After adjustment for covariates, women without obesity taking prescription opioids had higher odds of metabolic syndrome (OR = 3.4, 95% CI: 1.4–8.3), high triglycerides (OR = 2.6, 95% CI: 1.3–5.0), and low percent transferrin saturation (OR = 1.8, 95% CI: 1.1–3.0) than unexposed women without obesity. This evidence concerns the gene TF and metabolic syndrome.