Episode Transcript
[00:00:00] Speaker A: Welcome back, everyone, to the deep dive. Today we are going deep, deep, deep on the side effects of those GLP1 agonist medications. Oh, yes, we are. So we're talking about drugs like Ozempic. Gosh, do you know, Wegovy, Mounjaro, Zeppbound, even some of those earlier ones. You remember Bieta, Victoza. How could we forget?
Mounjaro, which is also known as Tirzepatide, which works a bit differently on both the GLP1 and GIP receptors.
[00:00:29] Speaker B: Right, right. Those dual agonists.
[00:00:30] Speaker A: Now, you probably know that these are primarily used for managing blood sugar, especially in type 2 diabetes, and some of them are also prescribed for weight management.
[00:00:39] Speaker B: Absolutely. Yeah. And if you're starting or considering starting these medications, it's totally natural to wonder about side effects, especially when you first begin or when your dose changes. The big part of the experience for a lot of people, it really is.
[00:00:54] Speaker A: And that's why we're doing this deep dive today specifically for you, is to give you a clear understanding of these potential side effects and more importantly, what you can actually do about them. Some actionable strategies to help you manage them. Okay.
[00:01:06] Speaker B: Love it.
[00:01:06] Speaker A: We're gonna be drawing from a physician's guide to unpack all of this. So let's start with what is usually top of mind, the gastrointestinal side effects.
[00:01:15] Speaker B: Okay, let's do it. This is where people really first feel the medication, right?
[00:01:19] Speaker A: Yeah.
[00:01:19] Speaker B: The most common side effect you might encounter is nausea.
[00:01:22] Speaker A: All right, nausea. With GLP1s, what does it actually feel like in your day to day?
[00:01:28] Speaker B: Well, you know, it's that sort of general queasiness in your stomach, kind of an unsettled feeling. You might just not want to eat as much or you get full really fast after just a little bit of food. Some people even say it feels like mild motion sickness.
[00:01:41] Speaker A: Interesting.
[00:01:42] Speaker B: And it's thought that this is because the GLP1s, they slow down how quickly food empties from your stomach.
[00:01:49] Speaker A: Okay. And when can you expect this nausea to start? And how long does it tend to last?
[00:01:54] Speaker B: So typically, it kicks in within the first one to three days of starting the medication.
[00:01:59] Speaker A: Okay.
[00:02:00] Speaker B: And the good news is, for a lot of folks, this feeling actually goes away as your body kind of gets used to the drug.
[00:02:06] Speaker A: It's used to it. Yeah.
[00:02:07] Speaker B: But it's important to remember it is dose dependent, meaning the higher the dose, the more likely or intense the nausea might be.
[00:02:16] Speaker A: Oh, okay.
[00:02:17] Speaker B: And it really is. It is the most common side effect that people report when they first Start.
[00:02:22] Speaker A: Yeah. So if you find yourself with this nausea, what can you do about it? What are some things that you can do to manage it?
[00:02:29] Speaker B: So a couple of things can be really helpful. Taking your medication right before bed, that's one thing that could work. You know, you might sleep through the worst of it.
[00:02:35] Speaker A: Right.
[00:02:36] Speaker B: Eating smaller, more frequent meals rather than the big three squares a day, that can make a difference, too.
[00:02:41] Speaker A: Okay.
[00:02:42] Speaker B: And try to avoid foods that can upset your stomach. Fatty foods, spicy foods, anything really heavily seasoned.
[00:02:49] Speaker A: Sure.
[00:02:50] Speaker B: And of course, you always want to stay hydrated. Sipping on water throughout the day is a good habit.
[00:02:54] Speaker A: That makes sense. Now, let's talk about something a little bit more serious. Vomiting.
[00:02:59] Speaker B: Okay. So while less common than nausea, vomiting definitely can happen. It's more likely if you're on a higher dose and it can kind of follow on from that nausea we were just talking about.
[00:03:10] Speaker A: And our guide has some key points about vomiting that we should keep in mind.
[00:03:14] Speaker B: It does. So like I said, it's not as common as nausea, but obviously when it happens, it's way more disruptive to your day.
[00:03:21] Speaker A: Yeah, of course.
