From the Guidelines
No, Hurthle cell metaplasia is not a contraindication for semaglutide. Patients with this thyroid condition can generally take semaglutide as prescribed for diabetes management or weight loss. Hurthle cell metaplasia is a benign change in thyroid cells that can occur in various thyroid conditions, and it doesn't directly interact with the mechanism of action of semaglutide. According to the AGA clinical practice guideline on pharmacological interventions for adults with obesity 1, semaglutide is contraindicated in patients with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2, but there is no mention of Hurthle cell metaplasia as a contraindication.
Key Points to Consider
- Semaglutide works as a GLP-1 receptor agonist, primarily affecting insulin secretion, glucagon suppression, and appetite regulation through the central nervous system.
- The main contraindications for semaglutide include personal or family history of medullary thyroid carcinoma, Multiple Endocrine Neoplasia syndrome type 2, pregnancy, severe gastrointestinal disease, or previous serious hypersensitivity reactions to the medication.
- Patients with thyroid conditions should continue regular monitoring of their thyroid function while on semaglutide, but the presence of Hurthle cell metaplasia alone should not prevent its use when clinically indicated, as supported by the recent guideline published in Gastroenterology 1.
Clinical Implications
- Clinicians should carefully evaluate the benefits and risks of semaglutide in patients with Hurthle cell metaplasia, considering the potential benefits of weight loss and improved glycemic control.
- Regular monitoring of thyroid function and adverse effects is essential to ensure safe use of semaglutide in patients with thyroid conditions, as recommended by the AGA clinical practice guideline 1.
From the Research
Hurthle Cell Metaplasia and Semaglutide
- There is no direct evidence in the provided studies that discusses the relationship between Hurthle cell metaplasia and semaglutide.
- However, the studies provide information on Hurthle cell metaplasia and its relationship with thyroid diseases, which may be relevant to understanding potential interactions with semaglutide, a medication used to treat type 2 diabetes and obesity 2, 3, 4, 5, 6.
Hurthle Cell Metaplasia and Thyroid Diseases
- Hurthle cell metaplasia is a feature of chronic lymphocytic thyroiditis, and its presence increases with age 3.
- The malignancy rate in patients with Hurthle cell metaplasia on fine-needle aspiration biopsy is similar to that of patients with benign colloid nodules 4.
- Hurthle cell neoplasms can be benign or malignant, and the treatment and outcome depend on the type and stage of the disease 5.
- Hurthle cell carcinoma is a type of thyroid cancer that can present as a minimally invasive or widely invasive tumor, and its treatment may involve surgery, radioactive iodine, and systemic therapy 6.