Episode 411: The GLP-1 Follow-Up: Side Effects, Microdosing & Ozempic Culture
Listen on Apple Podcasts | Listen on Spotify
Ozempic culture is officially here, and after last week’s GLP-1 episode with Jessica Brown, Erin has more to say.
This time, she’s getting into the side effects practitioners are seeing and the “microdosing” marketing language that’s gotten wildly out of hand. Erin talks about the difference between using GLP-1s skillfully vs. going a little willy nilly with telehealth prescriptions, and people chasing quick weight loss without understanding what’s happening physiologically.
This is an important “part 2” conversation around why these medications can be an incredibly effective tool… while still requiring education, self-awareness, support, and a whole lot more nuance than the internet shows.
In this episode:
Why Erin thinks we’re wildly underprepared to use GLP-1s correctly
What “Ozempic culture” gets right… and where the conversation completely misses the mark
“Food as skinny vs. food as fuel” and why micronutrients matter more than ever if you’re on a GLP-1
How Erin’s client used tirzepatide without jumping to higher and higher doses
The GLP-1 side effects Erin is seeing most often, including SIBO flares and reflux
Resources mentioned:
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Episode 410: GLP-1s Are Not Just About Weight Loss with Jessica Brown
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Glp1 Agonists delay Gastric emptying. That is one of the big things that they do in this makes you feel fuller, longer. This is why they have an appetite suppressant effect. But what can also happen is that you can be really, really nauseous. We can even see vomiting, we can see acid reflux, we can see diarrhea, we can see constipation. If you are delaying gastric emptying, if you are delaying GI emptying, then of course it just makes sense that we would see those effects. Now this can cause a lot of problems. If you already have gut issues and some red flags or careful considerations I would be thinking about is if you have a history of sibo, small intestinal bacterial overgrowth, there is a tendency for it to get a lot worse if you are on GLP1.
Welcome to the Funk’tional Nutrition podcast, spelled with a K, because we do things a little differently around here. I'm your host, Erin Holt, and I've got 15 years of clinical experience as a functional nutritionist and mindset coach, creating a new model that I call Intuitive Functional Medicine™, where we combine root cause medicine with the innate intelligence of your body. This is where science meets self trust. Your body already knows how to heal and this show is going to show you how. If you're looking for new ways of thinking about your health, be sure to follow and share with a friend because you never know whose life you might change.
Hello everybody. We're going to Talk more about GLP1s today. Last week we had Jessica Brown on the show to talk about GLP1s. I really hope you enjoyed that episode. I swear this is not becoming like a peptide or GLP1 podcast, but I do want to follow up with last week's episode with some more information for you guys, some more education and some more considerations if you are thinking through a GLP1 or you're currently on them. Now. At the time of this episode release, my clinical team and I are in San Diego for the IFM conference. I'm super excited recording this, obviously before we're there. Very excited about it. One thing that is really important to us here at The Funk’tional Nutritionist is to make sure we are on top of our continuing education. So I'm flying the clinical team out to California.
We're there right now. If you're listening to this in real time. Some of the lectures that I'm most interested in hearing about at the IFM conference are the GLP1s. I'm really, really fascinated by the research coming out and the clinical implications. And I really want to hear from more clinicians how they are using them in practice or what they are seeing in practice. And of course, the more I learn, the more I will share with you here on the Functional Nutrition podcast. So again, this is not going to become a GLP1 podcast, but I also, I've noticed a tendency, how do I say this? I've noticed a tendency in this industry for some people, especially those of us who have been around for a minute or two, to see a trend or to see a lot of interest in something and for us to take a hard stance before we actually completely understand it. And I, I'm seeing that a lot with GLP1s, and I think that's really why I wanted Jessica to come on the show because she, she has been around for a long time.
She's a smart cookie, but she can hold nuance in conversations. She can make space for multiple truths to exist and multiple sides of a conversation to exist. And I, that is what I am actively seeking out. I am 42 years old. I have been in this industry for 15 years. I have been a practitioner that long. And that's what I am curious about. And that's who I want to hear from.
I don't want to hear from company founders. I don't want business people to explain health to me and to my audience. I really want to hear from people who, who have a well rounded background, who are actively working with clients, who have their finger on the pulse of what's actually going on, who's up on the latest research, but can also talk like a human being without taking hard stances for or against something and, and say, hey yeah, like maybe that's true. And also maybe this is true too. So I keep hearing more and more about Ozempic culture and that's basically the claim that people don't want to change their lifestyle, they don't want to make behavioral change, they're just looking for a quick fix, they're just looking for an easy path. So it's set in sort of a derogatory term, Ozempic culture. And of course there's some truth to that. There's always been truth to that.
