Ozempic was first approved by the FDA in 2017 as a diabetes treatment and its use, alongside other GLP-1 agonist medications, has been in the spotlight in recent years. Similar medications, like Wegovy, containing double the amount of the active ingredient semaglutide, have also gained FDA approval for weight loss.
Glucagon-like peptide 1 (GLP-1) receptor agonists are a class of drugs designed to help with diabetes but are now often being used to help with weight reduction. These medications can help to lower blood sugar and regulate insulin, which is crucial for people with Type 2 diabetes. It helps by imitating a hormone naturally produced in our small intestines called glucagon-like peptide-1. It signals to our body that we feel full, reducing appetite, and prompting our stomachs to empty more slowly. It can reduce the risk of cardiovascular disease for people with diabetes and has been proven to be effective in these cases.
The initial discovery of GLP-1 and its potential therapeutic effects dates back to the 1970s and 1980s. While Dr. Daniel J. Drucker and his team at the University of Toronto were pivotal in identifying GLP-1 and its role in insulin secretion, other researchers, including Dr. Joel Habener at Massachusetts General Hospital and Harvard Medical School, also contributed to the understanding of GLP-1. GLP-1 was initially identified as a product of the proglucagon gene, and its effects on insulin secretion and blood sugar regulation were recognized. However, early research found that GLP-1 had a short half-life in the body, limiting its therapeutic potential—the problem: it needed to last longer to reach the pancreas.
Over subsequent years, researchers worked to develop GLP-1 agonists that could overcome this limitation by increasing the duration of action. This involved modifying the structure of GLP-1 to enhance its stability and prolong its activity in the body. Through scientific advancements and pharmaceutical development efforts, long-acting GLP-1 agonists suitable for daily injection were eventually developed and approved for treating type 2 diabetes.
But, with the good, naturally comes some bad. The most common side effects include:
- Constipation or diarrhea
- Dehydration
- Nausea
- Hair loss
- Increased risk of pancreatitis
- Mood changes
Beyond these side effects, patients may be drastically reducing their caloric intake—it’s advised to screen them for micronutrient deficiencies and supplement accordingly. Patients should always be monitored while taking these medications.
Our account manager, Dr. Lydia Thurton ND, recently hosted a webinar to review how to formulate with ease in these cases. You can watch the full recording and learn more here. Along with the prescription of GLP-1 agonist medications, practitioners often find themselves recommending supplements to support with the efficacy and side effects. Here are the supplements we recommend considering alongside the prescription of GLP-1 agonist medications:
Vitamin D
Vitamin D deficiency has been associated with insulin resistance, a key characteristic of type 2 diabetes. Ensuring adequate vitamin D intake can improve insulin sensitivity, which can complement the effects of GLP-1 agonists in managing blood sugar levels.
Vitamin B12
GLP-1 agonists can sometimes interfere with the absorption of vitamin B-12 in the gastrointestinal tract, potentially leading to lower levels of this essential nutrient over time. Vitamin B-12 is crucial for various functions, including the formation of red blood cells, neurological health, and DNA synthesis. Supplementing with vitamin B-12 can help mitigate any potential deficiencies that may arise from the use of GLP-1 agonists.
CoQ10
CoQ10 is a vital antioxidant that plays a key role in cellular energy production and supports overall cardiovascular health. It can help neutralize free radicals and reduce oxidative stress. CoQ10 may help reduce oxidative damage and inflammation seen in type 2 diabetes, complementing the therapeutic effects of GLP-1 agonists. CoQ10 can also play a critical role in mitochondrial function and cellular energy production.
Omega 3 Fatty Acids
People living with type 2 diabetes may be at increased risk of cognitive decline and neurodegenerative diseases. GLP-1 agonists have been shown to have neuroprotective effects and may help preserve cognitive function. Combining omega-3 supplementation with GLP-1 agonist therapy may further support brain health and potentially reduce the risk of cognitive impairment.
