The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
Effects of Treatment With Metformin on TSH Levels: A Meta-analysis of Literature Studies
Abstract
CONTEXT: Some data suggest that metformin affects the thyroid profile in patients with type 2 diabetes, but contrasting results are reported in different settings. OBJECTIVE: The aim of this meta-analysis was to assess the effect of metformin treatment on TSH in subjects with or without thyroid dysfunction. DATA SOURCES: We performed a systematic search of articles evaluating changes in TSH levels in patients receiving metformin. STUDY SELECTION: Studies evaluating TSH levels before and after metformin treatment were included. DATA EXTRACTION: Clinical data, demographic variables, and TSH levels before and after treatment with metformin were extracted. Data were analyzed according to the underlying thyroid disease. DATA SYNTHESIS: A total of 7 datasets (206 patients) were included in the final analysis. After metformin treatment, a slight but significant reduction in TSH levels was found in 4 datasets on 119 patients with overt hypothyroidism receiving l-T4 replacement (mean difference, 1.08; 95% confidence interval [CI], 0.50, 1.65; P=.0003). Similarly, in 2 datasets reporting on a total of 33 patients with subclinical hypothyroidism not receiving treatment with l-T4, a significant reduction in TSH levels was reported (mean difference, 1.59; 95% CI, 1.32, 1.87; P<.00001) after treatment with metformin. In 1 dataset, including 54 euthyroid patients not receiving l-T4, no changes in TSH levels were reported after treatment with metformin (mean difference, 0.18; 95% CI, -0.20, 0.56; P=.35). CONCLUSIONS: Metformin induces a reduction in TSH levels both in overt and in subclinical hypothyroidism. In contrast, no change in TSH levels is found in euthyroid patients.
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“Metformin lowers serum TSH in L-T4-treated OH and L-T4-untreated SCH patients, but not in euthyroid patients (33).”
From L-T4 therapy in the presence of pharmacological interferents (2020) · cites this paper as [33]
Citations
Cites
Measuring inconsistency in meta-analyses
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Role of AMP-Activated Protein Kinase in Mechanism of Metformin Action
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Investigating and dealing with publication and other biases in meta-analysis
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The Hazards of Scoring the Quality of Clinical Trials for Meta-analysis
Jüni, P. (1999) · JAMA · doi:10.1001/jama.282.11.1054 · Cited by 1,981
Statistics Notes: Detecting skewness from summary information: Table 1
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Hypothalamic AMPK and fatty acid metabolism mediate thyroid regulation of energy balance
López, M., Varela, L., Vazquez, M. J., Rodríguez‐Cuenca, S., González, C. R., Velagapudi, V., Morgan, D. A., Schoenmakers, E., Agassandian, K., Lage, R., et al. (2010) · Nature Medicine · doi:10.1038/nm.2207 · Cited by 686
Role of AMP-activated protein kinase in mechanism of metformin action
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Biondi, B., Kahaly, G. J., & Robertson, R. P. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00163 · Cited by 598
The role of thyroid hormone in metabolism and metabolic syndrome
Teixeira, P. D. F. D. S., dos Santos, P. B., & Pazos-Moura, C. C. (2020) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018820917869 · Cited by 258
Burch, H. B. (2019) · New England Journal of Medicine · doi:10.1056/nejmra1901214 · Cited by 164
Links between Thyroid Disorders and Glucose Homeostasis
Eom, Y. S., Wilson, J. R., & Bernet, V. J. (2022) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2022.0013 · Cited by 182
Laboratory Testing in Thyroid Conditions - Pitfalls and Clinical Utility
Soh, S.-B., & Aw, T.-C. (2019) · Annals of Laboratory Medicine · doi:10.3343/alm.2019.39.1.3 · Cited by 136
Metadata
- Authors
- Lupoli, R., Di Minno, A., Tortora, A., Ambrosino, P., Arianna Lupoli, G., & Di Minno, M. N. D.
- Affiliations
- Federico II University Hospital (IT)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2014-01
- Volume
- 99
- Issue
- 1
- Pages
- E143-E148
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2103695808
- Cited by
- 102
- References
- 25
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 5 · 2023: 8 · 2022: 10 · 2021: 8 · 2020: 11 · 2019: 10 · 2018: 9 · 2017: 9 · 2016: 4 · 2015: 6 · 2014: 8
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pfizer
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- metformin, thyroid-stimulating hormone, type 2 diabetes, overt hypothyroidism, subclinical hypothyroidism, thyroid dysfunction, levothyroxine, euthyroid patients, drug effects on thyroid function
- MeSH terms
- Humans, Hypoglycemic Agents, Hypothyroidism, Metformin, Thyrotropin, Thyroxine, Hormone Replacement Therapy
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