GLP-1 agonists and you
Reposting from THE SCRIPT a blog/newsletter from the folks at FullScript. Edits by Dr. Saleeby.
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Welcome to the first issue of The Script’s cardiometabolic series. This issue will explore trending topics related to GLP-1 and metabolic health. Continue reading to discover the latest innovations in this health space. Special LINK at bottom of this article.
GLP-1 agonists may lead to lean muscle loss
In a 2020 randomized, double-blind trial, individuals with diabetes mellitus taking once-weekly semaglutide (Ozempic/Wagovy) injections lost an average of 5.7 kg, 40% of which was lean muscle mass. The researchers noted that despite the significant amount of lean muscle mass loss, the overall proportion of lean muscle mass relative to other tissue increased. (McCrimmon et al., 2020) A 2021 randomized, double-blind, placebo-controlled trial involving individuals with a body mass index ≥ 30 also found similar results. (Wilding et al., 2021)
Although body composition improved overall, semaglutide may not be appropriate for all patients looking to lose weight (e.g., individuals with sarcopenic obesity). Efforts should be made to reduce the risk of lean muscle mass loss as much as possible. It is offered in generic form compounded by select compounding pharmacies and available in sub-lingual tabs by some. Prices vary. There are also other natural agents that can raise GLP-1 that may be safer and have fewer side effects.
GLP-1 agonists increase the risk of gastrointestinal adverse events
In a 2023 systematic review and meta-analysis, semaglutide increased the relative risk of nausea and vomiting, dyspepsia, decreased appetite, constipation, and diarrhea by 54% compared to placebo. (Bandyopadhyayet al., 2023) In addition, individuals taking GLP-1 agonists were nine times more likely to experience pancreatitis and about four times more likely to experience gastroparesis and bowel obstruction compared to those taking bupropion-naltrexone. (Sodhi et al., 2023)
GLP-1 agonists are unlikely to cause suicidal ideation
In 2023, the Food and Drug Administration’s (FDA) Adverse Event Reporting System (FAERS) received reports of suicidal ideation in individuals taking GLP-1 agonists. Since then, the FDA’s investigation has not revealed a clear causal relationship between GLP-1 use and suicidal ideation. However, the FDA will continue to investigate the issue as they cannot with certainty rule out the risk.
Popular ingredients for GLP-1 support
Berberine
Research demonstrates that supplementation with berberine may help increase the production and secretion of GLP-1 in the body. One animal study showed that it also increased insulin secretion and enhanced glucose tolerance in mice with obesity.
Read the study or view the ingredient
Curcumin
Several animal studies have found curcumin to be effective in enhancing the number of L cells in the body, promoting and increasing GLP-1 secretion. A clinical review also reported that curcumin may inhibit dipeptidyl peptidase IV (DPP-IV), an enzyme that degrades GLP-1.
Review the studies or view the ingredient
Probiotics
Probiotics are known for their role in improving gut health, but they have also been found to increase GLP-1 levels in the body. Specifically, live Akkermansia municiphila has been shown, in a mouse study, to secrete a newly identified protein named P9. This protein specifically stimulates GLP-1 production and secretion. Akkermansia has many health benefits and is an important microbe for our GI-microbiome. The difficulties in administration of this microbe have been accomplished by free-drying this agent or pasteurization.
Read the study or view the ingredient
Berberine quality concerns
Berberine, a constituent of goldenseal (Hydrastis canadensis) and other herbs, has been extensively studied for its potential role in metabolic support. In late 2023, NOW purchased berberine products and had them tested by Alkemist Labs. Test results indicated serious failures of some retail brands to meet label claims for potency. As part of our commitment to distributing pure and potent products, Fullscript will test popular berberine supplements for label potency claims with Alkemist Labs in Spring 2024.
Post-bariatric surgery nutritional deficiencies protocol
Bariatric surgery is a transformative intervention for individuals with obesity. However, the post-surgical gastrointestinal anatomy often leads to decreased absorption of key nutrients. Discover five evidence-informed ingredients for supporting patients following bariatric surgery.
Blood sugar support protocol
Blood sugar dysregulation is a common problem in the United States, with more than 29 million people having diabetes and 86 million people having prediabetes. Learn about five evidence-informed ingredients to help support blood sugar homeostasis.
Current supplements feature
Approximately 50% of physicians and physicians-in-training in the United States experience burnout in the workplace. (Medscape 2024) Burnout can be caused by many different factors, chief among them are long work hours and inefficient work processes.
Fullscript’s new current supplements feature lets patients easily submit and manage all of their supplements in one place, regardless of where they purchased the products. Fullscript generates an ingredient breakdown of each product and a patient’s total daily ingredient intake—helping physicians make informed clinical decisions and saving hours of cumbersome research and product analysis.
Learn more about current supplement feature or Learn more about combating physician burnout
… and if you want a complementary account with FullScript within the CHM family use this link: CHM-FS and get discounts and perks only available through this special registration link.
The use of the herbal hops may have the same GLP-1 agonist effect as the pharmaceuticals do. That may be worth a try.