The Influence of Energy Depletion by Metformin or Hypocaloric Diet on Thyroid Iodine Uptake in Healthy Volunteers: a Randomized Trial

Sloot, Yvette J E; Janssen, Marcel J.R.; Herwaarden, Antonius E. van; Peeters, Robin P.; Netea‐Maier, Romana T.; Smit, Johannes

doi:10.1038/s41598-019-41997-2

Cited by 10 publications

(6 citation statements)

References 38 publications

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“…Zn alone or combined with Se might also influence thyroid function, where mean serum-free T3 increased significantly [36]. Researchers enrolled 15 healthy male volunteers, suggesting that T3 and T3/rT3 ratios decreased after hypocaloric diet or metformin supplementation [37]. Jane Teas et al found seaweed supplementation led to a higher TSH level, while soy supplementation did not influence thyroid function end points [38].…”

Section: Discussionmentioning

confidence: 99%

The Association between the Dietary Inflammatory Index and Thyroid Function in U.S. Adult Males

Liu

Feng

et al. 2021

Nutrients

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Thyroid function has a close link with inflammation. However, it is still unknown whether the dietary inflammatory potential is associated with thyroid function. We aimed to assess the relationship among them using the data from the National Health and Nutrition Examination Survey (NHANES). This study was a cross-sectional study, where weighted multivariable linear regression, subgroup analyses, and interaction terms were employed. Thyroid function was assessed by eight indexes, including total and free T4 and T3, Tg, TgAb, TPOAb, and TSH. A total of 2346 male participants aged ≥20 years with an average age of 50.74 ± 17.68 years were enrolled. The mean DII score among participants was −0.46 ± 1.73, ranging from −4.12 to 4.41, and mean total thyroxine (T4) was 7.61 ± 1.51 μg/dL. We found a positive association between DII and total T4 (β = 0.07; p = 0.0044). Using subgroup analysis, this association became stronger in both the iodine-deficient and obese group (iodine-deficient group: β = 0.15, p < 0.0001; obese group: β = 0.14, p < 0.0001). In conclusion, men adhering to a more pro-inflammatory diet appeared to have higher total T4 levels. However, these hormone variations were still within the normal clinical range and more well-designed studies are still needed to validate the causal relationship between DII and thyroid function.

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Section: Discussionmentioning

confidence: 99%

The Association between the Dietary Inflammatory Index and Thyroid Function in U.S. Adult Males

Liu

Feng

et al. 2021

Nutrients

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“…To investigate the influence of metformin on thyroid function, a clinical study has recruited 19 healthy male volunteers, showing that metformin does not alter iodine uptake in the thyroid gland [ 219 ]. However, various clinical studies performed in hypothyroid subjects have shown that metformin reduces thyrotropin (TSH) levels even if the mechanism involved is not fully understood [ 220 , 221 ].…”

Section: Resultsmentioning

confidence: 99%

View on Metformin: Antidiabetic and Pleiotropic Effects, Pharmacokinetics, Side Effects, and Sex-Related Differences

Froldi

2024

Pharmaceuticals

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Metformin is a synthetic biguanide used as an antidiabetic drug in type 2 diabetes mellitus, achieved by studying the bioactive metabolites of Galega officinalis L. It is also used off-label for various other diseases, such as subclinical diabetes, obesity, polycystic ovary syndrome, etc. In addition, metformin is proposed as an add-on therapy for several conditions, including autoimmune diseases, neurodegenerative diseases, and cancer. Although metformin has been used for many decades, it is still the subject of many pharmacodynamic and pharmacokinetic studies in light of its extensive use. Metformin acts at the mitochondrial level by inhibiting the respiratory chain, thus increasing the AMP/ATP ratio and, subsequently, activating the AMP-activated protein kinase. However, several other mechanisms have been proposed, including binding to presenilin enhancer 2, increasing GLP1 release, and modification of microRNA expression. Regarding its pharmacokinetics, after oral administration, metformin is absorbed, distributed, and eliminated, mainly through the renal route, using transporters for cationic solutes, since it exists as an ionic molecule at physiological pH. In this review, particular consideration has been paid to literature data from the last 10 years, deepening the study of clinical trials inherent to new uses of metformin, the differences in effectiveness and safety observed between the sexes, and the unwanted side effects. For this last objective, metformin safety was also evaluated using both VigiBase and EudraVigilance, respectively, the WHO and European databases of the reported adverse drug reactions, to assess the extent of metformin side effects in real-life use.

