Can you take Ozempic if you have a thyroid problem?

In this article:

• Ozempic with thyroid problems
• Ozempic and thyroid levels
• The bottom line

In this article

• Ozempic with thyroid problems
• Ozempic and thyroid levels
• The bottom line

Thyroid conditions are more common than many people realize. According to the American Thyroid Association, an estimated 20 million Americans are living with some form of thyroid disorder. This small, butterfly-shaped gland located at the front of the neck plays a major role in regulating the body’s metabolism and energy use, so when something’s off, it can affect nearly every aspect of health.

At the same time, GLP-1 medications containing semaglutide—like Ozempic, Wegovy, and Rybelsus—are becoming increasingly popular. Originally approved by the U.S. Food and Drug Administration (FDA) to help manage Type 2 diabetes, these drugs are now also widely prescribed for weight loss, weight management, and cardiovascular health. As their popularity grows, questions are surfacing about how they might interact with other health conditions, including thyroid disorders.

You may have heard that semaglutide causes thyroid problems. In general, Ozempic is considered safe for those with common thyroid conditions such as hypothyroidism or hyperthyroidism. But if you are at high risk for certain types of thyroid cancer, it’s important to seek medical advice from a healthcare professional before starting treatment. Read on to explore the connection between Ozempic and thyroid health.

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Can you take Ozempic with thyroid problems? 

The short answer: In most cases, yes. “For most people with common thyroid conditions like hypothyroidism or hyperthyroidism, Ozempic is generally safe to use,” says Zaid Fadul, MD, CEO of Bespoke Concierge MD. In fact, it may be beneficial for people with hypothyroidism by helping with weight loss, which in turn may help improve thyroid levels. People with a personal or family history of medullary thyroid carcinoma (MTC) or people with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should not take Ozempic. Here’s what you should know about GLP-1s and thyroid conditions.

Ozempic and hypothyroidism 

The weight loss associated with GLP-1s like Ozempic can be beneficial for people with hypothyroidism, says Elizabeth Van Dril, Pharm.D., a clinical pharmacist with the University of Illinois Hospital and Health Sciences System. Hypothyroidism occurs when the thyroid gland doesn’t produce enough thyroid hormone. It causes symptoms such as weight gain, fatigue, dry skin, sensitivity to cold, and brain fog. It’s most common among postmenopausal women. Synthetic thyroid hormones help to replace the hormones that the thyroid gland is not making naturally. There aren’t any direct drug interactions between semaglutide injections and standard thyroid medications, such as Synthroid (levothyroxine) and Armour thyroid (desiccated thyroid hormone), says Lauren Cunningham, Pharm.D., another clinical pharmacist with the University of Illinois Hospital and Health Sciences System.

In fact, losing weight on Ozempic can “lead to reductions in levels of thyroid-stimulating hormone (TSH), suggesting a potential improvement in thyroid function and lower doses of thyroid replacement therapy,” Dr. Van Dril explains.

Dr. Van Dril and her clinical pharmacist colleague, Dr. Lauren Wilcox, co-authored a case study that followed a patient with diabetes who lost 31 pounds taking semaglutide. As a result, the patient subsequently required 25% less levothyroxine to maintain her thyroid hormone levels.

Ozempic and hyperthyroidism

It’s safe to take Ozempic with hyperthyroidism. Also known as overactive thyroid, this condition occurs when the thyroid gland produces too much thyroid hormone, causing symptoms such as nervousness, fatigue, unexpected weight loss, rapid heart rate, shakiness or tremors, and sensitivity to warm temperatures.

There is no interaction between Ozempic and the most common medications that treat hyperthyroidism: Tapazole (methimazole) and propylthiouracil, says Dr. Cunningham. Additionally, there is no evidence that “hyperthyroidism reduces the effectiveness of semaglutide or other GLP-1 receptor agonists for their intended uses,” Dr. Van Dril says. 

Ozempic and thyroid cancer

There are several types of thyroid cancer: papillary, follicular, medullary, and anaplastic. People with a personal or family history of medullary thyroid cancer or people with multiple endocrine neoplasia syndrome Type 2 (MEN 2) are advised against taking Ozempic because animal studies found an association between semaglutide and medullary thyroid tumors.

However, some initial recent research suggests Ozempic may actually be helpful, not harmful, for suppressing papillary thyroid carcinoma (PTC) growth and reducing tumor size—although these preliminary findings are not yet confirmed by clinical studies. Additionally, there is an association between elevated glucose levels and the risk of thyroid cancer. Using Ozempic to control diabetes could help to mitigate that risk, although again, more research is needed. 

Ozempic and other thyroid conditions

A meta-analysis of 45 clinical trials found that semaglutide didn’t seem to increase the likelihood of developing any of these thyroid conditions:

• Goiter
• Thyroiditis, or inflammation of the thyroid
• Noncancerous thyroid masses or growths

While the researchers note that more studies are needed to learn more about GLP-1s and thyroid conditions, current data suggests that Ozempic does not negatively impact the thyroid.

Does Ozempic affect thyroid levels?

Ozempic does not directly regulate thyroid levels the way it regulates blood sugar levels. However, it may indirectly affect thyroid levels, especially for people with hypothyroidism. Thyroid replacement therapy is typically weight-based, so you will need to work closely with your healthcare provider to monitor and adjust your levothyroxine dosage as needed.

“If you lose significant weight on Ozempic, plan for follow-up thyroid testing every three to six months during the first year,” Dr. Fadul says. “If you are taking thyroid replacement, be prepared that your dose may need adjustment as you lose weight. Pay attention to symptoms that might indicate your thyroid medication needs changing, such as fatigue, heart palpitations, or changes in your energy levels.” 

If you don’t have any existing thyroid issues, you shouldn’t have to worry about how your Ozempic will affect your thyroid. “Current evidence shows that semaglutide and other GLP-1 receptor agonists do not negatively affect thyroid function or hormone levels in people without existing thyroid issues,” Dr. Cunningham explains. 

The bottom line 

Ozempic is safe for people with thyroid problems, except those with a history or family history of certain thyroid cancers. Additionally, “clinical trials and systematic reviews show that GLP-1 receptor agonists remain effective for weight and diabetes management in people with thyroid disorders, and their side effects are primarily gastrointestinal, not thyroid-related,” Dr. Van Dril says.

However, people taking medication to treat hypothyroidism may need dose adjustments during periods of substantial weight loss, “as weight changes alone can affect thyroid functioning and thyroid hormone replacement requirements,” Dr. Van Dril says.