[00:03:22] Speaker B: But the good thing is that again, like nausea, it often gets better as you kind of adjust to the medication.
[00:03:28] Speaker A: That's good.
[00:03:29] Speaker B: However, if it is really bad or just doesn't go away, your doctor might need to reduce your dose for a bit.
[00:03:36] Speaker A: Okay. So keep your doctor in the loop.
[00:03:38] Speaker B: Yes, definitely. Keep them informed.
[00:03:39] Speaker A: So what are some things that you can do to manage vomiting?
[00:03:43] Speaker B: So, first of all, if your doctor has given you anti nausea medication.
[00:03:46] Speaker A: Okay.
[00:03:47] Speaker B: Make sure you take it exactly as prescribed.
[00:03:49] Speaker A: Of course. Yeah.
[00:03:50] Speaker B: It can also help to avoid eating for an hour or two after you take the medication. And staying upright after meals can help with digestion, too, instead of lying down right away. And again, as always, let your doctor know if the vomiting isn't getting any better.
[00:04:06] Speaker A: Right. Okay, let's talk about diarrhea now.
[00:04:08] Speaker B: Okay, so diarrhea. Diarrhea basically means you've got loose watery stools and you're going to the bathroom way more often, right?
[00:04:15] Speaker A: Yeah.
[00:04:16] Speaker B: Now, not everyone gets this with GLP1s, but when it happens, it can be pretty annoying.
And, you know, with all that fluid loss, you can also lose important electrolytes, right?
[00:04:26] Speaker A: Yeah.
[00:04:26] Speaker B: Electrolytes are things like sodium, potassium, magnesium. They're essential for basically everything in your body from muscle function to nerve signals.
[00:04:35] Speaker A: Oh, wow.
[00:04:36] Speaker B: So keeping those imbalance is really important.
[00:04:38] Speaker A: So how do you manage diarrhea and keep those electrolyte levels in check?
[00:04:42] Speaker B: Well, what you eat can actually make A big difference. So focus on foods that are rich in electrolytes. Good examples are bananas. They're a good source of potassium.
[00:04:51] Speaker A: Bananas. Yeah.
[00:04:51] Speaker B: Avocados have potassium and magnesium.
[00:04:54] Speaker A: Okay.
[00:04:55] Speaker B: Coconut water can help replenish a whole bunch of electrolytes. And, and even just adding some salty foods or broths to your diet can help with your sodium levels.
[00:05:04] Speaker A: Okay.
[00:05:05] Speaker B: Now on the flip side, it's smart to cut back on things that can make diarrhea worse. So, like fatty foods, spicy foods, caffeine, alcohol, all that good stuff. Right. And of course, staying super hydrated is absolutely crucial, especially to replace all that fluid you're losing.
[00:05:20] Speaker A: Okay. Yeah. So let's move on to another GI issue. Constipation.
[00:05:24] Speaker B: Okay, so constipation is basically the opposite of diarrhea. It means having a hard time going to the bathroom, your stools are hard and dry, you're going less often, and sometimes you even have to strain.
[00:05:35] Speaker A: Yeah.
[00:05:36] Speaker B: The main focus here is on increasing your fluid intake.
[00:05:39] Speaker A: Okay.
[00:05:40] Speaker B: So aim for like 2 to 3 liters of water per day. Gradually adding more fiber to your diet can also help. So eat lots of fruits, vegetables, whole grains. That helps to bulk up your stool and makes it easier to pass.
[00:05:52] Speaker A: Okay.
[00:05:52] Speaker B: Regular exercise can also stimulate your bowels.
[00:05:54] Speaker A: Okay.
[00:05:55] Speaker B: And then if those lifestyle changes aren't enough, your doctor might recommend a stool softener.
[00:06:01] Speaker A: Makes sense.
Okay. And the last main GI side effect we're going to talk about is abdominal discomfort or pain, which sounds like it can cover a lot of different things.
[00:06:11] Speaker B: It does. It can range from just mild discomfort, maybe some cramping, bloating.
[00:06:16] Speaker A: Yeah.
[00:06:16] Speaker B: A feeling of fullness all the way up to actual severe abdominal pain.
[00:06:21] Speaker A: And are there any specific signs that we should be looking out for that mean we need to call the doctor?
