Can I Take Ozempic With Levothyroxine for PCOS?

By now, we’ve all heard about Ozempic and its weight management benefits. For many with polycystic ovary syndrome (PCOS), it can sound like a miracle drug. But as more people use Ozempic and other semaglutide prescriptions off-label for weight loss, the drawbacks are becoming clearer. And the truth is, Ozempic isn’t a long-term solution. It just doesn’t address the root causes behind your PCOS symptoms—and often leaves you with lingering side effects that outweigh the benefits.

That said, everyone’s journey looks different. If you’re on Ozempic and also making intentional lifestyle changes to support your health, I’m here to celebrate your progress with you! Still, it’s not just Ozempic’s side effects you need to keep in mind. This medication can also interact with others you may be taking—reducing their effectiveness, worsening side effects, or even putting your health at risk.

If you’re on levothyroxine—or your doctor is considering prescribing it—it’s important to understand how these two drugs might interact. Knowing the potential risks and drawbacks can help you make an informed decision about your symptom management plan.

Here’s what you need to know about levothyroxine and Ozempic for PCOS:

Can I Take Ozempic With Levothyroxine for PCOS?

In most cases, yes, you can take levothyroxine and Ozempic (semaglutide) for PCOS. However, there is evidence that these medications do interact with one another in certain individuals. Even though Ozempic is for improving insulin resistance and levothyroxine is for thyroid hormone management, they both can have a big impact on the digestive system. We’ll get into more details about this below! 

That said, this combination should be used selectively. mainly when managing hypothyroidism alongside PCOS, Type 2 diabetes, or obesity. In these cases, Ozempic and levothyroxine together may be helpful for improving blood sugar control, supporting thyroid health, boosting metabolism, increasing energy, balancing hormones, and reducing your risk of thyroid cancer, type 2 diabetes, and other long-term complications. 

Of course, always discuss everything with your doctor. They’ll have the best understanding of how these medications may work together for people managing PCOS and thyroid issues.

Important note: Never use Ozempic if you have a personal or family history of Multiple Endocrine Neoplasia Syndrome type 2 (MEN2). This rare genetic disorder significantly increases the risk of developing medullary thyroid cancer! In fact, studies have shown that semaglutide can raise the risk of thyroid tumors, especially in those with a family history of medullary thyroid cancer. If you’ve been diagnosed with either, steer clear of Ozempic.

What Is Levothyroxine Used for?

Levothyroxine is FDA-approved for treating hypothyroidism, which is when your thyroid gland fails to produce adequate thyroid hormones. The underactive thyroid causes a chain reaction of hormonal imbalances, leading to weight gain, fatigue, cold intolerance, dry skin, mood issues, and more. Levothyroxine works by replacing the missing thyroid hormones to restore balance.

This can be especially important for women with PCOS, since hypothyroidism is more common in Cysters. In fact, it’s one of the four types of PCOS! Research shows thyroid disorders show up almost twice as often in people with PCOS compared to everyone else. So, if you’re using Ozempic to improve insulin resistance while taking levothyroxine for thyroid hormone support, you may find success in relieving chronic symptoms. (Here’s more on PCOS and thyroid health.)

Beyond hypothyroidism, levothyroxine is also prescribed for other thyroid-related issues, including goiter, thyroid cancer, and certain thyroid conditions during pregnancy. Essentially, if your thyroid isn’t producing enough hormones, levothyroxine can step in to fill the gap and help relieve symptoms.

That said, it’s important to remember that this medication isn’t a cure—it only works as long as you take it. This is why it’s essential to make diet, exercise, and lifestyle changes to improve hypothyroidism and PCOS for good!

Does Ozempic Interact With Levothyroxine?

Ozempic has the potential to interfere with levothyroxine (and vice versa). One of the ways Ozempic works is by slowing down digestion, which helps food move more gradually through your system to support weight loss. While that can be helpful for blood sugar and appetite control, it also creates a challenge when paired with levothyroxine.

Levothyroxine needs to be absorbed at a specific point in your digestive tract to work properly. If Ozempic is slowing down gastric emptying, it can delay or reduce levothyroxine’s absorption. That means the thyroid medication is less effective!

Because of this, it’s important to have a clear treatment plan in place with your doctor if you’re prescribed both medications. Timing, dosage, and monitoring really matter here.

Here are some helpful resources for managing blood sugar levels and thyroid hormones:

How to Take Ozempic and Levothyroxine Together for PCOS

Step One: Take levothyroxine first thing in the morning. 

Levothyroxine works best on an empty stomach. Taking it first thing in the morning helps your body absorb the hormone properly. At the same time, this ensures your thyroid levels stay consistent throughout the day.

Step Two: Don’t eat or drink for at least 30 minutes. 

After taking Levothyroxine, wait at least 30-60 minutes before eating or drinking anything besides water. Food, coffee, or supplements like calcium and iron can interfere with absorption and reduce the medication’s effectiveness.

Step Three: Administer your Ozempic injections weekly at the same time each day. 

Ozempic is taken once a week, so stick to the same day and time to keep your blood sugar steady. Just be sure it doesn’t overlap with your morning levothyroxine. Try scheduling your Ozempic shot in the afternoon or evening! Not only does this help with consistency, but it’s an easy way to make sure you’re pairing it with meals.

Step Four: Get thyroid labs done more frequently. 

Since you are taking levothyroxine, regular thyroid blood tests (TSH, T4) help your doctor make sure your dose is correct. Labs may be needed more frequently when starting treatment or adjusting doses. I recommend Equilife’s Stress, Mood & Metabolism Test for regular bloodwork!

Step Five: Track your side effects and symptoms. 

Keep track of any side effects you experience while taking Ozempic and levothyroxine. For Ozempic, watch for nausea, vomiting, or digestive changes. For levothyroxine, note symptoms of over- or under-treatment, like rapid heartbeat, jitteriness, fatigue, or extreme weight changes. Monitoring your response helps your doctor adjust doses safely.

Step Six: Work on your long-term solution.

Remember, neither Ozempic nor Levothyroxine provides permanent results. They only work while you’re taking them! Once you stop, thyroid and metabolic issues will come right back. That’s why I personally believe every prescription (when possible) should come with an “exit plan.” You can raise your insulin sensitivity, balance your hormones, and support your thyroid health naturally—without relying forever on meds or expensive therapies.

For more on long-term healing, read my full guide to natural PCOS symptom management. In addition to this, I recommend starting with these key lifestyle changes: 

Ozempic and levothyroxine can be taken together for short-term relief.

For decades, our relationship with healthcare has been: “there’s a pill for that.” However, we’ve all seen that this approach rarely brings true relief. Ultimately, it just means trading one set of side effects for another, relying on synthetic fixes instead of addressing the root cause. The side effects of Ozempic and levothyroxine, especially when taken long-term, can far outweigh the benefits. You deserve long-lasting relief and real results!

Changing just a few things about your lifestyle can have a profound effect on your health. And these results? They’re permanent! Stick with these new healthy habits, and you can reverse symptoms of PCOS and hypothyroidism for good.

For more PCOS healing tips and resources, browse the PCOS Weight Loss blog and listen weekly to the A Cyster and Her Mister Podcast. I’m excited to join you on your healing journey!