GLP-1 medications are similar to the natural hormone Incretin. Incretin has several effects on the body. It affects the brain to tell you that you are full, helping you to reduce your portion size at any given meal. It also seems to stop the “food chatter” or “food noise” that nags at us to snack when we are not hungry. This is a very powerful effect and a great tool to add when you are working on changing your diet and increasing your exercise. Incretin also helps to slow gut motility, this means your stomach feels fuller for longer, helping you to feel fuller at mealtime, and later, after you have finished eating. GLP1 medications help in metabolizing your glucose by increasing glucose-dependent insulin secretion and suppressing glucagon levels. The difference between Semaglutide and Tirzepatide is that Tirzepatide works on an extra enzyme in the gut that helps with fat metabolism, which gives some patients better results.

To qualify for a GLP-1 medication for weight loss you need to have a BMI of 27 or greater. For people with a BMI under 27, a “modified plan” of low dose GLP is available.

Some people reach a plateau with their weight-loss after they reach the top dose. This doesn’t happen to everyone, but a subset of people has difficulty continuing to lose weight after a time due to developing a tolerance to the medication. Currently, we recommend changing the GLP-1 medication. The medications are different enough that switching seems to restimulate the weight loss. So, Semaglutide to Tirzepatide or Tirzepatide to Semaglutide to get your weight moving again.

GLP-1 microdosing uses much smaller, steady doses of GLP-1 medications—often not primarily for weight loss—to gently improve inflammation, blood sugar control, and certain chronic conditions while limiting side effects. Microdosing may be used to help with: Migraine: fewer and/or milder migraine headaches Chronic pain: arthritis and autoimmune-related pain Inflammation: overall lower inflammatory levels Kidney health: support in some chronic kidney disease cases Heart & vessels: cardiovascular risk reduction Fatty liver: improvement in fatty liver disease Blood sugar: lower HbA1c and more stable blood sugar in prediabetes and type 2 diabetes PCOS: better insulin resistance and weight management, sometimes reducing need for metformin Sensitivity to medication: an option for people who need lower doses due to strong side effects

Many people can use GLP-1 medications in microdoses for health benefits beyond weight loss, but dosing is adjusted based on BMI to avoid unwanted weight loss.

Low-dose naltrexone may boost natural endorphins, modulate the immune system, and reduce neuroinflammation, which can help with central pain. LDN is also used as an add-on for weight loss. By briefly blocking opioid receptors, it triggers a rebound in endorphins that may help regulate appetite, reduce sugar and carb cravings, and lessen emotional or binge eating. LDN has anti-inflammatory effects that may reduce systemic inflammation and help address underlying drivers of many chronic illnesses, autoimmune conditions, weight gain, and chronic pain.

If you have reached a plateau with Semaglutide or you are not tolerating the side effects, you can switch to Tirzepatide. Switching from one GLP-1 to another does not mean you have to start over from the beginning. We recommend a starting “crossover” dose for you that is about 2 steps lower. If you are sensitive to medications, and you want to start at an even lower dose to see how you will respond, you can decrease your dose by another 10 units on the syringe. This will drop your dose by approximately another step. You can see how you tolerate it and move up to the recommended crossover dose the next week if you want to, or hold at a lower dose. Changing from one GLP-1 to another is not an equivalent exchange and we only make recommendations about how to do it. Please discuss it with your provider if you have any questions or concerns.

If it has been less than 2 weeks you can restart your GLP-1 without decreasing the dosage. If it has been longer than 2 weeks, you should speak to your provider about how to restart depending on your individual history. If it has been more than 30 days you should restart at the beginning dose.

You cannot take a GLP-1 medication if you are pregnant or breastfeeding. If you plan to become pregnant, it is advised you have at least 2 months off the medication before trying to conceive. You cannot take a GLP-1 medication if you have insulin-dependent diabetes, or if you have non-insulin-dependent diabetes and are on certain medications that lower blood sugar. You can talk this over with your provider. You cannot take a GLP-1 medication if you have a personal or family history of medullary thyroid cancer. If you have had a different type of thyroid cancer (not medullary) and you can obtain a pathology report showing what type of cancer you had, treatment with a GLP-1 may be considered. You cannot take a GLP-1 medication if you have a personal or family history of multiple endocrine neoplasia. Medications affected by GLP-1 decreasing gut motility and potentially slowing the absorption are Tylenol, Digoxin, Warfarin, Oral contraceptives, Metformin, Statins, ACE-inhibitors, and Griseofulvin. These medications should be taken at least 1 hour before taking any GLP-1.

For questions about your order, shipping, payment, or refills please contact the vendor where you originally placed the order. If you have medical questions or symptoms/side effects that you need to help with, you can text into the portal for help. If you are experiencing a medical emergency/urgency, please dial 911 or get immediate help from your PCP.

Store GLP-1 in the refrigerator at 36°F to 46°F (2°C to 8°C). Traveling | If needed, a single dose can be stored unrefrigerated at temperatures not to exceed 86°F (30°C) for up to 21 days. Do not freeze GLP-1. Do not use GLP-1 if it has been frozen. Protect from direct sunlight.

You are pregnant, breastfeeding, or plan to become pregnant within the next 2 months. You have insulin-dependent diabetes, or non–insulin-dependent diabetes on certain blood sugar–lowering drugs (must be reviewed with your provider). You or a family member has had medullary thyroid cancer or multiple endocrine neoplasia (MEN). You’ve had other thyroid cancer types only if your pathology confirms it is *not* medullary. If you take Tylenol, digoxin, warfarin, oral contraceptives, metformin, statins, ACE inhibitors, or griseofulvin, take them at least 1 hour before your GLP-1 dose, as GLP-1 can slow their absorption.