[00:06:26] Speaker B: Yeah, doctor, definitely. So watch out for severe pain that makes you double over, pain that keeps getting worse, or pain that comes with a fever.
[00:06:34] Speaker A: Okay.
[00:06:35] Speaker B: Those are all red flags. So if you have any of those signs, stop taking the medication and get medical help right away. Those could be signs of a small bowel obstruction or pancreatitis, which need immediate attention.
[00:06:46] Speaker A: Yeah, those sound serious. Alright, so let's switch gears and talk about some of the other common side effects that aren't related to your stomach and gut. First up, injection site reactions.
[00:06:56] Speaker B: Okay. Yeah, so these are pretty common, especially when you first start treatment. You might see some redness, itching, a little bit of swelling where you inject the medication. But the good news is that they usually go away on their own and they're usually not serious.
[00:07:09] Speaker A: And how do you manage those reactions?
[00:07:12] Speaker B: It's a good idea to rotate your injection sites with each dose.
[00:07:16] Speaker A: Okay. So don't use the same spot every time.
[00:07:19] Speaker B: Exactly. And a cold compress can help soothe the area. And of course, just make sure the site is clean when you inject to avoid any infections.
[00:07:27] Speaker A: Right. Makes sense. Now, headaches are also listed as a common side effect.
[00:07:32] Speaker B: Yeah, headaches are pretty common. They might pop up when you start the medication or when your dose increases, but again, they usually don't last very long.
[00:07:40] Speaker A: And what do you do if you get a headache?
[00:07:42] Speaker B: So making sure you're drinking enough water can help.
[00:07:45] Speaker A: Okay.
[00:07:46] Speaker B: Yeah, you could try an over the counter pain reliever like acetaminophen or ibuprofen. But check with your doctor first just to make sure it's safe for you, especially if you have any other health conditions. And then if the headaches are really bad or they just won't quit, let your doctor know about it.
[00:08:02] Speaker A: Okay. Another one is dizziness. What causes that?
[00:08:06] Speaker B: Dizziness can make you feel lightheaded, unsteady, like you might fall. Sometimes you even get that spinning sensation, which is called vertigo. It can happen when you stand up too quickly.
[00:08:16] Speaker A: Yeah, I've had that before.
[00:08:17] Speaker B: It could be related to not eating enough or being a little dehydrated. Especially if you're also dealing with those GI side effects we talked about earlier.
[00:08:25] Speaker A: Makes sense. So how can you minimize the dizziness?
[00:08:28] Speaker B: Well, just standing up slowly can help a lot.
[00:08:31] Speaker A: Okay, so don't jump up too fast.
[00:08:33] Speaker B: Exactly. And again, staying well hydrated is key.
[00:08:36] Speaker A: Right.
[00:08:37] Speaker B: Eating smaller, more frequent meals can also help keep your blood sugar levels stable, which can reduce dizziness. And as always, if it doesn't get better or it's really bothering you, talk to your doctor.
[00:08:48] Speaker A: Right? Yeah. Okay, next up is fatigue.
[00:08:51] Speaker B: Yeah, fatigue. It's that feeling of being completely wiped out. No energy, just blood. It can happen for a few reasons. It could be because you're not eating as much due to the appetite suppression, or it could even be a sign of mild dehydration.
[00:09:06] Speaker A: Okay. How do you deal with fatigue when you're taking these medications?
[00:09:10] Speaker B: First, make sure you're still getting enough calories. Even if you don't feel as hungry. Choose foods that are packed with nutrients.
[00:09:17] Speaker A: Yeah.
[00:09:17] Speaker B: Pay attention to your hydration and make sure you're drinking enough fluids throughout the day and getting enough sleep. And doing some light exercise. If you can manage it can also help boost your energy levels.
[00:09:29] Speaker A: Okay, makes sense. And last but not least, appetite Changes. For some people, this is actually the whole point of taking the medication.
[00:09:38] Speaker B: You got it. Less hunger, feeling full faster, maybe even changes in what foods you crave. Feeling satisfied after just a little bit of food. That's what helps people lose weight with these medications.
[00:09:48] Speaker A: Right.
[00:09:49] Speaker B: But it's important to remember that this could mean you're not getting all the nutrients you need if you're not careful.
