glycemic control but did not influence insulin levels. The incidence of thyroid cancer has been increasing significantly over the past years 1. Keywords: thyroid cancer, metformin, thyroglobulin, mTOR, AMPK. More extensive studies are required to determine if metformin slows NMTC progression. Interestingly, the summary for generic metformin states that “Renal failure or renal dysfunction (creatinine clearance <60 ml/min)” is a contraindication to use. Results: Both creatine and metformin decreased glucose concentrations to similar levels at all. In summary, metformin caused a TSH-independent Tg decrease in patients with persistent/recurrent NMTC. If CrCl or eGFR fall <45 mL/min or <45 mL/min/1.73 m 2 respectively, metformin must be discontinued immediately.” 1 This is reiterated in the patient information leaflet. Having high creatinine levels probably isn’t harmful on its own, though it can be a marker of other health conditionsincluding chronic kidney disease (CKD). This measurement is called creatinine clearance. The summary states that “Metformin may be used in patients with moderate renal impairment, stage 3a (creatinine clearance 45-59 mL/min or estimated glomerular filtration rate 45-59 mL/min/1.73 m 2) only in the absence of other conditions that may increase the risk of lactic acidosis. Your doctors can measure the amount of creatinine in your blood and in your urine to get an idea of how well your kidneys are working. In January, the electronic Medicines Compendium (eMC) updated the Summary of Product Characteristics for Glucophage (metformin), approved by the UK Medicines and Healthcare Products Regulatory Agency (MHRA). Current guidelines are too restrictive, and many patients who could benefit are missing out
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