Context: The conventional treatment of nonmedullary thyroid carcinoma (NMTC) includes surgical resection, thyrotropin (TSH) suppression, and 131-iodine. Some patients develop persistent/recurrent metastatic disease requiring expensive alternative therapies, such as external radiation and multikinase inhibitors, which may have clinically significant side effects. Recent in vitro studies, in vivo studies in animals, and association studies in humans suggest that metformin, an inexpensive medication with a modest side effect profile, may help prevent or treat NMTC. No interventional trials analyzing the effect of metformin have been performed in humans.
Objective: We hypothesize that metformin administration will decrease serum thyroglobulin concentration (Tg), a surrogate marker for NMTC burden.
Methods: This retrospective institutional review board-approved study included 10 patients with persistent/recurrent NMTC who had exhausted conventional therapies including total thyroidectomy and 131-iodine. Five had detectable disease on computed tomography imaging. All had biochemical evidence of NMTC with Tg > 2.0 ng/mL with nondetectable serum thyroglobulin antibody concentrations. Five elected to have metformin treatment at doses varying from 500 to 2000 mg/day for 2 to 5 months. The remaining 5 served as untreated controls. Statistical significance was determined by the Mann-Whitney test.
Results: Tg decreased (mean decrease = 21.7 ± 8.4%) in all 5 patients receiving metformin and increased (mean increase = 16.6 ± 12.1%) in all 5 controls ( < .01). TSH did not change significantly in either group.
Conclusion: In summary, metformin caused a TSH-independent Tg decrease in patients with persistent/recurrent NMTC. More extensive studies are required to determine if metformin slows NMTC progression.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577541 | PMC |
| http://dx.doi.org/10.1210/jendso/bvac140 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Ultrasound‑guided Percutaneous Radiofrequency and Microwave Ablation for Cervical Lymph Node Metastasis from Papillary Thyroid Carcinoma: A Systematic Review and Meta‑analysis of Clinical Efficacy and Safety.
Acad Radiol
January 2025
Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China (A.U., L.C., L.Y., W.X.). Electronic address:
Aim: To evaluate the efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) for treating cervical lymph node metastasis (CLNM) from papillary thyroid carcinoma (PTC).
Methods: Medline, EMBASE, Web of Science, and Cochrane Library were searched for studies on the efficacy and safety of thermal ablations for treating CLNM from PTC until July 2024. Among 544 papers, 11 articles were reviewed involving 233 patients and 432 CLNM cases.
The role of preoperative serum thyroglobulin in the diagnosis and treatment of differentiated thyroid cancer: a systematic review and meta-analysis.
Front Oncol
December 2024
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Background: Serum thyroglobulin (Tg) is a critical marker for monitoring tumor recurrence and metastasis in patients who have undergone total thyroidectomy for differentiated thyroid cancer (DTC). While the definitive role of preoperative serum Tg in DTC is not yet established, studies suggest its importance in differentiating between benign and malignant thyroid nodules with indeterminate cytology, as well as in predicting distant metastasis (DM) in patients with DTC.
Methods: A thorough literature review was conducted on the use of preoperative serum Tg in differentiating between benign and malignant thyroid nodules, and in evaluating the extent of DTC lesions.
Role of Thyrotropin-Releasing Hormone Stimulation Test and Autoantibody in 952 Subjects with Subclinical Hypothyroidism.
J Endocr Soc
November 2024
Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul 04401, Korea.
Context: Subclinical hypothyroidism (SCH) is characterized by elevated thyroid-stimulating hormone (TSH) levels and normal free thyroxine (fT4) levels. In upper normal TSH levels, thyrotropin-releasing hormone (TRH) stimulation test proved to be useful in identifying an exaggerated TSH response.
Objective: We aimed to evaluate the incidence and predictive ability of basal TSH, anti-thyroid peroxidase antibodies (TPOAb), and anti-thyroglobulin antibodies (TgAb) for exaggerated TRH stimulation test in SCH.
Iodine Deficiency Hypothyroidism Among Children in the United States - 21st Century Resurgence?
AACE Clin Case Rep
August 2024
Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Background/objective: Iodine deficiency hypothyroidism is an important cause of neurocognitive and motor impairment in children globally. In the United States, universal salt iodization, which began in the 1920s, led to a dramatic decline in iodine deficiency hypothyroidism. However, iodine deficiency may be reemerging due to increased consumption of noniodized salts, decreased dairy iodine concentrations, and decreased intake of iodine containing foods due to food allergies, dietary preferences such as vegan diets, or restrictive food intake disorders.
View Article and Find Full Text PDFMicronutrient Biomarkers and Their Association with Malaria Infection in Children in Buea Health District, Cameroon.
Trop Med Infect Dis
December 2024
Biotechnology Unit, University of Buea, Buea, Cameroon.
Recently malaria and micronutrient deficiencies have become a major worldwide public health problem, particularly in Africa and other endemic countries with children under 5 years old being the most vulnerable. Apart from nutritional problems that cause micronutrient deficiencies, studies have also reported that parasitic infections like malaria can affect the levels of micronutrients. Thus, this research was aimed at assessing the serum levels of micronutrient biomarkers and their association with malaria infection in children under 5 years old in the Buea Health District.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!