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Semaglutide and Thyroid Cancer

The Link Between Semaglutide and Thyroid Cancer - What You Need to Know

Obesity and diabetes are increasingly common, serious health conditions affecting millions worldwide. As a result, newer drugs like semaglutide (Ozempic) have emerged to help manage blood sugar and aid weight loss. But could these medications also carry risks? 

Early animal studies on semaglutide hinted at a potential issue. Rodents treated with semaglutide had an increased occurrence of thyroid C-cell tumors. This raised concerns that semaglutide could potentially increase thyroid cancer risk in humans as well. 

Understandably, this sparked fear for many patients already taking semaglutide or considering it as a treatment option. Could this popular diabetes and weight loss injection raise their chance of developing the serious health complication of the said type of cancer? Let’s look at the evidence.

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Early Concerns from Animal Studies

Before being approved for use in humans, all drugs undergo extensive preclinical animal testing. This helps determine effectiveness, optimal dosing, and identify any potential safety issues

During the studies focused on this particular glucagon-like peptide receptor, it was found that when mice and rats were injected with semaglutide “at clinically relevant exposures”, it led to C-cell hyperplasia (overgrowth) and malignant C-cell carcinoma. In fact, the brand Wegovy has had that warning since 2017. 

Naturally, this raised concerns that semaglutide could increase the risk of thyroid cancer in humans as well. However, the relevance to human thyroid safety was unclear. 

Thankfully, it didn’t take long for succeeding studies to put most of those doubts to rest. For one, it was revealed that rodents like mice and rats have a much higher percentage of C-cells in their thyroid glands compared to humans as shown by the following table.

SpeciesRodent ThyroidHuman Thyroid
Follicular cells55-80%>99%

Mice and rats have tons of C-cells that can be readily affected by GLP-1 receptor activation. Humans just don't have nearly that many C-cells since our thyroids contain mostly follicular cells instead.

So while rodent thyroids are packed with C-cells that drive tumor growth from GLP-1 drug effects, human thyroids have far fewer C-cells to be impacted. Our thyroid glands consist predominantly of follicular cells, with C-cells making up a tiny fraction in comparison.

So while concerning at first glance, the increased C-cell tumor risk seen in animal studies may not necessarily translate over to human patients treated with semaglutide. More research was needed to clarify if semaglutide posed a real risk for thyroid cancer in people, though.

Investigating the Semaglutide and Thyroid Cancer Connection at Present

Fortunately, newer research into semaglutide has only confirmed the lack of a causal link between the drug and thyroid cancer in human patients. Here’s a quick summary for your reference, coupled with a few notable findings in recent years. 

  • A 2022 meta-analysis combining data from randomized controlled trials and real-world studies concluded semaglutide was not associated with increased risk of any cancers, including thyroid cancer.
  • A 2022 real-world study analyzing FDA adverse event reports found no statistically significant increased risk of thyroid cancer with semaglutide.
  • However, a 2022 study using French national healthcare data did identify an increased risk of thyroid cancer with 1-3 years of GLP-1 receptor agonist use. The published paper does not specifically mention semaglutide, though. 
  • In May 2022, the European Medicines Agency issued a thyroid cancer safety signal for semaglutide and is requesting more safety data from Novo Nordisk. The signal does not immediately mean that the drug causes the said cancer, though. 

While longer-term studies are still needed, current evidence provides reassurance for patients using semaglutide. This article will break down the concerns around semaglutide and thyroid cancer and what we know so far. We’ll also overview the said type of cancer itself - such as the different types, risk factors, symptoms, diagnosis, and treatments.

Understanding Semaglutide (Ozempic)

Semaglutide (brand names Ozempic and Rybelsus) is an injectable prescription medication used for chronic weight management and to improve blood sugar levels in adults with type 2 diabetes. 

It belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs mimic the effects of GLP-1, a hormone produced in the body that stimulates the release of insulin when blood sugar rises after eating

By activating GLP-1 receptors, semaglutide helps regulate blood sugar by:

  • Increasing insulin secretion from the pancreas
  • Slowing digestion to prevent blood sugar spikes 
  • Suppressing appetite, leading to decreased food intake

The end result is better blood sugar control and weight loss - two major health benefits for many people with obesity or diabetes

In addition to semaglutide, other GLP-1 receptor agonists include exenatide (Byetta), liraglutide (Victoza), and dulaglutide (Trulicity).

Semaglutide comes in two forms. Ozempic is an injectable solution given once weekly, while Rybelsus is an oral tablet taken daily. Studies show semaglutide can lead to significant improvements in hemoglobin A1c (a measure of blood sugar control), along with weight loss of around 10-15% in people with obesity.

This makes semaglutide an appealing treatment option for many, but qualms about the alleged thyroid cancer risk have understandably raised concerns. 

Overview of Thyroid Cancer

a patient undergoes ultrasound for thyroid cancer diagnosis

Around 52,890 new cases of thyroid cancer are expected to be diagnosed in the US in 2023. This represents about 3% of all new cancer cases. About 2,120 deaths from this cancer are expected in 2023; although, the death rate has remained stable over the past decades.

