Can semaglutide (glucagon-like peptide-1 receptor agonist) be taken with congenital adrenal hyperplasia (CAH)?

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Last updated: May 13, 2025View editorial policy

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From the Guidelines

Semaglutide can be taken with adrenal hyperplasia, but it is crucial to consult a healthcare provider for individual assessment and monitoring due to potential interactions with hormone production and blood glucose regulation. Adrenal hyperplasia affects hormone production, particularly cortisol and sometimes aldosterone, which can impact blood glucose regulation [ 1 ]. Semaglutide works by mimicking GLP-1 hormones to regulate blood sugar and reduce appetite. The interaction between these medications and adrenal hyperplasia depends on several factors, including:

  • Severity of adrenal hyperplasia
  • Whether it's congenital or acquired
  • Current hormone replacement therapy
  • Overall metabolic health Your doctor may need to monitor your blood glucose levels more closely if semaglutide is prescribed, as the medication could potentially affect your hormone balance [ 1 ]. They might also need to adjust your steroid replacement therapy if you're taking any. The starting dose of semaglutide would likely be determined based on your specific medical profile, with careful titration to minimize side effects. It is essential to weigh the benefits of semaglutide in reducing cardiovascular risk, as shown in studies such as the SUSTAIN-6 trial [ 1 ], against the potential risks and interactions with adrenal hyperplasia.

From the Research

Semaglutide and Adrenal Hyperplasia

  • There is limited research on the use of semaglutide in patients with adrenal hyperplasia, but one case report suggests that it may be effective in achieving weight loss in an adolescent with congenital adrenal hyperplasia due to 21-hydroxylase deficiency 2.
  • The case report describes an 18-year-old male with classic congenital adrenal hyperplasia who was treated with semaglutide, achieving an 11% body mass index reduction 2.
  • Another study found that metformin, a medication often used to treat type 2 diabetes, decreased plasma levels of androgens in women with non-classic congenital adrenal hyperplasia 3.
  • However, there is no direct evidence on the interaction between semaglutide and adrenal hyperplasia, and more research is needed to fully understand its effects in this population.
  • Semaglutide has been shown to be effective in achieving weight loss and improving cardiovascular risk factors in the general population 4.

Considerations for Patients with Adrenal Hyperplasia

  • Patients with adrenal hyperplasia may require careful management of their condition, including glucocorticoid therapy, to control androgen excess and prevent complications 5.
  • The use of semaglutide in patients with adrenal hyperplasia should be carefully considered, taking into account the potential benefits and risks, and monitored closely by a healthcare provider 2.
  • Further research is needed to fully understand the effects of semaglutide in patients with adrenal hyperplasia and to develop comprehensive care approaches for managing obesity and related comorbidities in this population 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The effect of metformin on androgen production in diabetic women with non-classic congenital adrenal hyperplasia.

Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association, 2014

Research

Semaglutide for the treatment of obesity.

Trends in cardiovascular medicine, 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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