If you’ve been diagnosed with hypothyroidism and are considering or already using semaglutide to support weight loss, you might be wondering how these two things interact. Will semaglutide help or hinder your thyroid health? Will hypothyroidism slow down your results? The relationship between semaglutide and hypothyroidism isn’t always straightforward, but understanding how they can influence each other may help you better navigate your energy levels, metabolism, and expectations.
Let’s break it down.
First, What Is Hypothyroidism?
Hypothyroidism occurs when your thyroid gland doesn’t produce enough thyroid hormone. Since the thyroid regulates everything from energy production to metabolism and body temperature, low levels can impact how your body burns calories, how you store fat, and how energetic you feel.
Common symptoms of hypothyroidism include:
- Fatigue or sluggishness
- Unexplained weight gain or difficulty losing weight
- Cold intolerance
- Constipation
- Dry skin
- Hair thinning
- Brain fog
- Mood changes
These symptoms can make weight loss feel harder, even when you’re doing all the right things. If your thyroid levels are being managed properly by your healthcare provider, medications like semaglutide may offer additional support.
How Semaglutide Supports Weight Loss
Semaglutide is a type of GLP-1 medication that helps regulate appetite, slow digestion, and improve blood sugar control. Originally approved for type 2 diabetes, it’s now widely used to support weight management, even for people without diabetes.
At PeachesRx, we offer Slim, a compounded oral dissolving semaglutide + vitamin B6 tablet, designed to make this treatment more accessible without the need for injections.
By helping reduce cravings and promote earlier fullness, semaglutide can be especially helpful for people who feel like their metabolism has slowed or their hunger cues are out of sync, which are two common struggles for those with hypothyroidism.
But how do semaglutide and hypothyroidism affect each other directly? That’s where recent research gets interesting.
What the Research Says About Semaglutide and Hypothyroidism
A 2024 study conducted by Epic Research looked at over 21,500 patients with a history of hypothyroidism who were prescribed GLP-1 medications, including semaglutide. The researchers set out to understand the relationship between GLP-1 use, weight loss, and thyroid-stimulating hormone (TSH) levels.
When looking at hypothyroidism, lower TSH levels indicate improved thyroid function.
Key findings:
- Patients who lost more than five pounds after starting a GLP-1 medication saw the greatest reductions in TSH levels.
- Semaglutide was the most effective of the medications studied. Patients in this group who lost more than five pounds saw an average TSH reduction of 0.55 mIU/L.
- Patients who were prescribed GLP-1s but gained weight saw no significant change in their thyroid levels.
The amount of weight loss was a critical factor, suggesting that weight loss itself may be what supports improved thyroid regulation in people with hypothyroidism, and that semaglutide could be a helpful tool in achieving that weight loss.
Although this was not a randomized trial and more research is needed to confirm the long-term clinical impact, these findings may point toward a meaningful connection between semaglutide-supported weight loss and thyroid health.
How Hypothyroidism Might Affect Your Weight Loss on Semaglutide
Even though semaglutide may support weight loss, hypothyroidism can still influence your experience in a few key ways:
1. Slower Results
If your thyroid hormone levels aren’t properly managed (even while on a thyroid medication), your metabolism may still be underperforming. That can lead to slower weight loss, more fatigue, and an overall feeling of something being off.
2. Energy Fluctuations
Fatigue from hypothyroidism may make it harder to move regularly or prepare healthy meals, two important components for supporting your weight loss results.
3. Appetite Signals Can Be Blunted
Some people with hypothyroidism may already experience appetite dysregulation. GLP-1s may either help by providing stronger satiety signals or make it harder to eat enough protein and nutrients if appetite becomes too suppressed.
What to do:
- Check in with your healthcare provider or endocrinologist regularly to make sure your thyroid levels (especially TSH, T3, and T4) are within optimal range.
- Track your energy, appetite, and mood to spot signs your thyroid meds may need adjusting.
- Prioritize protein and nutrient-dense foods, even if your appetite is low.
How to Support Your Metabolism While on Semaglutide
If you have hypothyroidism, supporting your metabolism goes beyond just taking your meds. Here’s how to help semaglutide work more effectively for you:
- Eat enough: Avoid undereating. It may seem counterintuitive, but eating too little can make your thyroid work harder and stall weight loss.
- Don’t skip protein: Aim for 0.7 to 1 gram of protein per pound of goal body weight per day to help preserve lean muscle. Click here for some tips on how to avoid losing muscle while on semaglutide.
- Exercise: Even a few short sessions per week can help protect your metabolism and support fat loss. Try going for a 15-minute walk, practicing yoga or taking up Pilates.
- Sleep and manage stress: Chronic stress and sleep deprivation raise cortisol, which can interfere with thyroid function and fat metabolism.
- Be patient: Weight loss may be slower, but consistency pays off. Compare month-to-month or week-to-week, not day-to-day.
When to Talk to Your Healthcare Provider
If you’re undergoing treatment for hypothyroidism, we recommend speaking with your endocrinologist or primary care physician before beginning a GLP-1 medication like semaglutide.
If you’re on semaglutide and aren’t seeing results or are feeling more sluggish, cold, or bloated than usual, it’s worth having your thyroid levels rechecked by your healthcare provider. Even slight changes can affect your progress and how you feel.
Our PeachesRx providers will review your intake form carefully before prescribing semaglutide, but your thyroid needs may shift over time, especially as your weight or medications change. Ongoing communication with both your PeachesRx provider and your regular healthcare team is key.
Semaglutide and Hypothyroidism: Weight Loss Could Be Within Reach
The connection between semaglutide and hypothyroidism is still being studied, but early research suggests that weight loss supported by semaglutide may help improve TSH levels.
At PeachesRx, we’re here to help you navigate the journey. Slim is our oral dissolving semaglutide + vitamin B6 tablet designed to make weight loss easier to manage, without the need for injections or in-person visits.
See if you qualify for Slim at peachesrx.app.
