Sep 6 2023
Fresh Start with Dr. David - Season 2 - Episode 28 - Diabetes Drugs, COVID19 (COVID Brain Fog & Clotting Proteins), The Season of Fall, Healthcare Insurance, & The See Saw Principle
Fresh Start with Dr. David - Season 2 - Episode 28 -Diabetes Drugs, COVID19 (COVID Brain Fog & Clotting Proteins), The Season of Fall, Healthcare Insurance, & The See Saw Principle (Equalizer Principle) (Proportionality Principle) (Plastic Surgery Principle)
This Podcast Episode is all about Diabetes Drugs, COVID & Other Viruses (Study on COVID Brain Fog and Clotting Proteins), The Energy & Power of Fall, and Healthcare Insurance (FSAs vs. HSAs [Investment Rollover], PPOs vs. HMOs, etc.), Correlations between Diabetes Drugs and other things (SSRIs Depression, Stimulants for ADHD, Marijuana for Anxiety, Cigarettes/Vaping [Nicotine] for Anxiety/Boredom, EtOH for Anxiety/Relaxation).
I also discuss The See Saw Principle (Equalizer Principle) (Proportionality Principle) (Plastic Surgery Principle).
You don't want to miss this episode where I chat about Jillian Michaels, one of Americans Top Trainers, and what she and others are sharing about the dangers of using Diabetes Drugs just to lose weight.
Ozempic injections, which contain the active ingredient Semaglutide, function as a GLP-1 receptor agonist. GLP-1 receptor agonists mimic the actions of the metabolic hormone glucagon-like peptide-1 (GLP-1). By stimulating insulin secretion, GLP-1 receptor agonists can help lower blood sugar levels, making them beneficial for individuals with diabetes.
One of the effects of GLP-1 receptor agonists like Semaglutide is the slowing of gastric emptying. This means that food stays in the stomach for a longer period, leading to increased satiety and a reduced desire to eat. This aspect of Ozempic injections can be helpful in weight management and promoting weight loss.
However, it is important to acknowledge the existing controversy surrounding GLP-1-based therapy, including Ozempic injections. Studies and research have examined the potential risks associated with GLP-1 receptor agonists, such as the development of malignant diseases like pancreatic carcinoma and thyroid cancer.
The most common include nausea, diarrhea, vomiting, stomach pain and constipation, according to Novo Nordisk, the company that makes both Ozempic and Wegovy. But patients may also experience serious side effects such as pancreatitis, gallbladder problems and kidney failure, it warns.
Ozempic® may cause serious side effects, including:
Possible thyroid tumors, including cancer. Tell your health care provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. In studies with rodents, Ozempic® and medicines that work like Ozempic® caused thyroid tumors, including thyroid cancer. It is not known if Ozempic® will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people.
Do not use Ozempic® if you or any of your family have ever had MTC, or if you have an endocrine
1. Nausea and vomiting
Nausea is the most common semaglutide side effect. Up to 20% of people taking it for Type 2 diabetes reported nausea in clinical trials. Nausea is even more common if you’re taking the higher-dose version for weight loss. Vomiting tends to be less common than nausea.
You’re more likely to experience these side effects with higher doses of semaglutide. That’s why your healthcare provider will raise your dose slowly over a few weeks to minimize these effects. For most people, these side effects should improve over time as your body gets used to the medication.
Eating smaller meals, avoiding high-fat foods, and remaining upright after you eat can also help manage potential nausea and vomiting from semaglutide. But if these side effects are accompanied by severe stomach pain that may or may not spread to your back, get medical attention right away. This could be a sign of pancreatitis, a rare but serious side effect. More on that later.
Diarrhea is another common semaglutide side effect. Around 9% of people taking it for Type 2 diabetes and 30% of people taking it for weight loss reported diarrhea during clinical trials.
Similar to nausea and vomiting, you’re more likely to experience diarrhea with higher doses of semaglutide. As mentioned above, your healthcare provider will slowly raise your dose over time to minimize this side effect. Constipation can also happen, but it tends to be less common than diarrhea.
3. Stomach pain
Mild stomach pain is another common stomach-related side effect of semaglutide. Similar to nausea, vomiting, and diarrhea, this should subside over time. Using the tips listed above can also help minimize this side effect.
Severe stomach pain can be a sign of other side effects, like pancreatitis or gallbladder problems (like gallstones). Contact your healthcare provider right away if this develops.
Fatigue is a common side effect of Wegovy, affecting 11% of people taking it in clinical trials. Fatigue was also reported in less than 5% of people taking Ozempic, and it wasn’t reported at all with Rybelsus.
Semaglutide works for weight loss by making you feel less hungry. And eating fewer calories may cause you to feel more tired. Feelings of fatigue should subside as your body adjusts to potential changes in your diet.
