From the Research
SGLT2 inhibitors generally have minimal direct effects on thyroid function, and current evidence does not indicate that they significantly alter thyroid hormone levels or function in most patients. These medications, which include empagliflozin, dapagliflozin, and canagliflozin, work primarily in the kidneys to reduce blood glucose by increasing urinary glucose excretion 1. The primary mechanism of action of SGLT2 inhibitors is to block glucose reabsorption by the kidneys, leading to increased glucosuria, which in turn helps to lower blood glucose levels 2.
Key Points to Consider
- Patients with pre-existing thyroid conditions should monitor their thyroid function as usual while taking SGLT2 inhibitors 3.
- Some animal studies have suggested potential protective effects against thyroid cancer, but this has not been conclusively demonstrated in humans 4.
- If a patient notices symptoms of thyroid dysfunction while taking an SGLT2 inhibitor, such as unusual fatigue, weight changes, temperature sensitivity, or heart rhythm changes, they should consult their healthcare provider for evaluation 5.
- The primary focus when prescribing SGLT2 inhibitors remains their benefits for diabetes management, cardiovascular protection, and kidney function rather than any thyroid-related effects.
Clinical Implications
The use of SGLT2 inhibitors is expected to increase, and it is essential for healthcare providers to be aware of their potential effects on thyroid function 1. While the current evidence suggests that SGLT2 inhibitors have minimal direct effects on thyroid function, patients with pre-existing thyroid conditions should be closely monitored. The benefits of SGLT2 inhibitors in diabetes management, cardiovascular protection, and kidney function make them a valuable treatment option for patients with type 2 diabetes.