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Hyperthyroidism primarily occurs as a result of Graves disease, but can have several other potential causes too, including: Graves disease: The most common cause of hyperthyroidism which causes the immune system to enlarge the thyroid and overstimulate hormone production Thyroid nodules: Benign lumps in the thyroid that become overactive and produce too much thyroid hormone, more common in older adults Thyroiditis: Inflammation of the thyroid which causes stored thyroid hormone to leak from the gland

Metformin Dulaglutide reduced metformin Cmax by 9% and delayed Tmax by 1 hour but did not change metformin AUC [14]