[00:09:55] Speaker A: So how do you make sure you're getting all the nutrition you need when you're not eating as much?
[00:09:59] Speaker B: The trick is to choose foods that are really nutrient dense, so even small portions give you a lot of bang for your buck.
[00:10:06] Speaker A: Okay.
[00:10:06] Speaker B: Make sure you're getting enough protein, too, to keep your muscles healthy.
[00:10:09] Speaker A: Right.
[00:10:09] Speaker B: And if you notice that you're eating way less than usual, talk to your doctor about whether you might need to take vitamin supplements.
[00:10:16] Speaker A: All right. So those are the more common side effects. Now let's talk about the serious, less common ones. These are things you really need to know about, even if they don't happen very often.
[00:10:26] Speaker B: Yeah, absolutely. While they're not as frequent, they do require immediate medical attention if they do occur.
[00:10:33] Speaker A: Okay.
[00:10:33] Speaker B: One of those is pancreatitis.
[00:10:35] Speaker A: So what are the warning signs of pancreatitis?
[00:10:38] Speaker B: Look out for severe pain in your upper abdomen, especially if it spreads to your back.
[00:10:43] Speaker A: Okay.
[00:10:44] Speaker B: The pain often gets worse after you eat.
[00:10:46] Speaker A: Okay.
[00:10:46] Speaker B: You might also feel nauseous, vomit. Have a seaver, and your abdomen might be tender to the touch.
[00:10:52] Speaker A: Okay.
[00:10:52] Speaker B: If you have any of those, stop taking the medication and get to the ER immediately.
And make sure you tell the doctors that you're taking a GLP1 agonist.
[00:11:02] Speaker A: Okay. Yeah. Very important. Another serious side effect is kidney problems.
[00:11:07] Speaker B: Right. So pay attention to any changes in your urination. That could be how much you pee, how often you have to go, or even the color of your urine.
[00:11:15] Speaker A: Oh. Okay.
[00:11:16] Speaker B: If you notice swelling in your legs, ankles, or feet, or you feel really tired and confused, those could be signs of kidney issues, too.
[00:11:24] Speaker A: Okay.
[00:11:24] Speaker B: And certain things can increase your risk of kidney problems, like if you already have kidney disease, if you get dehydrated from other side effects, or if you're taking certain medications.
[00:11:33] Speaker A: Okay. So lots of things to watch out for.
[00:11:35] Speaker B: Yeah. Yeah. And then there are gallbladder problems, which are another, less common but serious side effect.
[00:11:42] Speaker A: What are the signs of gallbladder problems?
[00:11:45] Speaker B: So you might have pain in the upper right part of your abdomen, especially after you eat fatty foods.
[00:11:50] Speaker A: Okay.
[00:11:51] Speaker B: You might also feel nauseous, vomit, and have a fever.
[00:11:54] Speaker A: Okay.
[00:11:54] Speaker B: And it's worth noting that these problems can happen more often when someone loses weight quickly.
[00:12:00] Speaker A: Interesting.
[00:12:01] Speaker B: In some cases, surgery might be necessary to fix the problem.
[00:12:04] Speaker A: All right, now another one is hypoglycemia, which is low blood sugar. We always hear about high blood sugar. So what does low blood sugar look like?
[00:12:12] Speaker B: Right, so with hypoglycemia, you might feel shaky, sweaty, confused, irritable.
[00:12:18] Speaker A: Oh, wow.
[00:12:18] Speaker B: Might feel dizzy, super hungry, or notice your heart beating really fast.
[00:12:23] Speaker A: Okay.
[00:12:24] Speaker B: The risk of this is higher if you're also taking other meds that lower blood sugar like insulin or sulfonylureas, or if you skip meals or if you suddenly increase your physical activity without adjusting your meds or food.
[00:12:37] Speaker A: Okay.
[00:12:38] Speaker B: If you're diabetic and you get these symptoms, there's a rule called the 1515 rule. Eat 15 grams of fast acting carbs, wait 15 minutes, then check your blood sugar. It's a good idea to keep glucose tablets or juice handy if you're prone to low blood sugar.
[00:12:52] Speaker A: Okay. Yeah, makes sense. Now, allergic reactions, those can happen too.
