Hormonal
Long-term use of GLP-1 receptor agonists (specifically liraglutide, dulaglutide, and exenatide) is associated with an increased risk of thyroid tumors, including C-cell hyperplasia and medullary thyroid carcinoma, primarily through the stimulation of GLP-1 receptors on thyroid C cells leading to calcitonin gene expression and cellular hyperplasia.
If you are taking a GLP-1 medication (like Ozempic, Wegovy, or Victoza), your doctor should monitor your thyroid health, specifically checking calcitonin levels and potentially performing ultrasounds if you have symptoms or risk factors. This is because these drugs stimulate thyroid C-cells, which can lead to hyperplasia in animal models. While human risk is debated, caution is advised, especially if you have a family history of medullary thyroid cancer or Multiple Endocrine Neoplasia type 2 (MEN2).
prolonged use, specifically for 1–3 years, of GLP-1 receptor agonists is associated with an increased risk of various types of thyroid tumors... The strongest association was observed with liraglutide, followed by exenatide... Stimulation of GLP-1RA by commercial analogs leads to an increase in the expression of the calcitonin gene... This enhanced hormone synthesis subsequently leads to hyperplasia of C cells in both male and female mice and rats, which could evolve into medullary thyroid carcinoma
Why this rating
The paper is a review citing mixed evidence: rodent studies show clear hyperplasia, but human data is conflicting with some studies showing no correlation and others showing signals. The paper notes interspecies differences.
Source
GLP-1 Receptor Agonists: A Promising Therapy for Modern Lifestyle Diseases with Unforeseen Challenges
Patrycja Kupnicka et al. · Pharmaceuticals · 2024
DOI 10.3390/ph17111470
More from this paper
- GLP-1 receptor agonists lower serum TSH levels in patients with Type 2 Diabetes, particularly those who experience weight loss, without necessarily changing free thyroxine (FT4) levels, suggesting a mechanism involving central nervous system GLP-1 receptors or improved thyroid hormone sensitivity.Good
- GLP-1 receptor agonists may increase the risk of acute pancreatitis and pancreatic cancer, although meta-analyses have sometimes excluded this risk, and the evidence remains inconclusive with conflicting study results.Moderate
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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