People do want quick fixes, people do want easy outs, people do want magic bullets. It is easier to take a pill or an injection than changing your whole ass life. That is true. And as somebody who's been educating people on how to build the foundations of their health for 15 years, obviously I get that. Where I think the conversation or even the accusation can go sideways. And where it misses the mark is that it doesn't account for. For the people who are already doing all of those things, who are not just trying to escape the hard work, they're actually working their hardest. These are the people that could, like, write a book on nutrition or holistic healing and they're still not better.
And these people who are turning to peptides. Yes. Including GLP1s and seeing symptom resolutions, seeing their chronic illness symptoms that they've been struggling with for years and have literally done every. Everything in their power to change, they're seeing some alleviation. What about that? Like, that has to be part of the conversation. If you want to go 10 toes down into the GLP1 conversation and you want to be a big, loud talking head on social media or on your podcast, you got to have the whole conversation, my dude. You got to be willing to go all the way in. What I'm seeing, mostly, and I'm assuming if I'm seeing this, then you guys are seeing this too, is that people are taking a very hard and quite frankly, judgmental stance against.
And that is coming, I think it's coming more from a reactional, like an emotional reaction place based on their own beliefs and their own experience. Or on the other side, I'm seeing people go all the way into. This is the magic bullet that will save everybody, everywhere, all of the time. And based on what I'm saying, like, nine times out of 10, that's coming from either an uneducated place or a very profitable place where there's profit potential on the line or a combination of both. So a great example of this would be influencers selling their discount codes. They're like, this thing changed me. Here's the 25 different things that it did for me. Now I'm going to sell it to you.
Even though they've never worked with another human body in their entire life. So that's where. I mean uneducated, but also, like, there's a lot of money to be made with that too. And as with most things, the truth is usually somewhere in the middle. And that's really why I wanted to have Jessica come on the show again. She's been around for a long time time. She has a lot of experience. She really knows the research.
And I think she can just hold this conversation with a lot more nuance than perhaps most. So last week we talked about some of the bigger side effects, especially like the black box warnings that's associated with GLP1 medications, which I think is very, very important for people to be aware of. Today I want to do something a little different and I want to talk about the side effects that we're seeing more commonly. So if you are on a GLP1 or you are considering it, you can prepare yourself them and how to navigate yourself through them. Kind of like, here's what to expect and here's how to mitigate some of those side effects. What is really important to understand is that a lot of the side effects with These medications, these GLP1 meds, are dose in management dependent. Meaning your symptoms or your reactions or your side effects might not be a reaction from the actual medication itself, but more so as a result of being on too high of a dose. And some of the side effects people are experiencing are actually just side effects of losing weight too quickly because that can come with its own set of problems.
So GLP1s are really kind of getting blamed when it's more of a mismanagement issue. People going on these medications without being properly educated, without being appropriately guided and just kind of like going at it a little bit willy nilly. People just really don't know how to use these drugs correctly. I think when I am asked my thoughts on GLP1s, like point blank, behind closed doors, this is exactly what I say. I say I think that they are an incredibly effective tool and I think we are incredibly unprepared to utilize them correctly. That's my thought based off of everything that I've seen. Practitioners are not necessarily even super savvy with this stuff. And when I say practitioners, I mean prescribing doctors.
I mean the telehealth companies where a lot of people are getting these GLP1s. Some of these companies, you don't even need a doctor's appointment. You just fill out a quick little intake form and then within a day you have a prescription for GLP1s. It's literally that easy right now to get your hands on these things. Med spots are even offering GLP1s now, so you can go in for some Botox and get a little quick hit, little quick squirt of a GLP1 while you're at a little dab will do. Yeah, I mean it's getting kind of crazy. It's getting kind of hectic out there. So these things are everywhere and people are being put on them or putting themselves on them, like getting them on the Internet and finding ways to get on GLP1s and they just really are pretty uneducated and underprepared.
For how to use them effectively. And I'm not here to tell you what to do with your body. Never have I ever. But I am hopefully here to inform you so that you can make the best choices for yourself. I'm not an idiot. I know how readily available these things are right now and I know that some of you might be on them or you might be considering them. So my goal with this particular episode is to set you up for the best success. If you are in that camp, you need to know what to expect.
