Evidence map›Paper›PMID 42220875›Full record

ReviewCureus2026

Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists and Thyroid Function Tests: A Systematic Review Identifying a Critical Evidence Gap.

Sulafa Salama, Eltayeb Osman Elfaki Omer, Alaa Mahmoud, Mohamed Abdalla Mohamed ElshikhIdris, Tasneem Mohammed Mahadi Hussien, Mohammed Ahmed, Samah Osman Fadulelsayed, Sara Abdalaziz Mohammed Ibrahim, Hind Osman Ali Mohammed, Ali Hadi M Alhajri

Abstract readReview
In one paragraph

Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sulafa SalamaDepartment of Endocrinology and Diabetes, Altnagelvin Area Hospital, Londonderry, GBR.
Eltayeb Osman Elfaki OmerEndocrinology, Dr. Sulaiman Al Habib Hospital, Riyadh, SAU.
Alaa MahmoudCardiology, Lincoln County Hospital, Lincoln, GBR.
Mohamed Abdalla Mohamed ElshikhIdrisGeneral Medicine, Al Yarmouk College, Khartoum, SDN.
Tasneem Mohammed Mahadi HussienInternal Medicine, Pioneer Health Medical Clinics, Saham, OMN.
Mohammed AhmedEndocrinology and Diabetes, James Cook University Hospital, Middlesbrough, GBR.
Samah Osman FadulelsayedEndocrinology and Diabetes, NHS/Health Education England, Chelmsford, GBR.
Sara Abdalaziz Mohammed IbrahimInternal Medicine, Dana Medical Center, Healthline Medical Group, Abu Dhabi, ARE.
Hind Osman Ali MohammedGeneral Medicine, University Hospital Waterford, Waterford, IRL.
Ali Hadi M AlhajriEndocrinology, Najran Armed Forces Hospital, Ministry of Defense Health Services, Najran, SAU.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Glucagon-like peptide-1 (GLP-1) receptor agonists are widely used for type 2 diabetes and obesity management, yet their effects on thyroid function tests remain inadequately characterized. Preclinical rodent studies demonstrating C-cell hyperplasia have raised safety concerns, while clinical evidence regarding thyroid hormone dynamics is sparse and inconsistent. This systematic review aimed to synthesize available evidence on the effects of GLP-1 receptor agonists on thyroid function tests, explicitly acknowledging that direct evidence is limited and that characterizing this evidence gap is a primary objective. A comprehensive search of PubMed, Scopus, Web of Science, and ClinicalTrials.gov was conducted for studies published between January 2021 and December 2025. Eligible studies included randomized controlled trials and observational studies evaluating thyroid function parameters in adult patients receiving GLP-1 receptor agonists. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool for randomized trials and the Risk Of Bias In Non-randomized Studies of Interventions tool for observational studies. A narrative synthesis was performed due to substantial methodological heterogeneity precluding meta-analysis. Six studies encompassing 900,225 participants met the inclusion criteria, including three randomized controlled trials, two retrospective cohort studies, and one combined Mendelian randomization and cohort study. Only one study directly assessed thyroid function tests, reporting a mild decrease in free thyroxine and slight thyroid nodule progression after 12 months of therapy, though Mendelian randomization analysis revealed no significant causal effect. The remaining five studies did not systematically evaluate thyroid function parameters, focusing instead on thyroid malignancy outcomes or weight loss efficacy. The large-scale cohort studies demonstrated no increased risk of thyroid tumors or thyroid cancer with GLP-1 receptor agonist use. Risk of bias was low for two observational studies and moderate for one due to potential residual confounding, while two randomized trials demonstrated low risk of bias and one raised some concerns regarding outcome measurement. This systematic review aims to critically evaluate the available evidence - and, more explicitly, to characterize the substantial evidence gap - concerning the effects of GLP-1 receptor agonists on thyroid function tests. While only one of six included studies directly addressed this outcome, and available data suggest no increased thyroid malignancy risk, definitive conclusions regarding functional thyroid effects cannot be drawn due to the absence of systematic thyroid function assessments in most included studies, particularly the major randomized controlled trials. Future research should incorporate systematic thyroid hormone monitoring to clarify the clinical significance of GLP-1 receptor agonist therapy on thyroid axis regulation.

Indexed as

free thyroxineglp-1 receptor agonistsliraglutidesemaglutidesystematic reviewthyroid function teststhyroid safetythyrotropin

Identifiers

PMID42220875
PMCPMC13221614

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.