What are the different types of thyroid cancer and their characteristics?

Papillary carcinomaMost common form (80% of cases)Usually grows slowlyOften curable
Follicular carcinomaSecond most commonSlightly more aggressive than papillary
Medullary carcinomaAccounts for 3-5% of casesCan run in families
Anaplastic carcinomaRare but most aggressive typeHarder to treat

Who is most at risk of developing thyroid cancer?

  • History of thyroid disease or thyroid nodules
  • Radiation exposure 
  • Family history 
  • Being female - women are 3 times more likely to develop it 
  • Age over 50 

What are some common signs and symptoms?

  • Swelling or a lump in the neck 
  • Swallowing difficulties
  • Voice changes or hoarseness  
  • Pain in the throat or neck 
  • Swollen lymph nodes
  • Cough not from cold

How is thyroid cancer diagnosed?

If suspected, your doctor will likely order:

  • Physical exam and medical history
  • Blood tests (TSH, thyroid hormones, calcitonin)
  • Thyroid ultrasound to visualize nodules
  • Biopsy of abnormal nodules for cancer cells
  • CT or MRI scans to check spread 

If tests confirm the presence of this cancer, the next step is determining the type, stage, and appropriate treatments.

Overview of Thyroid Cancer Treatments

If caught early while still localized, it is very treatable. The main therapies include:

  1. Surgery - Most patients have a thyroidectomy to remove the thyroid gland with cancerous nodules. Nearby lymph nodes may also be taken out. 
  1. Radioactive Iodine - This oral treatment uses I-131 to destroy any remaining thyroid tissue. It's typically done after thyroidectomy.
  1. Thyroid Hormone Replacement - Since the thyroid is removed, patients must take daily levothyroxine (Synthroid) long-term to replace hormones. Regular blood checks help determine the proper dose.
  1. External Radiation - In some cases, external beam radiation may be recommended after surgery to target any tissue not removed.
  1. Targeted Therapies - For later stage or recurrent thyroid cancers, targeted drugs can help slow further growth. Examples include lenvatinib and sorafenib. 

Chemotherapy may also be used in some advanced, rapidly progressing cancers.

Talk to your oncologist about which treatments provide the best chance for long-term remission and cure based on your specific cancer type, stage, and individual factors.

What is the Typical Prognosis for Thyroid Cancer Patients?

The prognosis is closely linked to the stage at diagnosis:

  • Stage 1 or 2 thyroid cancers localized to the thyroid itself generally have 5-year survival rates over 95% with appropriate treatment.
  • Locally advanced stage 3 cancers that have spread to nearby structures have somewhat lower 5-year survival around 55%. 
  • Stage 4 cancers that have metastasized more distantly have the lowest survival rates around 15%.

So early detection and treatment are key. Most patients who receive timely care can go on to live healthy, active lives even after thyroid cancer. Blood tests and imaging should continue periodically to monitor for potential recurrence.

With papillary thyroid cancer, despite a high tendency to recur locally, long-term survival over 15-20 years remains very favorable in most cases.

Can You Take Semaglutide If You Have Had Thyroid Cancer?

There are no contraindications for taking semaglutide if you have a history of thyroid cancer. But it’s wise to discuss use with your endocrinologist first.

They may recommend more frequent monitoring of your thyroid blood work while on semaglutide. Report any new neck lumps, voice changes, or other suspicious symptoms promptly for evaluation.

With no evidence definitively linking semaglutide to increased cancer risk in humans, many doctors deem it reasonably safe in thyroid cancer survivors who may benefit from blood sugar and weight control.

Controlling obesity and diabetes provides overall health benefits that may outweigh low potential risks for those with medical supervision. But as with any medication, weigh the pros and cons carefully with your healthcare provider.

Staying Informed on Drug Safety Research

While current data is reassuring, more research on semaglutide's long-term safety profile is still warranted. Patients should stay on top of new studies that emerge by:

  • Reading diabetes and endocrinology journals 
  • Checking for updates from the FDA/WHO
  • Discussing any new findings or concerns with their doctor

Drug risks can take time to fully characterize. Being an engaged, informed health advocate is key to making wise treatment choices.

Safely Managing Weight and Blood Sugar with Semaglutide

Dr. V

If you are struggling with obesity or type 2 diabetes, semaglutide may be an option to consider under your doctor's supervision.

While rodent studies raised initial concerns, current research shows no increased risk of thyroid cancer in humans taking semaglutide. It remains one of the most effective medications for weight loss and blood sugar control.  

However, it's important to stay closely monitored by your healthcare provider while on semaglutide, especially if you have any history of thyroid issues.

At Dr. V Medical Aesthetics, we offer semaglutide (Ozempic) injections for chronic weight management in adults with obesity or overweight with at least one weight-related condition. Contact us today to learn more and see if semaglutide is right for you.

Our experienced medical staff can evaluate your health history, describe potential side effects, and work with you to set realistic weight loss goals. We combine semaglutide with customized nutrition and exercise plans for optimal, lasting results. Don’t struggle with weight or blood sugar control alone - call us now to begin your transformation.


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