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Does Metformin Cause Weight Loss With Hypothyroidism?

Learn about this common medication for type 2 diabetes and its effects on weight for hypothyroid patients.
Does Metformin Cause Weight Loss With Hypothyroidism?
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Hypothyroidism and weight struggles often go hand in hand. Indeed, a slowed metabolism coupled with difficult-to-manage symptoms can make staying at a healthy weight challenging when you have an underactive thyroid. Not only that, hypothyroidism sometimes pairs with insulin resistance as well, making weight loss even more challenging. Ahead, we look to whether metformin, one of the most common medications for insulin resistance, helps people with hypothyroidism lose weight.

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What is metformin?


Metformin is a medication used to treat type 2 diabetes. As part of the drug class of biguanides, this medication helps control the amount of blood glucose in your blood. Specifically, it reduces the amount of glucose that you absorb from the food you eat and the amount that is processed and released by the liver. 


Aside from its regulation of glucose, metformin also boosts your body's sensitivity to insulin, which is the hormone that helps your cells take in glucose for energy. When the body is exposed to too much glucose over time, our cells become less sensitive to insulin, leaving more glucose circulating in our blood vessels and causing tissue damage. Thus, when abnormally high glucose levels go untreated, it can lead to severe complications like heart disease, nerve damage, kidney disease, loss of eyesight, and stroke. 


Metformin may be used by itself or as one of many medications used to control blood sugar in people with type 2 diabetes. 


Does metformin cause weight loss?


Metformin is not a weight loss medication. However, research shows that it does help with weight loss in people with type 2 diabetes. In a study conducted by the Diabetes Prevention Program (DPP) Research Group and published in the journal Diabetes Care, metformin was considered safe and well-tolerated by patients taking the medication. It also led to sustained weight loss over a ten-year period. Indeed, study participants who adhered to the medication regimen found their overall weight decreased, as did their waist circumference. 


One theory why metformin may help with weight loss is that the body is more likely to use stored energy sources when blood glucose levels are not as high. Thus, it may increase your ability to burn fat for energy. Another thought is that one of the more troublesome side effects of metformin is stomach upset, including diarrhea, reduced appetite, and nausea—all symptoms that decrease your interest in food.


The connection between insulin resistance and hypothyroidism


Hypothyroidism is the condition in which your thyroid hormone production drops causing your body processes to slow down and change. Your body needs thyroid hormones to regulate energy use. A healthy thyroid function helps to regulate the body's metabolism in the form of blood pressure, blood temperature, and heart rate.


Common symptoms of hypothyroidism include: 

  • Fatigue
  • Cold intolerance
  • Constipation
  • Dry skin
  • Weight gain
  • Puffy face
  • Hoarseness
  • Muscle weakness
  • Elevated blood cholesterol level
  • Muscle aches, tenderness, or stiffness
  • Joint pain, stiffness, or swelling
  • Heavy or irregular menstrual periods
  • Thinning hair
  • Slowed heart rate
  • Depression
  • Impaired memory
  • Infertility
  • Goiter (enlarged thyroid gland)


For many people living with hypothyroidism, the associated weight gain or difficulty in losing weight can be one of the most frustrating symptoms.


Of course, metformin should not be prescribed just for the sake of weight loss. Indeed, it is considered safe and well-tolerated only for diabetic patients or those with metabolic syndrome. Used outside of those conditions, it may lead to serious and life-threatening complications like hypoglycemia. Therefore, it should not be prescribed solely for weight loss.


With that said, many people with hypothyroidism often have insulin resistance as well. Unfortunately, the two often go hand-in-hand. What is more, patients with primary hypothyroidism are also three times more likely to develop cardiovascular diseases like atherosclerosis and hypertension earlier in life. We also know that type 2 diabetes increases your risk for cardiovascular disease. Thus, if you have either condition, it is essential to be on the lookout for the other as well.


If you do need treatment for type 2 diabetes and also have hypothyroidism, metformin treatment may very well be an effective option for you. And yes, it may also help you lose some weight. We know that taking the right dose of thyroid medication can help patients with underactive thyroid glands lose between 5-8 pounds, so matching that with proper management of type 2 diabetes may also help further your weight loss. 


Why is weight loss so tricky with hypothyroidism?


Whether you have type 2 diabetes or not, trying to lose weight with hypothyroidism is tough. The thyroid is responsible for producing thyroid hormones that help regulate your metabolism. When there is not enough thyroid hormone available in your blood, it can cause your organs to slow down. This slowing occurs partly because there is not enough energy available to run your cellular function at optimal speed. One of the side effects of a slowed metabolism is difficulty taking energy from stored sources like adipose (fatty) tissue.


While a slowed metabolism is at the root of weight gain in hypothyroidism, other factors undoubtedly play a role. Firstly, the symptoms of hypothyroidism make it extremely difficult for a person to lose weight. Between crippling fatiguejoint pain, slowed movements, depression, constipation, and cold intolerance, it is hard to get up and get moving. 


Secondly, one of the leading causes of hypothyroidism in developed countries is Hashimoto's thyroiditis, an autoimmune condition where the immune system attacks healthy thyroid cells. At the root of any autoimmune condition is chronic inflammation, which primarily targets the thyroid but can also show up in other tissues. Inflammation takes a significant toll on the body, and as a result, may make weight management more difficult. 


Strategies for weight loss with hypothyroidism


If you have hypothyroidism, weight loss can be more challenging, but it certainly is attainable with proper management. To optimize your whole body health, you will want to work closely with your healthcare provider who can guide you in a unique treatment plan for your profile.

This weight loss plan may include:

  • Proper thyroid medication management
  • Communication between all of your providers and you about medications and treatment plans related to other conditions (like type 2 diabetes)
  • Regular thyroid testing, among other necessary labs
  • A healthy, low inflammatory diet that may be best supported by a nutritionist
  • An exercise plan that you can adhere to and enjoy
  • Lifestyle changes such as stress reduction and improved sleep


If you are struggling with weight loss and have hypothyroidism, meet with a Paloma thyroid doctor specializing in hypothyroidism. Every hypothyroid patient is unique and deserves a thyroid care plan tailored to their specific needs. 

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