Semaglutide, marketed as Ozempic and Wegovy, is a Glucagon Like Peptide-1 (GLP-1) agonist that has been used in helping patients with type 2 diabetes control their blood sugar for many years.  The FDA recently added an additional indication to the drug, allowing it to be used to help patients lose weight.  By increasing GLP-1, a hormone in the GI tract, semaglutide reduces appetite and helps you feel fuller longer, which can lead to significant weight loss.  

Tirzepatide, marketed as Mounjaro, is also a GLP-1 agonist like semaglutide but also increases the hormone Glucose-dependent Insulinotropic Polypeptide (GIP). The Pharmacy we use compounds their semaglutide and Tirzepatide as subcutaneous injectables in combination with cyanocobalamin (vitamin B12). Cyanocobalamin can help boost energy and help minimize side effects of the medications, specifically nausea and fatigue.

Semaglutide is a GLP-1 receptor agonist that was originally developed for patients with Type 2 diabetes, but when providers and pharmaceutical developers noticed how much weight their patients were losing, they began to study semaglutide exclusively for weight loss. 

GLP-1 receptor agonists work by stimulating your pancreas to increase insulin.  This additional insulin causes the stomach to empty over a longer period of time. The idea of the stomach processing food more slowly can seem counterintuitive to patients.  The slow and consistent digestion causes the stomach to take more time to empty itself of food. This delayed gastric emptying sends signals of “fullness” to the brain. The end result of this process is a powerful appetite suppression effect based on the patient’s own natural insulin production. This means patients can benefit from medically assisted weight loss without any need for invasive surgeries, harsh stimulants, or extreme food deprivation. 

Tirzepatide mimics the GLP-1 and GIP hormones that the intestines secrete after eating, while semaglutide only activates GLP-1 receptors. Tirzepatide’s dual action on both GLP-1 and GIP receptors make it more effective than Semaglutide for lowering blood sugar and promoting weight loss.

A Semaglutide or Tirzepatide regimen will also lead to healthier blood sugar levels, which can help patients feel more energetic throughout their day. Stabilized and controlled blood sugar levels can also help improve other areas of overall health.

• The most common side effects of Semaglutide and Tirzepatide include gastrointestinal (GI) related symptoms such as abdominal cramps, constipation, diarrhea, nausea, and vomiting.  Additional side effects include headache and fatigue. Side effects may be more common right after initiation and during dose escalation.  These side effects tend to lessen over time with longer use of these medications.

Semaglutide and Tirzepatide is contraindicated if you have had medullary thyroid carcinoma (MTC) or an endocrine system condition known as Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2), or if you have had a serious allergic reaction to Semaglutide/Tirzepatide, or if you are currently pregnant or breastfeeding.

We’ll discuss your medical history during the consultation to ensure that you are a viable candidate.

• Patients who are less than 18 years old
• Patients who are regnant, breastfeeding or planning to become pregnant
• Patients with any of the following:
  • Type 1 Diabetes Mellitus
  • Diabetes Ketoacidosis
  • Hypersensitivity to Semaglutide, Tirzepatide or any components of this medication
  • Personal or family history of medullary thyroid carcinoma
  • History of multiple endocrine neoplasia syndrome
  • History pancreatitis 
  • Chronic kidney disease or end stage renal disease (on dialysis)
  • Patients with diabetic retinopathy
  • Patients with a history of anaphylaxis or angioedema
• Caution in patients:
  • Type 2 diabetic patients that are on insulin or a sulfonylurea. This is due to the increased need for glucose monitoring
  • Patients that are on several antihypertensive medications. This is due to risk of hypotension (low blood pressure)

We recommend injecting your weekly dose into your abdomen, at least one to two inches away from your naval. 

Rotate injection sites each week.  Additionally, injections can be placed in the back of the arm or thigh.  Ensure you clean the site thoroughly with alcohol before injecting.

Semaglutide and Tirzepatide are dosed once weekly by subcutaneous injection.  The injections should be given on the same day each week.  The dosage of Semaglutide and Tirzepatide are gradually increased, usually every month or so. 

Semaglutide doses range from 0.25 mg ot 2.5 mg and Tirzeratide doses range from 2.5 mg to 15 mg.  Starting low and increasing slowly will help minimize side effects.

This is INCREDIBLY important and a question that you should ask.

Our Semaglutide comes from a highly reputable, sterile compound pharmacy in the Southeast.  It is critical that you know that your medication is coming from a nationally accredited compounding pharmacy and that it is registered with the FDA.  

Reduce Sugar In Your Diet

While Semaglutide and Tirzepatide do help to manage blood sugar levels, you can maximize their overall effectiveness by minimizing the amount of added sugar you consume. Start with the obvious: cut back on soda and sugary beverages, put less (or no) sugar in your coffee or tea, and eat fewer sweets. But don’t forget about all the added sugar that’s hiding out in the grocery store aisles. Just check the labels for “added sugar”, and you might be surprised by what you find!

Add More (Lean) Protein to Your Diet

Keep your body satiated and energized throughout the day by including 20-30 grams of protein per meal. Foods packed with protein include…

• Lean Beef
• Fish
• Chicken Breast
• Eggs
• Cottage Cheese
• Greek Yogurt
• Tree Nuts
• Beans

Add More Fiber to Your Diet

We can’t say it enough: Eat more fiber! Fiber is essential for slowing the digestive process, managing blood sugar, helping you feel “full” longer, improving gut biome health, and (as a bonus) keeping you regular. Oh, and fiber can also help prevent colorectal cancer.

Adults should consume 25 to 30 grams of fiber per day. (Most adults in the U.S. get only about half that amount.) Fortunately, it’s not difficult to achieve this. Just one cup of beans can contain as much as 15 grams of fiber. Prefer something a little sweeter? A cup of raspberries provides 8 grams of fiber! A cup of instant oatmeal provides 5 grams.

Cut Fried and Fatty Foods

Fatty or greasy foods are already more difficult for your body to digest. With semaglutide, some patients report more discomfort or even nausea after consuming them. You don’t have to give them up, but you’ll feel better and see results faster when you cut back.

Increase Your Physical Activity

You don’t need a vigorous exercise routine to help you lose weight. But physical activity is an important component of any weight loss program. You can easily increase it by modifying your daily activities. 

Get Enough Quality Sleep

How much sleep you get, and how good it is, can have consequences for your weight and your overall health. Put simply, when you’re feeling tired, you’re more likely to expend less energy but consume more calories.