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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

Author - Greta Daniskova

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

Greta used MediSearch to find sources for this blog.
MediSearch gives instant answers to medical questions based on 30 million scientific articles.

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].

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