metformin & tsh level

[Merema]

does anybody have any experience with metformin lowering TSH level? I came upon a study that said it can lower tsh in hypo patients. My daughter has been on 500 mg metformin for years. Her tsh is always low and she has a ton of hypo symptoms. I have hashimotos and my gut tells me she is headed there. I posted re her levels and someone suggested a pituitary issue but all her hormones were checked and wnl. Dr appt tomorrow which I will be attending just wondering if anyone has experienced a lower tsh on metformin only? She was prescribed it for pcos 10 years ago , the dose has never been increased but since giving birth 3 years ago she's gained at least 15 lbs. works out all the time, eats clean. Enlarged thyroid w multi nodules. Ok thanks

[SlowDragon Administrator]

Having PCOS makes hashimoto’s much more likely

you are correct Metformin lowers TSH

cureus.com/articles/50564-e...

For full Thyroid evaluation she needs TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[Merema]

thank you for the reply. Yes she's had antibodies checked currently thyroglobulin and tpo are negative . After giving birth her tpo was 55, for about a year ( 2021) this new endo only ordered Ft4 index and tsh and t3 uptake. Useless I'm aware, I been on this thyroid rollercoaster for 30 years and understand the need for Ft4 and ft3 testing. I will be telling her to ask Dr tomorrow to retest , her blood was drawn before 8am. Her Vit d was 44 last June and ferritin low at 25. Nodules been biopsied 3x and molecular was done on one last June result was less than 1% chance of malignancy. So it grew again since that biopsy we will see what this new dr thinks tomorrow.

[Merema in reply to Merema]

Oh forgot to add her thyroid has enlarged since last ultrasound a year ago.

[SlowDragon Administrator in reply to Merema]

Her Vit d was 44 last June and ferritin low at 25.

So vitamin D was insufficient

How much vitamin D is she taking

Should retest twice year

Low vitamin D will almost always result in low B vitamins

She needs B12 and folate tested

Ferritin deficient

GP MUST do full iron panel test for anaemia

Aiming to improve ferritin to at least 70

Low vitamin levels, especially low ferritin will falsely lower TSH