Myo-Inositol Potentiates the Inhibitory Effect of Metformin on Prolactin Levels

Pharmacology. 2023;108(3):238-244. doi: 10.1159/000528542. Epub 2023 Feb 3.

Abstract

Introduction: Metformin was found to reduce elevated levels of anterior pituitary hormones. Its thyrotropin-lowering effect was more pronounced in individuals receiving myo-inositol. The aim of the present study was to investigate whether the concomitant supplementation of myo-inositol determines the impact of metformin on prolactin levels.

Methods: The study population consisted of two groups of women with mild-to-moderate hyperprolactinemia. Group 1 included 24 individuals receiving myo-inositol preparations (2 g daily for at least 6 months), while 24 inositol-naïve women belonged to group 2. Both groups were matched for age, insulin sensitivity, and prolactin concentration. For the following 6 months, all women were treated with metformin (1.7 daily). Plasma glucose levels, the homeostatic model assessment of insulin resistance ratio (HOMA-IR), glycated hemoglobin, as well as plasma levels of total prolactin, monomeric prolactin, thyrotropin, free thyroid hormones, adrenocorticotropic hormone, and insulin-like growth factor-1 were measured at baseline and after 6 months of metformin treatment.

Results: Metformin reduced plasma glucose, HOMA-IR, and glycated hemoglobin in both study groups, but this effect was more pronounced in group 1 than group 2. Treatment-induced changes in total and monomeric prolactin levels were significant only in group 1. There were no differences between follow-up and baseline values of thyrotropin, free thyroxine, free tri-iodothyronine, adrenocorticotropic hormone, and insulin-like growth factor-1. Treatment-induced changes in prolactin concentration correlated with baseline prolactin levels, baseline values of HOMA-IR, and the impact of treatment on HOMA-IR.

Discussion: The obtained results suggest that myo-inositol supplementation potentiates the inhibitory effect of metformin on prolactin levels in women with hyperprolactinemia.

Keywords: Insulin sensitivity; Metformin; Myo-inositol; Pituitary; Prolactin; hormones.

MeSH terms

  • Adrenocorticotropic Hormone
  • Blood Glucose
  • Female
  • Glycated Hemoglobin
  • Humans
  • Hyperprolactinemia*
  • Inositol / pharmacology
  • Insulin Resistance*
  • Insulin-Like Growth Factor I
  • Metformin* / pharmacology
  • Prolactin
  • Thyrotropin

Substances

  • Metformin
  • Prolactin
  • Insulin-Like Growth Factor I
  • Blood Glucose
  • Glycated Hemoglobin
  • Thyrotropin
  • Inositol
  • Adrenocorticotropic Hormone

Grants and funding

The study was supported by the statutory grant of the Medical University of Silesia (PCN-1-185/N/9/O).