GLP-1 Agonist Side Effects & Supplements

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. 

We also suggest adding a blend of the following nutrients that can be helpful with patient side effects, depending on what they are experiencing. ​​These protocols can be added to a personalized blend tailored to your patient’s deficiencies and main concerns: 

• Digestive Support
  Ease constipation, support the gut microbiome and resolve GI upset associated with delayed gastric emptying.
  • L-Glutamine 
  • Pancreatic Enzymes 
  • DGL
  • Chamomile 
  • Marshmallow 
  • Lemon Balm 
  • Probiotics 

• Thyroid & Adrenal Support
  Changing metabolic function can be a stressor on the body. Offer support with these ingredients.
  • K Iodide 
  • Ashwagandha 
  • Selenium 
  • Zinc
  • Vitamin D 
  • Holy Basil 

• Hair Loss Support
  Decreased micronutrient or protein status can impact hair, skin and nails. 
  • Iron 
  • Biotin 
  • Saw Palmetto 
  • Collagen 
  • Cysteine 
  • Lysine 
  • Methionine

• Mitochondrial Support
  Can help improve energy and support cellular protection while the body is making metabolic changes.
  • CoQ10 
  • NMN 
  • Resveratrol 
  • EGCG 
  • Vitamin D 
  • Chinese Mushrooms

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.

Always consult with a healthcare professional before adding supplements to your routine.