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A more extensive list of potential side effect risks (which are very rare), can be read on the Botox for chronic migraine AbbVie website

Metformin may cause lactic acidosis, and its mechanism includes inhibiting the activity of mitochondrial complexes, leading to reduced ATP production, which in turn causes lactic acid accumulation and subsequently triggers lactic acidosis

Glutathione peroxidase degrades intracellular hydrogen peroxide and thereby inhibits intracellular protein iodination in thyroid epithelium
Heliyon 8 (11), e11194
High Amounts of Stress Never underestimate the power of stress on your thyroid health