5. Changes to your face
Some people taking semaglutide may notice less fullness in their face. In fact, this phenomenon has been referred to as “Ozempic face.” While Ozempic isn’t approved for weight loss, some people taking it lose weight. And facial fat loss is one potential effect of fast and significant weight loss. This can also result in looser skin and wrinkles that are more noticeable.
Keep in mind the benefits of semaglutide on your health outweigh these effects. But if you’re concerned about possible changes to your appearance, talk to your healthcare provider. They can suggest treatments for lessening the appearance of wrinkles or increasing fullness in your face.
6. Rebound weight gain
Semaglutide is a medication that’s intended to be taken long term. Wegovy, specifically, is approved for chronic weight management. As long as you’re taking the medication, weight loss is typically sustained. But if you stop taking it, it’s possible to gain some (or all) of the weight back.
Semaglutide should be paired with a healthy diet and regular exercise. Establishing habits that you can maintain long term is important if you decide to stop semaglutide.
If you’re concerned about regaining weight after stopping semaglutide, talk to your healthcare provider. They can help you weigh the pros and cons of stopping or continuing treatment.
7. Low blood sugar
Low blood sugar (hypoglycemia) isn’t very common if you’re taking semaglutide on its own. That’s because it works by telling your body to release insulin in response to a meal specifically.
But taking semaglutide with other blood sugar-lowering medications, like insulin and sulfonylureas, raises the risk of hypoglycemia. So, your healthcare provider may need to change the dose of these medications when starting semaglutide.
If you have Type 2 diabetes, it’s important to regularly check your blood sugar levels to help avoid hypoglycemia. You may be advised to have an emergency glucagon or glucagon-like product to raise your blood sugar quickly if severe hypoglycemia happens.
8. Vivid dreams
Some people taking Ozempic or Wegovy have reported experiencing vivid or abnormal dreams. Experts don’t know for sure why this may happen. And it’s not entirely clear yet if this side effect is linked to semaglutide itself.
Keep in mind that several other medications can cause vivid dreams. If they start happening while you’re taking Wegovy or Ozempic, let your healthcare provider know, especially if they’re interfering with your sleep or quality of life. They can help determine the potential cause and next steps.
9. Hair loss
Losing weight quickly can result in hair shedding or loss. This may be one of the reasons why some people taking Wegovy or Ozempic are reporting hair loss during treatment. During Wegovy’s clinical trials, 3% of people receiving the medication reported this side effect.
This type of hair loss, called telogen effluvium, is usually temporary. Hair loss you may be experiencing from Wegovy or Ozempic should subside as your body adjusts. Keep in mind this may take several months.
Since these medications can also affect your appetite, it’s important to make sure you’re getting enough vitamins, minerals, and protein. If you’re not, this can also contribute to hair loss. Your healthcare provider can help you ensure you’re getting adequate nutrition during treatment.
Although rare, pancreatitis has been reported with semaglutide. If it happens, it can be life-threatening. Seek immediate medical attention if you develop severe abdominal pain, nausea and vomiting, and/or jaundice (yellowing of skin and eyes).
Let your healthcare provider know before starting semaglutide if you have a history of acute pancreatitis. They may recommend a different medication for you.
11. Gallbladder disease
Gallbladder disease, including gallstones, is possible with semaglutide, but it isn’t common. It was reported in less than 2% of people taking it in clinical trials.
Symptoms of gallbladder problems include upper stomach pain, fever, and jaundice. You may also notice clay-colored stools. Let your healthcare provider know right away if these develop.
Talk to your healthcare provider about ways you can avoid gallbladder problems while taking semaglutide. This may include dietary changes and routine physical activity.
12. Kidney damage
Studies have suggested that semaglutide may have some kidney benefits if you have Type 2 diabetes. But in rare cases, kidney damage has also been reported. This is more likely if you have severe nausea, vomiting, and/or diarrhea leading to dehydration.
Kidney damage is also more common if you already have kidney problems. Taking medications that cause you to get rid of excess water, like diuretics (water pills), also puts you at risk.
Your healthcare provider may monitor your kidneys if you’re experiencing a lot of stomach-related side effects. Let them know right away if you’re not urinating very much or at all, or notice swelling in your arms or legs.
13. Allergic reactions
Severe allergic reactions to semaglutide are rare, but possible. Call 911 or get immediate medical attention if you have swelling of the face, tongue, or throat, or shortness of breath after your dose.
Mild allergic reactions can include itching, rash, or redness at the injection site. Stopping semaglutide isn’t always necessary with mild reactions. But make sure to still tell your healthcare provider about your reaction.
Don’t use oral or injectable semaglutide if you’re allergic to any of their ingredients. And there’s a chance you could have an allergic reaction to semaglutide if you’ve had a reaction to a medication in the same class.
