If you’re living with Hashimoto’s thyroiditis and considering weight loss medications, you might be wondering if GLP-1 medications are a safe option. These medications—like semaglutide and tirzepatide—have become popular for their ability to support weight loss. But if you’re dealing with an autoimmune condition like Hashimoto’s, caution is essential.

At Genesis Lifestyle Medicine, we understand how complex autoimmune conditions like Hashimoto’s can be—especially when paired with challenges like weight gain or hormone imbalances. That’s why we’re committed to helping you make informed, personalized choices about your health. In this article, we explore whether GLP-1 medications are safe for people with Hashimoto’s and the steps you can take to use them safely and effectively.

What is Hashimoto’s disease?

Hashimoto’s disease is an autoimmune condition in which your immune system mistakenly attacks your thyroid gland. Over time, this chronic inflammation damages the thyroid, leading to hypothyroidism—or underactive thyroid function. This affects many aspects of your health, from your metabolism and energy levels to your mood and weight.

Hashimoto’s is the most common cause of hypothyroidism in the United States and tends to affect women more than men. While there is no cure, the condition can be managed effectively with the right treatment plan and lifestyle support.

Common signs and symptoms of Hashimoto’s disease:

• Feeling constantly tired or fatigued
• Struggling to lose weight or gaining weight easily
• Experiencing sensitivity to cold temperatures
• Having dry skin or thinning hair
• Feeling depressed or anxious
• Experiencing irregular or heavy menstrual periods
• Dealing with constipation
• Noticing a puffy face or hoarseness
• Feeling forgetful or mentally “foggy”

Are GLP-1 medications safe for Hashimoto’s?

The short answer is: yes, GLP-1 medications can be safe for people with Hashimoto’s—but they must be used under medical supervision. GLP-1 receptor agonists like semaglutide mimic a naturally occurring hormone that helps regulate blood sugar and appetite. These medications were originally developed for type 2 diabetes but are now widely used for medical weight loss. Since many people with Hashimoto’s struggle with weight gain due to a slower metabolism, GLP-1 medications can be a valuable tool for weight management.

GLP-1 medications may indirectly help with Hashimoto’s

Chronic inflammation is a core feature of Hashimoto’s. Interestingly, some research has shown that GLP-1 medications may reduce markers of inflammation in the body. While they don’t treat the autoimmune condition directly, lowering inflammation may ease common symptoms like fatigue and joint pain. Additionally, weight loss achieved through GLP-1s can reduce stress on the body, improve insulin sensitivity, and support hormone balance—all of which may help your thyroid function more efficiently.

Who is not a candidate for GLP-1 medications?

While GLP-1 medications are effective for many people, they are not suitable for everyone. You may not be a candidate if you:

• Have a personal or family history of medullary thyroid carcinoma (MTC)
• Have Multiple Endocrine Neoplasia syndrome type 2 (MEN2)
• Are currently pregnant or breastfeeding
• Have a known allergy to GLP-1 ingredients
• Are experiencing severe gastrointestinal issues such as gastroparesis
• Are under 18 years old

Before starting treatment, your provider at Genesis Lifestyle Medicine will review your full medical history to determine whether GLP-1 therapy is safe for you.

How to take GLP-1 medications safely and effectively:

• Work with a knowledgeable medical provider: Because Hashimoto’s is a complex autoimmune disease, it’s essential to work with a provider who understands how to tailor GLP-1 treatment to your unique needs. At Genesis Lifestyle Medicine, we evaluate your thyroid function, inflammation levels, and overall health before beginning treatment.
  
• Monitor your thyroid hormone levels regularly: GLP-1 medications don’t treat thyroid function, so you’ll still need to monitor your TSH, T3, and T4 levels. Any adjustments to your medication should be made by a healthcare provider based on lab results and symptoms.
  
• Support your body with the right nutrition: Eating a nutrient-rich, anti-inflammatory diet can help reduce autoimmune activity and enhance the effectiveness of GLP-1 medications. Focus on whole foods, lean proteins, healthy fats, and plenty of fiber.
  
• Prioritize gut health: Gut health is linked to autoimmune function and GLP-1 medication tolerance. Support your gut with probiotics, fermented foods, and fiber-rich vegetables to reduce inflammation and improve the absorption of nutrients.
  
• Stay hydrated and manage side effects: Some people experience nausea, constipation, or bloating with GLP-1 medications. Staying well-hydrated, eating smaller meals, and gradually increasing your dose can help minimize these side effects. Your provider may also recommend additional supplements or remedies to ease discomfort.
  
• Incorporate gentle exercise: While intense workouts may not always feel doable with Hashimoto’s fatigue, gentle movements like walking, yoga, or strength training can help regulate metabolism, reduce stress, and enhance the benefits of GLP-1 medications.

If you’re navigating life with Hashimoto’s and struggling with weight gain or fatigue, GLP-1 medications could help—but only if used thoughtfully and safely. At Genesis Lifestyle Medicine, we take a personalized, holistic approach to your care. Our team of experienced providers is here to help you optimize your thyroid health, reduce inflammation, and achieve sustainable weight loss. Schedule a consultation today to explore your options.