Natural GLP-1 support
The hype about GLP-1 agonist medications (ie. semaglutide aka Ozempic, Wegovy), and now the dual agonists (ie. GLP-1/GIP: tirzepatide aka Mounjaro) for weight loss and diabetes/blood sugar benefits is growing. These drugs act by slowing down digestion and thus increasing a sense of fullness after smaller portions of food.
What else should you know about these drugs, do they have risks/side effects and how can a natural approach be incorporated either instead or in support of these medications? Read on for some suggestions of what you can do before starting or when using a GLP-1 type medication to support your health goals.
Healthy blood sugar tips: you may be able to reduce/prevent your need for a medication, or improve the effecitveness of a medication if concurrently doing these things!
1) Exercise daily - none of these medications should be started without a concomitant exercise routine. It is so essential that you do NOT treat the drug as if it is doing the exercise for you. Exercise has so many physiological and metabolic benefits that you cannot make up for it with a pill - sorry!
walk for 10 min after every meal - if your goal includes blood sugar balancing (*this is not your main workout of your day, just strategic movement to blunt the spike in blood sugar that occurs after we eat)
2) Eat foods to support your goals - this means reducing or eliminating the junk, the inflammatory foods (sometimes individualized assessments help us find a few otherwise healthy foods that trigger inflammation or autoimmune reactivity for you)
eat more fiber from vegetables, flax and psyllium (supports hormonal detox), as well as gut supporting flavonoids in: pomegranates, cranberry (unsweetened), red onion
add cinnamon (supports blood sugar - as tea or spice on foods - try also adding ginger and turmeric)
eat bitter foods (support appetite/satiety balance) - specific bitter foods have GLP-1 like effects: buckwheat, lemon, collard greens, arugula, extra virgin olive oil, hops (as tea), turmeric (as tea or spice)
eat enough protein (NOT too high - it can be hard on the kidneys - but some protein), especially in combination with fiber helps stabilize blood sugar - try incorporating legumes, and unsalted nuts and seeds
avoid fructose (tends to worsen insulin signalling over time, by increasing fat accumulation in the liver) - this means cane sugar with equal parts glucose and fructose is less fructose relatively than agave or high fructose corn syrup.
timing for a sweet treat: at the end of a meal with lots of fiber and some protein - waiting 10-20 minutes to allow satiety from the main meal to kick in may help curb your appetite
*If you aren't sure whether walking and diet will make a difference or need more motivation, asking your MD about a prescription for a CGM (continuous glucose monitor) is highly recommended, especially if your HbA1C levels are flagged as "at risk" or "pre-diabetes".
3) Custom herbs that support GLP-1 activity:
Speak with a Naturopathic Doctor about what herbs may be right for you to support GLP-1 activity in your body naturally, reduce inflammation and improve insulin responsiveness. Some herbs support the production of more GLP-1 while others extend the duration of GLP-1 activity, thus a blend of herbs can work synergistically together. Herbs may be recommended in capsules or customized herbal tincture blends. No new GLP-1 herbs should be added in the first month of a new medication or dose adjustment. Some herbs include: astragalus membranaceous, ganoderma lucidum, panax ginseng, ocimum sanctum, and scutellaria baicalensis.
4) Acupuncture to stimulate the vagus nerve and GLP-1 like activity
You can also use acupuncture to help manage side effects of GLP-1 drugs, including: nausea, bloating, constipation
Acupuncture can be added any time and in any amount. I recommend you start with a series of 4 sessions to get a sense of how your body responds to it - timing your visits to be more frequently initially: every 1-2 weeks starting before and/or with the start of your medications.
5) Lab testing: I am always happy to review results from your MD. If you ahve a lab requisition but have not yet done the testing, I can review what was ordered and recommend additional testing to do at the same time if needed. Testing likely recommended:
Nutrients (vitamin D, ferritin, B12, folate, mineral panel, sodium, potassium, phosphate) - see below about nutritional deficiency risks to test for
Also ensure you are being monitored for a full metabolic profile - including fasting insulin, lipid profile with ApoB and Lp(a), thorough liver enzymes including GGT and Alkaline phosphatase, as well as kidney function including serum urate
Test inflammatory markers (CRP, ESR) and consider other related hormones like the thyroid
Risks & Side effects fo GLP-1 and GLP-1/GIP drugs
Side effects tend to be worse closest to the initial injection, and improve over time. However, getting off this medication can be difficult - as it tends to cause rebound weight gain.
Most common side effects are gastrointestinal: nausea, diarrhea or constipation, bloating, gas, abdominal pain (all associated with the slowed digestive motility and decreased appetite). There is also a risk of hypoglycemia (blood sugar crashing too low), gallbladder issues (stones or inflammation) and acute pancreatitis. Supporting a healthy gut microbiome using targeted fiber and prebiotic foods and supplements to repair the mucosal lining in your gut can help to support GLP-1 activity and reduce stomach irritation.
Risks of rapid weight loss: If you are on this medication, you don't want to have too rapid weight losses as this can be a shock to your body and increase the risk of side effects including muscle loss (sarcopenia), painful gallstones or gallbladder spasms and nutritional deficiencies. Rapid weight loss can also trigger the body to try to stop losing weight if it senses it is in a "starvation" state.
How much is too much? Ask your provider to reduce your dose if you are losing more than 2 lbs per week (or 1% of your body weight).
Nutritional deficiencies: If you notice you are eating much less food on these medications, make sure to check that you are meeting your daily need for nutrients. If you are experiencing hair shedding, extreme fatigue or dizziness, you should notify your provider and get support to increase essential nutrient intake. Nutrients that tend to be depleted by these medications include: iron, zinc, vitamin D, calcium, vitamin B1 (and other B vitamins).
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As always, these tips are for general informational purposes and not intended as medical advice! I highly recommend seeking out professional support to tailor support for your own health needs and ensure there are no contraindications to you following the tips listed here.
Dr. Natalie Senst, ND
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