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“…However, it is important to review the temporal nature of changes in rT3 levels. Prior studies show that following weight loss through diet or bariatric surgery, rT3 levels increase significantly by 2-3 weeks [8,43] and regress towards baseline levels by 3 months post-surgery [8]. To reduce participant burden, the current study accepted rT3 labs collected at any time over the entire 2 week to 3-month post-surgery time period.…”

Section: Discussionmentioning

confidence: 99%

Do early indicators of euthyroid sick syndrome predict longer-term post-bariatric weight loss? A hypothesis-generating preliminary study

Fowler

Adler

Najarian³

et al. 2022

Preprint

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Background: Despite the success of bariatric surgery for most patients, up to 30 % do not experience optimal weight loss outcomes. Reasons remain incompletely understood. Thyroid hormones, due to their role in energy expenditure, have received study. Yet research to date is inconclusive regarding the impact of standard thyroid markers (e.g., thyroid stimulating hormone, or TSH) on weight regulation after bariatric surgery. This prospective observational study investigates whether the early development of euthyroid sick syndrome (ESS) predicts reduced longer-term post-bariatric weight loss. ESS develops during periods of stress (e.g., critical illness, severe infection, famine) and is thought to serve a protective function by suppressing metabolism and conserving weight. Levels of metabolically active free triiodothyronine (FT3) drop, levels of non-catabolic reverse 3, 3, 5-triiodothyronine (rT3) rise, and TSH levels remain euthyroid. Reductions in the ratio of FT3 to rT3 significantly predict outcomes in critically ill patients with ESS yet have been unexamined in intentional weight loss among post-bariatric patients. Hence this hypothesis-generating preliminary study investigated whether early changes in the FT3:rT3 ratio predict weight changes at 1-2 years post-bariatric surgery. Methods: Twenty-three adult patients undergoing Roux-en-Y gastric bypass (n=12) or sleeve gastrectomy (n=11) were recruited from a bariatric surgery clinic. The TSH, FT4, FT3, rT3, and self-reported hypothyroid symptoms were collected 2-weeks pre-surgery and between 2 weeks to 3 months post-surgery. Body mass index was measured pre-surgery and 1-2 years post-surgery. Results: Reductions in the FT3:rT3 ratio from pre- to early post-surgery significantly predicted reduced weight loss at 1 (p= 0.03) and 2 years (p= 0.02) post-surgery. No other thyroid-related markers nor hypothyroid symptoms were predictive. Conclusions: Although replication with larger samples is needed (especially given sizeable study attrition), this small exploratory study provides provocative support that early changes in the FT3:rT3 ratio associated with ESS predict longer-term reductions in post-bariatric surgery weight loss. Clinical implications are discussed.

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The Influence of Energy Depletion by Metformin or Hypocaloric Diet on Thyroid Iodine Uptake in Healthy Volunteers: a Randomized Trial

Cited by 10 publications

References 38 publications

The Association between the Dietary Inflammatory Index and Thyroid Function in U.S. Adult Males

The Association between the Dietary Inflammatory Index and Thyroid Function in U.S. Adult Males

View on Metformin: Antidiabetic and Pleiotropic Effects, Pharmacokinetics, Side Effects, and Sex-Related Differences

Do early indicators of euthyroid sick syndrome predict longer-term post-bariatric weight loss? A hypothesis-generating preliminary study

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