I am on bio identical hormone replacement including cortisol for low levels. Is it good to take metformin when taking cortisol for low cortisol levels? I thought I read somewhere that metformin lowers your cortisol levels.

1 Answer 1


This study was examining the effects of metformin on hormone levels responding to hypoglycemia. It found that metformin did not significantly alter the body's hormonal response to hypoglycemia in their study population.


It looks like according to the study that recurring hypoglycemia can cause a lowering of cortisol:

Antecedent hypoglycemia significantly reduced epinephrine, ACTH, cortisol, glucagon, GH, and symptomatic responses to hypoglycemia (P < 0.05 for all variables)

This may have been partially misconstrued; since metformin helps lower blood glucose, and low blood glucose is associated with decreased cortisol levels, one could assume that metformin could in theory lower cortisol levels, but this does not seem to be the case at least according to this study.

Metformin works by decreasing the absorption of glucose, decreasing the amount of glucose the liver produces, and by improving insulin sensitivity. It does not directly stimulate insulin release or mimic the actions of insulin; therefore it is not linked to much hypoglycemia.

When checking interactions between hydrocortisone (cortisol as a medication) and metformin the only interaction reported was: cortisol may decrease the effect of metformin and other anti-diabetic agents.

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