Taking wegovy tablets (or injections) when you have an underactive thyroid and take thyroxine

[Springup24]

I wondered if anyone is using the injections or starting the tablets, and also takes daily thyroxine? It is putting me off starting.

Has it caused any thyroid issues? Anything I need to be aware of? Google suggests spacing the doses to reduce drug interaction.

Does it mean you have to tell your GP you have started medication?

Thanks!

I have been on a low dose of thyroxine, 50mcg for 20 years. I've been on Mounjaro for 14 months. I have had no problems at all, felt fine and stayed on the same dose, and levels all fine when checked.

It is a good idea to tell your GP and make sure you have your thyroid levels checked frequently when you're on WLI as your weight and metabolism are changing and your medication might need adjusted.

There have been no issues reported with thyroxine use and WLI at all as far as I know. Good luck on your journey!

The problem is the Wegovy tablets change the stomach environment. You need to take Wegovy tablets after 6-8 hrs fasting overnight with max. 120ml of water, then no other drinks/food/medication for at least 30 minutes.

So thyroid tablets will need to be timed after Wegovy tablets. I’d stick to injections which are more effective at lower doses anyway.

it is because of the SNAC enhancer -

Taking SNAC (an absorption enhancer present in oral semaglutide pills like Rybelsus) alongside thyroid tablets(like Levothyroxine or Armour Thyroid) requires careful timing.
Clinical research shows that taking oral semaglutide and thyroid hormones together can lead to a roughly 33% increase in overall thyroid hormone (T₄) exposure in your blood

Thanks both. I really want to try the tablets rather than the injections, but you're right, it does sound more complicated.

I could definitely time things so I could wait 30 minutes and then take my thyroxine. But I still have the niggling feeling I'm going mess up a finally stable level of thyroxine!

I have to take 100mcg thyroxine first thing on empty stomach. I’m also taking MJ injections. It’s all good. But the timing issues of the wegovy injections put me off, too much risk of messing up one or other medication.

@Springup24 I agree with that, especially after reading the longer you fast after Wegovy tablets the higher the absorption (although it is uncertain whether than makes any meaningful clinical difference to the Wegovy effects) - I would feel uncomfortable with taking a equally sensitive medication soon after.

What concerns you about the injections?

Is it the needle? - I was terrified the first time I took one, it took me two days to pluck up the courage to do it, then over an hour of tears, shaking, swearing, and false landings to actually eventually do it - then felt like an idiot for making such a big deal of a tiny 4-6mm super fine needle. Once a week and it is done.

Is it injecting medication? - It is the exact same medication in the tablets with the same half life, similar side effects, but the injection is more effectively absorbed so you can take lower doses.

Can you advise how you accessed these please? My DD is struggling with her weight following total thyroid removal but we’ve been denied them each time as she is on thyroxine.
GP won’t prescribe as not “yet” overweight enough and pharmacies decline due to the thyroxine. Her weight gain has been overwhelming for her and is now leading to a vicious cycle of related symptoms.
Just curious !

Assuming your dd is an adult 18+ @Lupinhere37 to be eligible for private prescribing.

If her BMI is 25+ the only providers that publicly advertise prescribing to this group is Voy and Medexpress. Medexpress are known not to only take on simple clear cut prescribing cases so probably wouldn't help. She could try Voy - they are more expensive but might help and once she has been prescribed there she can later switch to another pharmacy.

Otherwise if her BMI is 27+ I would suggest she tries either Swift Doctor (book a consultation to discuss with their Dr Bano), or Oushk (will depend which independent prescriber gets her order whether it is approved) to see if they would help. Pharmulous, I have never used but might also be worth a try. It might still be a no, but they will hopefully give you reasons why.

I have a bit of a complex medical history and when I did ‘test runs’ with a few online pharmacies I got ‘not eligible’ messages. Never even got as far as a consultation, so was refused by their initial screening tool. I went to a local independent pharmacy, had a very comprehensive assessment and the pharmacist said there were no red flags and she was happy to prescribe. It does cost a bit more but I’ve been really happy with the service and monthly check ups. She’s also described their approach to maintenance, prescribing gaps etc. Might be worth trying that if no other options? As an aside, I haven’t had a thyroid for decades, although that was the least of the issues.

Ah, so if I do get my head around injections, is MJ better alongside thyroxine than wegovy? How long after thyroxine do you inject?

Hmm. Good question.

I think it is the shame of my partner seeing the packets in the fridge. Whereas I could do the tablets secretly.

Plus the thought of injecting something into my body. Seems more medical than swallowing a pill.

And yes, the idea of the needle and actually injecting! Is it a syringe where you have to push down to squeeze the dose into you? Or do you stab it in and then pull it out?

You have made me feel a little better about the last two tbh. And perhaps I could store the syringes in a cold pack?

I had wegovy while on thyroxine
Pulse rate went up. I waa crabby all the time.
Switched to munjaro but that interfered with HRT.
No advice from company I went with. GP sorted problem in the end . (Did not prescribe or supply munjaro)

Eek! Have you stuck with mounjaro? Or stopped both completely?

I take thyroxine following a complete thyroidectomy five years ago. Have been on a GLP-1 (started with Ozempic, now on Wegovy) for over two years and haven’t had any issues at all. All prescribed through my GP so she had a 360° view.

I believe the concern is that weightloss medication can cause an increased risk of thyroid cancer which obviously doesn’t apply to me so I can’t comment on that (other than to say that the use of WLI is linked to a reduction in something like 13 obesity-linked cancers, IIRC).

Overall, I’ve had no issues at all. Take my thyroxine daily, my jab weekly, and haven’t had any cause for concern.

@Springup24 the shame is overwhelming isn't it. When I wanted to do the injections back in June 2024, it was a barrier to starting for me too, but I didn't want to do it in secret. I bought my first pen and it sat hidden in the fridge for 2 weeks before I started. It took a bit of time to find the words and build up the courage to tell dh.

When I did, I told him we needed to have a serious conversation that would be difficult for me to talk about. It was an emotional conversation, difficult to say those words, I am morbidly obese. Then it was full disclosure where I managed to get across how desperate I was feeling, the embarrassing ways my obesity was impacting my health, the problems I had with food noise, secret snacking, dh was shocked as he had no idea, he had lots of questions, was concerned about the medication as he didn't understand what it did to support hormones, but at the end once he understood more about them, that it was a serious health issue, obesity is a chronic disease and he was very supportive. It was a huge relief once it was out there.

I then also had a chat with adult living at home ds to let him know as he would likely see it in the fridge, who was also supportive. Both have respected my request to be discrete and not tell anyone else and they treat it pretty much in the same way they treated the other meds I was on at the time.

Thank you for posting this; really helpful.

Thank you @RedApplePie this helps loads. I have argued with some independent pharmacists that the total removal of the thyroid means there is no risk of thyroid cancer but yo no avail.
I’m going to try a private GP next, I think, and it’s reassuring to know that there is flexibility out there.

I take thyroxine each morning and do MJ on Friday lunchtime. I’m not risking taking another pill that has to be taken am on empty stomach.