You need to know how to circumvent some of the most common side effects. You need to know why these side effects are happening. And I also want to be really honest about what we're seeing in practice. I will keep saying this. I do see that for your best experience, you do want to get your health house in order first. I'll talk about that a little bit later. The people that I've heard describe these drugs as a quote unquote miracle drug already had their health foundations on lock. You cannot just inject yourself with a peptide and it cleans up like every bad choice you've ever made made in your life.
I'm sorry. They can be a quick fix for quick weight loss, but they are not going to fix your body of health. And I think the people that are telling you they will. I would question that and question the profit on the other side of that statement, to be honest. So I'm going to use a case study from one of our actual clients that leverage tirzepatide, which is a GLP one in a very, very effective way. Because I want to give you like a real world example. You guys seem to love our case studies. And just as a reminder, I do want to say this because I would feel that this conversation would be incomplete if I don't at least say this.
Weight loss can be addictive. We talked about that last week. So I'm going to also share a few signs to look out for to know when it's gone too far. And I would recommend that if you're going to go on these drugs and you're going to put yourself on them for weight loss, you need to have like a trusted confidant, whether that's a practitioner who you trust or a partner or a friend, somebody that can clock you and say like, hey, I think it's gone too far. Like, I think you've lost enough weight. Because unfortunately we are seeing it go too far on social media and we are seeing people who are showing very, very, very clear signs of malnourishment, promoting GLP1s. And I think that is a slippery slope. And listen, I'm like I said, I'm 42.
I done been around the block guys. You know, like I was around for the last heroin cheek surge. I remember it. So if that is the trajectory you go down, you will eventually pay the piper. And that is just physiology.
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Okay, so how is that for an intro to a podcast? Let's now actually get into it. I want to start by talking about micro dosing. And this conversation might sound a little bit like splitting hairs, but I actually think it's really, really, really important, especially in the context of today's conversation. Because like I said, some of the side effects that people are seeing when on GLP1s are really more of a dosing issue, meaning that their dose is too high, but they might be told that they're on a micro dose. So Dr. Tina Moore, I have to shout her out. She's a naturopath and she's really the person that put the concept of micro dosing GLP1s on the map. This was a few years back, I want to guess, like 2023, she started talking about this.
And she'll also be the first one to tell you that people have really bastardized that concept and turned it into a marketing ploy. So right now, present day 2026, people are being sold microdoses. I'm using air quotes, micro doses that are not actually microdoses. And one of the tricky parts of this is that there's no definition of what makes a microdose. But when Dr. Tina was putting forth this idea, this concept, she was really basing it on her years of one using peptides in her clinical practice, but also using bhrt, bioidentical hormone replacement therapy. And from naturopathic standpoint, the idea behind this is to use the lowest dose to get the change that you want to see to alleviate symptoms. And then patients on BHRT are closely monitored.
They are cycled. The treatment is individualized to the person, but they're constantly being monitored by their clinician. And every person is very unique. Therefore every person will respond to hormone replacement therapy differently. So you're not just giving somebody a shit ton of hormones at super high doses and throwing the peace sign at them, being like, good luck out there. And I think that most of us would agree that we wouldn't just willy nilly put ourselves on hormones without some guidance. Right? Right. Well, GLP1s are naturally occurring hormone peptides, meaning they behave and they signal like hormones.
I think we touched upon this briefly last week, but just as a little bit of a recap, let's go over the mechanism of action of a GLP1. It's an incretin mimetic. So incretins, gut hormones that are released into the bloodstream after eating and this helps to regulate blood sugar. In, in layman's terms, that's essentially what they help to do. We have two primary incretin hormones. We have GLP1 glucagon, like peptide one, and we also have GIP, which is glucose dependent insulinotropic polypeptide. So a GLP1 medication, like a semi glutide, for example, is an analog of the GLP1 that incretin hormone, and they are receptor agonists. So an agonist is a substance that mimics the action of a hormone to produce a response when it binds to a specific receptor on a cell.
So GLP1 agonists mimic what the naturally occurring GLP1 peptide hormone does inside the body. And as we talked about last week, it doesn't just affect the gut, it doesn't just affect stomach emptying, it doesn't just affect blood sugar. It really has effects throughout the entire body. So tub big ones that we hear a lot about are Semaglutide. So the brand names for this are Ozempic, Ozempic is approved for type 2 diabetes. And then Wegovy, which is approved for weight loss. And then Tirzepatide is another very common one. Tirzepatite is actually a dual agent, so it's a GLP1 agonist and a GIP agonist as well.
