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These downstream shifts impact growth, metabolism, and reproductive function in quantifiable ways
Obtain comprehensive baseline labs: TSH, free T4, free T3 Thyroid antibodies (TPO and thyroglobulin if not previously checked) Complete metabolic panel HbA1c and fasting glucose Lipid panel Vitamin D and B12 (commonly deficient in hypothyroidism) During Treatment When to Contact Your Provider Reach out if you experience: Unusual or worsening fatigue not explained by semaglutide initiation New or returning brain fog or cognitive difficulty Constipation that does not improve with typical measures Heart rate changes (especially sustained bradycardia) Cold intolerance or dry skin changes Weight loss plateau despite medication adherence Hair loss beyond what is expected with weight loss Mood changes including depression or anxiety Semaglutide Alternatives for Hypothyroid Patients For patients who cannot take semaglutide or prefer alternatives, several options exist: Tirzepatide (Mounjaro/Zepbound): Dual GLP-1/GIP agonist with potentially greater weight loss
Your monthly visit: what we review Symptoms & side-effects: Whats new, whats improved, and where we can help Dose & timing: Stay, increase, or adjustbased on your feedback and safety Body-comp & trends: Not just weighthow composition is shifting Lifestyle wins: The small habits youre nailing (well build on those) Next steps: Clear, doable focus areas for the coming weeks When to contact us sooner Persistent vomiting or severe abdominal pain Signs of dehydration that dont improve with fluids Any new or concerning symptoms Were here to troubleshootdont wait until your next visit
If your swelling lasts more than two to three weeks without improvement, or if its getting worse, contact your healthcare provider to rule out infection or other issues
The right approach depends on your symptoms and goals, so its best worked out with your doctor
In our December 2025 edition, we called it: 2026 would be the year of obesity pills
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