From the Research
There is no immediate need to stop Mounjaro (tirzepatide) medication in a patient with TI-RADS 4 (moderately suspicious) thyroid nodules and thyroid goiter. The patient should proceed with the recommended follow-up ultrasound to monitor the thyroid nodules, but can continue taking Mounjaro as prescribed in the meantime. If a thyroid biopsy becomes necessary in the future, the healthcare provider might give specific instructions about medication timing around the procedure, but this would be determined after the follow-up imaging. Thyroid nodules are common findings and while these are rated as moderately suspicious, many turn out to be benign. The patient should discuss any specific concerns about medication interactions with their prescribing physician, but there is no established contraindication between Mounjaro and thyroid nodules or imaging procedures, as supported by the most recent studies on TI-RADS, such as the one published in 2021 1. Some key points to consider include:
- The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) is used to standardize thyroid ultrasound reports and predict the probability of malignancy in thyroid nodules 2.
- A study published in 2020 found that ACR TI-RADS scores are correlated with fine-needle aspiration (FNA) cytology results, with higher scores indicating a greater likelihood of malignancy 3.
- However, another study from 2021 found that ACR TI-RADS has favorable sensitivity but moderate specificity in risk stratification of thyroid nodules, which could lead to a slight decline in sensitivity if used to avoid unnecessary biopsies 1.
- The patient's medication, Mounjaro, is not known to cause or worsen thyroid nodules or goiter, and there is no established contraindication between Mounjaro and thyroid nodules or imaging procedures. It is essential to prioritize the patient's overall health and well-being, considering factors such as morbidity, mortality, and quality of life when making decisions about their care. In this case, continuing Mounjaro and proceeding with the recommended follow-up ultrasound is the most appropriate course of action, as it allows for monitoring of the thyroid nodules while also considering the patient's overall health and potential risks associated with stopping their medication.