And the brand names for these are Mongero, which is Approved for type 2 diabetes, and then Zepbound, which is approved for weight loss. And both of these are delivered via a weekly injection. Now, because side effects of GLP1s are so common, we're going to talk about why in a little bit. It's common practice to titrate up the dose so the dose is increased slowly. I'm going to use Tirzepatide dosing as an example because they're all dosed very differently. And I, I think if I was to try to explain all the different dosing, it would get really confusing really, really fast. But tirzepatide starts at 2.5 milligrams, then it goes up to 5 milligrams, then 7.5, then 10, then 12.5, and eventually 15 milligrams, which is really the maximum recommended dose, 15 milligrams once weekly. Now, none of those numbers that I just said to you are micro doses.
Those are all standard dosing. And we were lucky enough for Jessica to share her dosing with us. She shared that she started at 0.5 milligrams, 0.5 milligrams of tirzepatide. Standard starting dose is 2.5 milligrams, and it goes all the way up to 15. Jessica started at 0.25. Okay, so I'm spending some time here, so you can really understand this. It took her close to a year to get up to 2.5 milligrams, which is only the standard starting dose. And as she worked her way up, she was really paying attention to how her body responded.
She was working with her practitioner, her doctor, the whole time. So the original idea of a microdose was exactly this. It's a small, small fraction of standard dosing. I'm talking like one tenth of standard dosing. So you might start at 0.5 and maybe go up to 1.5, maybe go up to 2.5. At 2.5, though, it's not a microdose, it's a standard starting dose. This is why I say this conversation might sound like I'm splitting hairs, but the reason that I bring this up and the reason why I think it's a big deal is that people right now are being put on 2.5 milligrams of tirzepatide. We're just sticking with tirzepatide.
Again, to. To make the conversation less confusing, that is a standard starting dose, but they are being told that it's a microdose. Why? Because microdosing sells. That's why telehealth companies are promoting it. That's why med spas are promoting it. That's why influencers are promoting it with their discount codes. But it's not actually micro dosing. It's standard dosing.
So it's just wrapped up in a very specific marketing package. And the original concept of micro dosing was to use the smallest amount of these peptides to just knock, knock, knock at the door of the receptor, to wake that receptor up. So the body starts doing what it's supposed to do. It wasn't to flood the receptor sites with. With tons and tons of this peptide, but that's what people are doing. That's what people are being sold and there's just a lack of education and a lack of understanding of all of this stuff. And so people are seeing a lot of side effects because anytime you flood the body with anything, there's going to be side effects. So let's talk about those side effects.
GLP1 agonists delay gastric emptying. That is is one of the big things that they do in this makes you feel fuller, longer. This is why they have an appetite suppressant effect. But what can also happen is that you can be really, really nauseous. We can even see vomiting, we can see acid reflux, we can see diarrhea, we can see constipation. If you are delaying gastric emptying, if you are delaying GI emptying, then of course it just makes sense that we would see those effects. Now, this can cause a lot of problems. If you already have gut issues and some red flags or careful considerations I would be thinking about is if you have a history of sibo, small intestinal bacterial overgrowth, there is a tendency for it to get a lot worse if you are on GLP1s.
Same deal for reflux in GERD. If we are delaying gastric emptying, then there's more likelihood that we're going to put more pressure on that les, that lower esophageal sphincter, which is going to translate to more reflux, more GERD like symptoms. Same deal for gallstones. If you have a history of gallstones, that's something to be mindful of because we can see gallbladder issues, we can see bile issues pop up. Now, if you really want to use GLP1s as part of your overall care plan, my recommendation is that you do some prep work for your gut before introducing GLP1s and then they're more likely to be used without incident. Otherwise you are in a very, very real risk of worsening GI symptoms. That's just physiology. That's just what we're seeing.
It makes sense once you understand how these peptides work. And again, the dosing matters here. So if you are on a true microdose, you're going to be less likely to see those symptoms. Can they still pop up? Up? Yes, absolutely. But you're going to be less likely to see them with than you are with the higher dose. I know we hear a lot about gastroparesis and that is a very, very, very real side effect. That is a very real concern. But again, that is another thing that might be more of a dosing issue.
