Toggle Main Menu Toggle Search

Open Access padlockePrints

The GLP-1 receptor agonist Exenatide reduces serum TSH by its effect on body weight in people with Type 2 Diabetes

Lookup NU author(s): Dr Salman Razvi



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley-Blackwell Publishing Ltd., 2023.

For re-use rights please refer to the publisher's terms and conditions.


Objective: Glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy in patients with type 2 diabetes and obesity leads to a significant reduction in serum thyrotropin (TSH) levels but it is unclear whether this is related to weight loss and improvement in sensitivity to thyroid hormones (TH). Methods: We prospectively analysed clinical and biochemical data in patients with type 2 diabetes and obesity who were commenced on the GLP-1 RA exenatide and followed them for 12 months. We assessed the relationship between changes in body weight and serum TSH and resistance to TH indices. Results: In 112 patients (mean age 53.5years, 43.8% female, mean body mass index 39.8kg/m2), 12 months of exenatide treatment was associated with a mean (95%CI) percent body weight loss of 6.5% (5.0% to 8.1%) and change in serum TSH of -0.25mU/L (-0.43 to -0.06). There was a significant negative and non-linear relationship between change in serum TSH and percent body weight loss: -0.25mU/L with 5%, -0.4mU/L with 10%, and -0.5mU/L with 15%, respectively, whereas a rise in serum TSH of 0.5mU/L was associated with 5% weight gain. There were no changes observed in serum FT4 levels with weight loss but a significant reduction in resistance to TH indices was noted. Conclusions: Exenatide therapy reduces serum TSH levels and improves central sensitivity to TH action over 12 months via its effect on weight loss. The effectiveness of weight loss strategies, rather than TH replacement, should be investigated in individuals with obesity and mildly raised serum TSH levels.

Publication metadata

Author(s): Tee SuAnn, Tsatlidis V, Razvi S

Publication type: Article

Publication status: Published

Journal: Clinical Endocrinology

Year: 2023

Volume: 99

Issue: 4

Pages: 401-408

Print publication date: 01/10/2023

Online publication date: 26/02/2023

Acceptance date: 24/02/2023

Date deposited: 24/02/2023

ISSN (print): 0300-0664

ISSN (electronic): 1365-2265

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/cen.14901

ePrints DOI: 10.57711/x8nr-h689


Altmetrics provided by Altmetric