Understanding Ozempic and its Risks in Hashimoto's Disease

In this blog, we will concentrate on Ozempic, a drug used to treat type 2 diabetes and weight loss, and its potential risks in patients with Hashimoto's disease. We will look into the mechanism of action of Ozempic, the nature of Hashimoto's disease, and the possible complications that may arise when these two intersect.
Greta Daniskova

Greta Daniskova

Greta is a BSc Biomedical Science student at the University of Westminster, London.

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What is Ozempic?

Ozempic contains the active ingredient semaglutide, uniquely approved for treating type 2 diabetes in adults as an injection under the skin (subcutaneous) in two formulations – as a once-weekly or once-monthly prescription. The active ingredient is an anti-diabetic agent or drug class named glucagon-like peptide-1 (GLP-1) receptor agonists [1, 2].

What does Ozempic do?

Ozempic slows digestion; it begins to act by mimicking the body’s hormone GLP-1, known for regulating a blood sugar spike. This drug reduces a patient’s energy after a meal, by increasing the amount of insulin their body produces as they digest, and reduces how much sugar is released into the blood as a result of food absorption. It also slows down gastric emptying, which appears to prevent a sharp spike in blood sugar after consuming a meal [3].

Aside from lowering blood sugar levels, the drug is also used to reduce the risk of heart attack and stroke in type 2 diabetics with heart disease [1].

Also, it makes you less hungry, which can result in weight loss – although it’s not officially approved for weight, it’s sometimes prescribed off-label for this purpose [2, 4].

What is Hashimoto's Disease?

Hashimoto’s disease (also known as Hashimoto’s thyroiditis), which causes the immune system to attack the thyroid, is a common cause of hypothyroidism. The thyroid gland, which lies in front of the windpipe, is responsible for releasing hormones that control the rate at which the body’s metabolism functions, its internal temperature, as well as muscle strength [5]. If your thyroid is damaged, it can affect the normal functioning of your metabolism. Symptoms include fatigue and constipation.

What Causes Hashimoto's Disease?

Hashimoto’s disease occurs from a combination of genetic and environmental factors. No specific environmental trigger has been identified, but genetic risk is well established based on twin studies with an almost 55% concordance between identical twins, in contrast to only 3% for nonidentical twins [6].

In genetically susceptible individuals, environmental triggers such as viral infections or exposure to some chemicals or drugs may kick off an immune-mediated attack against the thyroid gland [6]. In some animal models, Herpes simplex virus infections have been implicated in the development of several autoimmune disorders, including Hashimoto’s thyroiditis [7].

Furthermore, several dietary factors and deficiencies, such as iodine, selenium, vitamin D, and gluten, may heavily impact the development and management of Hashimoto's Disease [8].

Risks associated with Ozempic and Hashimoto's Disease

Ozempic, used to help treat type 2 diabetes and weight loss, carries a host of side effects and warnings that might be relevant to Hashimoto’s.

Near the top of the list of warnings for Ozempic is thyroid cancer. This risk was identified in animal studies, and while the FDA doesn’t know for sure if the drug raises thyroid cancer risk in people, the warning it gave for Ozempic is the most serious, known as a ‘black box’ warning. For a person with Hashimoto’s disease, where the immune system attacks the thyroid, the risk of thyroid complications may already be elevated [9, 10, 11, 3, 12].


Other possible side effects include developing kidney issues. Weight loss with Ozempic has led to new or worsening kidney disease and renal impairment, including some people requiring dialysis. Dehydration, including vomiting or diarrhoea – which are both risk factors for developing kidney disease – are noted as common side effects of Ozempic. Thus, for those with Hashimoto’s disease, and especially those with existing kidney issues, this is another reason to consider if Ozempic may be right for them [9, 12].

In addition, Ozempic carries a warning that it could constitute an allergy trigger in sensitive persons specifically those who are allergic to GLP-1 agonists, the drug class into which Ozempic belongs. If you’ve had an allergic reaction to Ozempic or any of its ingredients, you could have a severe allergic reaction to Ozempic [9, 12].


Keep in mind that these dangers are with Ozempic and do not have a specific link to Hashimoto’s disease, so patients with Hashimoto’s disease using Ozempic should have a thorough conversation with their healthcare provider to get a detailed insight prior to deciding whether or not to take the medication.

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Greta Daniskova

Greta Daniskova

Greta is a 2nd-year student currently pursuing her Bachelor's Degree in Biomedical Sciences at the University of Westminster in London. Currently, in her second year of undergraduate studies, she exhibits a keen interest in the dynamic field of healthcare. With a focus on understanding the intricacies of human biology and disease mechanisms, Greta is driven by a desire to contribute to advancements in medical research and patient care.