Semaglutide-induced Subclinical Hypothyroidism: A Case Report

Abstract

Introduction/Background: Drug-induced hypothyroidism is well established in the literature. I describe the first case of symptomatic subclinical hypothyroidism (SCH) in a thyroidectomy woman with diabetes mellitus 2 receiving therapy with per os levothyroxine and sc semaglutide (Ozempic). Case Presentation: A 37-year-old overweight and thyroidectomy woman with diabetes mellitus 2 was admitted to our hospital with complaints of increasing fatigue, weakness and shortness of breath. She received levothyroxine (150 μcg per day), sc semaglutide (1 mg per week the last six months), and rosuvastatin (20 mg per day). A detailed clinical examination and laboratory tests revealed, among others, an elevated TSH serum level (92-98 mIU/L) with normal serum FT3 and FT4 levels on first and next measurements. Based on the possible diagnosis of semaglutide-induced SCH, semaglutide was withdrawn. Thyroid dysfunction was restored (serum TSH: 1.8 mIU/L) after two months with a significant improvement in symptoms. Conclusion: An influence of sc semaglutide on thyroid function is possible. Thyroid function tests are suggested in patients receiving both per os levothyroxine and sc semaglutide.