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Can people with hypothyroidism take Ozempic or Mounjaro?

GLP Guidebook teamUpdated 5 Oct 202613 sourcesWritten from published sources
The short answer

The US labels for Ozempic (semaglutide) and Mounjaro (tirzepatide) do not list hypothyroidism as a reason to avoid them. Their thyroid warning is about medullary thyroid cancer and MEN 2, which are different conditions. With Rybelsus (oral semaglutide), levothyroxine exposure was 33% higher in a US label study. Thyroid medicine is not a weight-loss medicine.

Before you go further
  • GLP‑1 medicines are prescription-only in India, not sold over the counter.11
  • A government statement on 1 Apr 2026 said only endocrinologists, internal-medicine specialists and cardiologists can prescribe them.11 CDSCO expert-committee minutes attach a similar condition to some approvals (endocrinologist or internal-medicine specialist), but we found no rule covering every brand.12,13
  • The risks are in Guide 5: Side effects and risks.
  • Nothing here promises any result.

Is hypothyroidism a reason not to use Ozempic or Mounjaro?

The US Ozempic and Mounjaro labels list only two situations where the medicines must not be used, and hypothyroidism is not one of them.

The two are a personal or family history of medullary thyroid cancer (MTC) or a condition called MEN 2, and a serious allergy to the medicine. MEN 2 is short for multiple endocrine neoplasia type 2.1,2 India's ESI 2025 obesity guideline lists MTC, MEN 2, pregnancy and breastfeeding for semaglutide 2.4 mg and for tirzepatide. Hypothyroidism is not on that list either.5

Hypothyroidism is common in India. In a 2013 study of 5,360 adults in 8 Indian cities, 10.95% had hypothyroidism, about 1 in 10. It was 15.86% in women and 5.02% in men.6 Guide 4, Should I consider a GLP‑1?, covers the other reasons a doctor may say no.

Does the thyroid cancer warning apply to an underactive thyroid?

No, the boxed warning on both US labels is about thyroid C-cell tumours, including MTC, which rodents developed on these medicines in lab studies.

Both labels say it is unknown whether this happens in humans.1,2 An underactive thyroid (hypothyroidism) is a different problem. The gland makes too little hormone. It is usually treated with levothyroxine tablets.7

Three UK endocrine and thyroid societies advise avoiding GLP‑1 medicines after MTC, a harmful RET gene change or a family history of MEN 2. They cite a 2022 review that found no raised risk of hypothyroidism with these medicines.8 Our post on what the thyroid cancer warning means goes through the studies.

Does Rybelsus or Ozempic change how much levothyroxine is absorbed?

Rybelsus can raise it, as a study on its US label found 33% more thyroid hormone in the blood with levothyroxine and semaglutide tablets together.

That study used a single 600 mcg dose of levothyroxine.3 The EU Rybelsus label says doctors should consider checking thyroid levels when both medicines are used.4

Ozempic and Mounjaro injections slow how fast the stomach empties. Their US labels say this may change how tablets taken by mouth are absorbed.1,2 We found no levothyroxine study in either injection's US label. Both Rybelsus and levothyroxine are taken on an empty stomach, so the morning routine needs planning.3,9 Our Answer on how and when to take Rybelsus covers the 30-minute wait.

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Does thyroid medicine work for weight loss?

No, thyroid medicine is not for weight loss, and the US levothyroxine (Synthroid) label has a boxed warning against using it that way.

The warning says thyroid hormones should not be used to treat obesity or for weight loss. In people with normal thyroid levels, usual doses do not reduce weight. Larger doses can cause serious or life-threatening harm, the label says, especially with stimulant drugs taken to curb appetite.9 The American Thyroid Association's 2014 guideline makes a strong recommendation against using levothyroxine to treat obesity in people with normal thyroid levels.10

The same guideline says most weight gained with hypothyroidism, and lost with treatment, is fluid. Even after severe hypothyroidism is treated, there is no significant loss of body fat.10 Weight-loss medicines are a separate decision, covered in Guide 4.

Read the full picture

Related questions

How and when do you take Rybelsus? Is Ozempic safe? Do you need a prescription for GLP-1 medicines in India? Is Ozempic used for PCOS?
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Sources

  1. Novo Nordisk. Ozempic (semaglutide) injection, US prescribing information, revised 05/2026. US label, not the Indian one. Boxed warning, sections 4, 5.1, 7.2. novo-pi.com
  2. Eli Lilly. Mounjaro (tirzepatide) injection, US prescribing information, revised 08/2026. US label, not the Indian one. Sections 4, 7.2. pi.lilly.com
  3. Novo Nordisk. Rybelsus and Ozempic tablets (oral semaglutide), US prescribing information, revised 1/2026. US label. Sections 2.1, 7.2, 12.3. novo-pi.com
  4. European Medicines Agency. Rybelsus (semaglutide) product information, summary of product characteristics section 4.5. EU label, not the Indian one. Accessed 5 Oct 2026. ema.europa.eu
  5. Madhu SV, Kapoor N, Das S, Raizada N, Kalra S. ESI clinical practice guidelines for the evaluation and management of obesity in India: an update (2025). Indian J Endocrinol Metab 2025. Table 1. doi:10.4103/ijem.ijem_680_25 · PMID 40917319
  6. Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: an epidemiological study in eight cities of India. Indian J Endocrinol Metab 2013;17(4):647-52. doi:10.4103/2230-8210.113755 · PMID 23961480
  7. NHS. Underactive thyroid (hypothyroidism). Page last reviewed 28 Apr 2025. nhs.uk
  8. Watts E, Wadsley J, Sharma N, Boelaert K; UK Thyroid Cancer Study Group. Joint society statement from the Society for Endocrinology, British Thyroid Association and British Association of Endocrine and Thyroid Surgeons on GLP-1 agonists and thyroid cancer. Clin Endocrinol 2026;104:507-509 (online 21 Dec 2025). doi:10.1111/cen.70084 · PMID 41423434 · full text (PMC)
  9. AbbVie. Synthroid (levothyroxine sodium) tablets, US prescribing information, revised 2/2024. US label. Boxed warning, section 2.1. rxabbvie.com
  10. Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid 2014;24(12):1670-751. Recommendation 10c. doi:10.1089/thy.2014.0028 · PMID 25266247 · full text (PMC)
  11. PIB Research. GLP-1 drugs: use, risks and regulation. Government backgrounder, 1 Apr 2026. static.pib.gov.in (PDF)
  12. CDSCO. Recommendations of the Subject Expert Committee (Endocrinology & Metabolism), 20–21 Apr 2023 (tirzepatide). Committee minutes, not the final permission. cdsco.gov.in (PDF) · archived copy
  13. CDSCO. Recommendations of the Subject Expert Committee (Endocrinology & Metabolism), 13–14 Feb 2024 (semaglutide). Committee minutes for named products. cdsco.gov.in (PDF) · archived copy

Last checked 5 Oct 2026 · Next review due 5 Oct 2027 · Report an error

How this answer was made. Written by the GLP Guidebook team from the sources above. It's general information, not medical advice. Talk to a qualified doctor before starting, stopping or changing any medicine. How we write