14. Thyroid tumors
Semaglutide has a boxed warning (the strictest warning) from the FDA about a risk of thyroid C-cell tumors. This is because animal studies found that rodents developed thyroid tumors when exposed to GLP-1 agonists. However, human studies have yet to confirm this risk.
Still, you shouldn’t take semaglutide if you or your family have a history of medullary thyroid cancer or multiple endocrine neoplasia (MEN) type 2. Contact your healthcare provider immediately if you notice signs or symptoms of thyroid cancer. These include a lump in your neck, and neck or jaw pain.
Here are five things to expect when you stop Ozempic.
1. Your Appetite Will Return
People eat less when they take Ozempic because semaglutide slows the digestion, keeping food in the stomach longer and increasing feelings of fullness, and because it triggers changes in the brain that decrease hunger and blunt the feelings of satisfaction that can accompany eating, the FDA notes.
“I used to be able to eat half a pizza, but now on semaglutide, I take a few bites and feel full,” says David Shafer, MD, an attending plastic surgeon at Lenox Hill Hospital and Northwell Health in New York City who takes semaglutide. “If I miss a dose, my consumption increases as I lose the effect of feeling full.”
But that rapid feeling of satiety produced by semaglutide goes away as soon as people stop taking Ozempic, says Kushner.
“Once Ozempic is stopped, all of the benefits from the medication cease,” Kushner says. “If the patient experienced a reduction in appetite and body weight that resulted from consuming a lower-calorie diet, the individual’s appetite will increase back to baseline when the medication is stopped, making it harder to follow a lower calorie diet.”
2. You Will Regain Weight
Because people stop feeling full and their food cravings return when they stop Ozempic, weight gain is likely, Kushner says.
Whether people take Ozempic for obesity or type 2 diabetes, medication should be just one piece of a treatment plan that also includes healthy lifestyle changes like eating a balanced diet and getting plenty of exercise.
“Ozempic should always be taken along with making healthy lifestyle changes in diet and physical activity,” Kushner says. “These changes should be continued even after stopping the medication and can help maintain some of the health benefits seen with body weight and blood sugar control.”
3. ‘Ozempic Face’ Will Go Away
Rapid weight loss spurred by Ozempic can change the skin and reduce fat volume all over the body, including in the face. Many people who shed dramatic amounts of weight with Ozempic find their face can take on a gaunt, shrunken, and dehydrated appearance that’s been dubbed “Ozempic face.”
These changes can be addressed with injectable facial fillers administered by a board-certified dermatologist or plastic surgeon, says Joshua Zeichner, MD, an associate professor of dermatology at Mount Sinai Hospital in New York City.
Stopping Ozempic will also reverse facial changes caused by the drug. “Ozempic face will go away if you gain back the weight you lost from the drug,” Dr. Zeichner says. “The face can get full the way it used to, just as you can regain the weight in your body.”
4. Side Effects Will Subside
Ozempic has other common side effects, including nausea, constipation, vomiting, heartburn, gas, headache, and dizziness.
Not everyone experiences side effects, and they may be mild for others. They can also be avoided or minimized by taking the ramp up in dosage more slowly from the lowest starter dose of Ozempic to the higher dose that’s typically used for ongoing treatment, Kushner says.
How you eat — and what you eat — also makes a difference. “Side effects can be greatly mitigated by reducing dietary fat, consuming smaller portions, and not skipping meals,” Kushner says.
Anyone who experiences side effects but still sticks with treatment would see those side effects go away when they stop taking Ozempic, Kushner adds.
5. Blood Sugar Climbs
For people with type 2 diabetes who take Ozempic to manage their blood sugar, halting treatment may cause blood sugar to rebound to around pre-medication levels, says Beverly Tchang, MD, an endocrinologist and an assistant professor at Weill Cornell Medicine in New York City.
“Since Ozempic treats the chronic disease of diabetes, people can potentially see a worsening of their diabetes when they stop Ozempic,” Dr. Tchang says.
Because Ozempic helps people eat less, a halt to treatment may lead them to consume more calories and eat larger portions, leading to an increase in blood sugar, Tchang says. And even if people manage to maintain the eating habits they developed while on Ozempic, their blood sugar might still rise when they stop treatment because the drug boosts the production of insulin, a hormone involved in blood sugar control.
These realities are among the reasons many doctors have expressed concern over Ozempic shortages potentially driven by people using the drug to shed unwanted pounds. These shortages are harming people with type 2 diabetes who need the drug for blood sugar control.
The good news is that people with diabetes still have other medicines they can take instead of Ozempic, including several in the same family of medicines as semaglutide, Tchang notes. Ozempic is what’s known as a glucagon-like peptide-1 (GLP-1) receptor agonist, a class of drugs that also includes liraglutide (Victoza), dulaglutide (Trulicity), and exenatide (Bydureon).
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