[00:12:56] Speaker B: Yeah, they're less common. Allergic reactions can be anything from hives and rashes to more serious stuff like swelling of your face, lips, tongue, throat, trouble breathing, rapid heartbeat, feeling dizzy, or even fainting.
[00:13:08] Speaker A: Yeah, those are scary.
[00:13:10] Speaker B: If you have any of those serious symptoms, call 911 right away.
[00:13:14] Speaker A: Okay.
[00:13:14] Speaker B: And don't take any more of the medication. Right?
[00:13:16] Speaker A: Yeah. Very important. And finally, there's intestinal blockage, which is super rare, but very serious.
[00:13:23] Speaker B: Right. With an intestinal blockage, you might have severe abdominal pain.
[00:13:27] Speaker A: Okay.
[00:13:28] Speaker B: You can't pass gas or stool, your belly is swollen, you're vomiting, and your bowel sounds are absent. This is a medical emergency, so call 911 immediately and stop taking the medication. You might need to be hospitalized and maybe even have surgery.
[00:13:42] Speaker A: So we've talked about a lot of side effects, both common and less common. To recap, when should you call your doctor or go to the er?
[00:13:49] Speaker B: Okay, so if you have severe or persistent vomiting, signs of dehydration, like extreme thirst, or not peeing much, really bad abdominal pain if you can't keep any fluids down, symptoms of a bowel obstruction, severe allergic reaction, diarrhea that won't quit, or any signs of pancreatitis that we talked about, get medical help right away.
[00:14:09] Speaker A: Okay? Very important. Now, for those more common GI side effects, what are some things that people can do to manage them?
[00:14:15] Speaker B: So a few things can help. Take your medication with a little bit of food unless your doctor tells you not to.
[00:14:21] Speaker A: Okay?
[00:14:22] Speaker B: Stay super hydrated remember, like 2 to 3 liters of water a day.
[00:14:26] Speaker A: Yeah.
[00:14:27] Speaker B: Start with a low dose and increase it slowly as your doctor directs.
[00:14:32] Speaker A: Okay.
[00:14:32] Speaker B: If your doctor gives you anti nausea meds, take them as prescribed. Keep track of all your side effects and let your doctor know about them.
[00:14:39] Speaker A: Yeah.
[00:14:40] Speaker B: You can even keep a symptom diary to see if you notice any patterns or triggers.
Getting some exercise, if you can, is also good for you.
[00:14:48] Speaker A: Okay.
[00:14:48] Speaker B: Some people find it helps to take the medication at bedtime so they sleep through the side effects.
[00:14:53] Speaker A: Yeah, that makes sense.
[00:14:53] Speaker B: Talk to your doctor about that. And finally, just avoid foods that you know make your symptoms worse.
[00:14:59] Speaker A: Right. Okay. So what about long term management? What can people expect over time?
[00:15:04] Speaker B: So the good news is, for most people, those initial side effects get better over time as your body adjusts to the medication.
[00:15:12] Speaker A: Okay, that's good.
[00:15:13] Speaker B: Your doctor might tweak your dose as you go along. It's important to see your doctor regularly so they can keep an eye on how you're doing. And remember to pay attention to what you're eating, especially if your appetite is decreased.
[00:15:25] Speaker A: Right? Yeah.
[00:15:26] Speaker B: If you're trying to lose weight, it should be a gradual process, like one to two pounds a week.
[00:15:30] Speaker A: Okay.
[00:15:30] Speaker B: And always, always, always let your doctor know about any new symptoms or if your current symptoms get worse.
[00:15:38] Speaker A: Okay. So to wrap things up, it seems like these GLP1 medications can be really helpful for managing blood sugar and weight. But it's super important to know about the potential side effects and how to deal with them.
[00:15:49] Speaker B: Absolutely. Talk to your doctor about any side effects you're having. They can give you personalized advice and adjust your treatment plan if needed.
[00:15:56] Speaker A: Okay. And on that note, here's something to think about. How can you be proactive about managing these side effects to make sure you have a good experience with this treatment in the long run. What small changes can you make to your routine based on what we talked about today, to help manage any side effects you might be dealing with? Yeah, that's a great question for everyone to consider.
[00:16:16] Speaker B: Thanks for joining us for this deep dive today. We'll see you next time.
