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4 The second A1C tier between 7.6% and 9.0% lists the use of a GLP-1 analogue or metformin as initial treatment or later as a component of triple therapy

For example, the FDA has approved the following drugs when combined with diet and exercise: Wegovy and Zepbound (trade names) to reduce excess body weight and maintain weight reduction long term in adults with obesity or adults who are overweight and have at least one weight-related condition

Scott Butsch, MD, explains why its not a recommended practice

Cancer-induced anorexia and malaise are mediated by CGRP neurons in the parabrachial nucleus

Such a strategy could include thyroid function assessment at GLP-1RA initiation, and every 3 months during active weight loss period (or more frequent, e.g., every month when 5% weight reduction is achieved), and timely levothyroxine dose titration to optimize thyroid hormone replacement

Not everyone will have this side effect, but for some, the interplay between hormonal balance and body weight shifts can be a factor that contributes to period irregularity