjects with an intact thyroid axis is not associated with a significant change of TSH levels. Concernin Continue reading >>

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