Cardiovascular disease is a concern for people with type 2 diabetes, as they have an elevated risk of heart attacks and strokes. GLP-1 agonists can help reduce the risk of cardiovascular events. Omega-3 fatty acids have also been studied for their cardiovascular benefits, including reducing triglyceride levels, lowering blood pressure, and improving endothelial function. By combining omega-3 with GLP-1 agonists, patients may further improve overall heart health.
Magnesium
Magnesium plays a crucial role in insulin signalling and glucose metabolism. Adequate magnesium levels are associated with improved insulin sensitivity, which is beneficial for patients with type 2 diabetes.
Constipation is a common GI side effect of GLP-1 agonists, particularly during the initial stages of treatment. GLP-1 agonists can slow gastric emptying and intestinal motility, which may lead to constipation. Magnesium is known for its laxative effect and can help alleviate constipation by promoting bowel movements and supporting regularity.
Probiotics
For gastrointestinal side effects such as nausea or diarrhea, probiotic supplements containing beneficial bacteria may help restore gut flora balance and alleviate symptoms.
Practitioner Protocols
We also offer a handful of protocols in our practitioner portal. These are designed for licensed practitioners to use in conjunction with GLP-1 agonist prescriptions in order to support their patients experiencing side effects. These protocols can be added to a personalized blend tailored to your patient’s deficiencies and main concerns:
- Optimal Digest: GLP-1 Optimal Digest is a synergistic formula designed to aid digestion in the patient on GLP-1 agonist medication. Between 20-50% of patients will experience side effects of nausea, vomiting and diarrhea. Symptoms tend to be most severe as patients begin the medication and titrate up their dose. Managing side effects can help improve compliance, quality of life and ensure optimal nutrient absorption.
- Pancreatin
- Lactobacillus rhamnosus
- Lactobacillus Acidophilus
- Bifidobacterium Bifidum
- Saccharomyces boulardii
- Bacillus Coagulans
- Ginger Root
- L-Glutamine
- Hair Health: As patients reduce their caloric intake, they are subject to protein and nutrient deficiencies that can contribute to hair loss. This is especially relevant for patients with polycystic ovarian syndrome. This synergistic formula supports keratin production, healthy hair follicles and may combat hormonal factors that contribute to hair loss.
- Biotin
- Iodine
- Selenium
- Hydrolyzed Fish Collagen
- Ashwagandha
- Saw Palmetto
- Turmeric Root
- Hyaluronic Acid
- L-Cystine
- L-Lysine
- L-Methionine
- Resveratrol
- Black Pepper Extract
- L-Arginine
- Holy Basil
- Zinc
- Muscle Restore: This formula may help patients maintain lean muscle mass during a phase of weight loss.
- L-Isoleucine
- L-Leucine
- L-Valine
- Vitamin C
- Hyaluronic Acid
- Vitamin D3
- Zinc
- Resveratrol
- Muscle Restore 2: This synergistic formula is optimized to support facial muscle retention, collagen production and skin hydration.
- Creatine Monohydrate
- Bovine Hydrolyzed Collagen
- Hyaluronic Acid
Beyond these recommendations, we always suggest running micronutrient tests on your patients taking GLP-1 agonists. With a reduced appetite comes the potential for deficiencies. Running tests allows you to supplement accordingly. In these cases we suggest a multivitamin.
What makes a good multi?
- More than one capsule—therapeutic dosing requires more than one cap daily
- Active forms of vitamins (phosphates and methylated where applicable)
- Glycinate minerals for easy absorption and limited GI impacts
- Adequate Vitamin D—no additional supplement required
Watch our most recent webinar to learn more about how to use these protocols in your practice.
The information in this blog is intended for educational purposes only and should not be used as a substitute for professional medical advice. Always consult with your healthcare provider before starting any new supplement, especially if you are currently taking medication or managing a health condition.
