From the Research
GLP-1 receptor agonists can be used with caution in patients with hyperthyroidism, but close monitoring is recommended. These medications (such as semaglutide, liraglutide, dulaglutide, and exenatide) do not directly worsen hyperthyroidism and may actually be beneficial for weight management in patients with both conditions 1. However, several considerations are important:
- Patients with uncontrolled hyperthyroidism may already experience gastrointestinal symptoms like increased bowel movements and nausea, which could be exacerbated by GLP-1 agonists' common side effects.
- Both conditions can affect heart rate, so monitoring for tachycardia is advisable.
- Hyperthyroid patients often have increased appetite despite weight loss, and the appetite-suppressing effects of GLP-1 agonists should be balanced against nutritional needs. Start with the lowest dose of the chosen GLP-1 agonist and titrate slowly while monitoring thyroid function tests regularly 2. The priority should be to control the hyperthyroidism with appropriate treatment (antithyroid medications, radioactive iodine, or surgery) while adjusting the GLP-1 agonist therapy as needed based on the patient's response and symptom control. Although some studies suggest a potential link between GLP-1 receptor agonists and thyroid cancer, the evidence is not conclusive, and the benefits of using these medications may outweigh the risks in certain patients 3, 4, 5.