We're going to be more likely to see gastroparesis with higher doses of these GLP1s. Now, there are some ways to troubleshoot some of these GI symptoms if you're experiencing them. Same stuff that we talk about all of the time here on the show. Leveraging the use of digestive bitters. You can take those in tincture form. You can take them with your meals. Same deal with HCl, hydrochloric acid, digestive enzymes, bile acids. All of these things will help to break down the food and stimulate bile flow.
This can also help with acid reflux, but it can just help to break down the food that is essentially sitting in your stomach. Ibero Gast is another one that I really like, but Bayer bought them out. So you can actually just buy that at like a CVS or a Walgreens, but it's a liquid form. You put some drops in a little bit of water and you can take that. And that can help with bloating or reflux or nausea or any of the digestive symptoms that can come along with the GLP1 show. Constipation, another big thing. And what people are being told, because we know that constipation can be just. Can be such a huge side effect of GLP1s, they're basically just being told, eat more fiber and drink water.
Which isn't bad advice. But it's not the whole story. It's certainly not the whole picture, because here's what's real. When you have no appetite, it's really hard to eat bulk, meaning it's hard to eat fiber. What is also not discussed nearly enough is that GLP1 agonists decrease the signal to drink water. So if somebody's telling you eat more fiber and drink more water, but your brain is telling you the opposite. Ruh Ro. That should be a conversation before we start a GLP one.
And I guess my point with saying this is that there's just so much education that needs to come online if somebody is starting these things to understand all the different things that can be impacted. So you're gonna lose your appetite and you're gonna lose your drive to drink water, especially if you're on higher doses. So if you do end up with constipation, sure, fiber and water, really, really important. But you can also utilize some of those digestive enzyme strategies I just talked about. Magnesium can be super helpful here. Taurine can be really helpful here. We do see a lot of people have good luck with taurine if you've like. You're like, I'm taking as much magnesium as I can.
It's not moving the bowels. Try taurine. We really like sun fiber as a type of fiber that you can try and get your water, be mindful of dehydration because again, they're going to decrease the signal to drink water. So it is something that you have to be really, really mindful of. I like to recommend doing water with electrolytes that can also prevent headaches. That can sometimes come alongside with the GLP1 medications as well. So drink your water, take your electrolytes and that can help get the bowels moving. Also, if you're just not not eating a lot, that is going to change your bowel habits as well.
So you might be pooping less just because you're eating less. And that's the next big thing we have to talk about is the GLP1's impact on appetite. It is a heavy appetite suppressant, which is the main reason why people can drop weight so quickly. You're not hungry, so you're not eating, you will forget to eat. And it's not a situation where you can force food in because it can be really uncomfortable or even painful to do that. So you have to be super, super careful with not under eating. And again, this is where micro dosing can really come into play, where you start at low, low, low, low, low doses. And some even say that microdosing is actually not a weight loss strategy.
You would really want to use microdosing for anti inflammatory effects and immune modulation effects because if you're doing a true microdose, you're not going to get that appetite suppressant, which can be a really, really good thing depending on why you're using these meds and how you're using them. But either way, malnourishment is a real risk because of that appetite suppression. So this is why we talked about this last week. We absolutely do see nutrient deficiencies. This is super, super common. So nutrient density in micronutrition needs to be a focus. If you are on a GLP1 hard stop. And if you don't know how to eat a nutrient dense diet prior to a GLP1, it's going to be even more challenging to do so once you start because you're not going to have an appetite, you're not going to have that drive to eat.
So you're going to be more likely to default to whatever's around in whatever your old eating habits were unless you're actively working on nutrition and nutrient status. And I just really want to Emphasize this point that that has to be a primary focus when you are restricting calories in any way, shape or form. Otherwise you're going to run the risk of nutrient deficiencies. I think I shared this last week, but I'm not totally sure. My friend who was dabbling in a GLP1 totally not prescribed to her, and she netted out with, she was like, this is actually, like, really not healthy for me at all. I'm going to stop. But after she told me about it and she's like, she was just like, this is so great. I can eat whatever I want. You know, I can eat chips, I can eat cookies. It doesn't matter what I eat because I have such little appetite. So she was really looking through food as the lens of will this make me skinny or will this make me fat? Not will this make me healthy or will this make me sick? And if you are listening to me and you are above the age of, I don't know, 22, you gotta start thinking about food as fuel. Chances are, if you're listening to the show, you probably already do that. But we're not leveraging food as like, is this gonna make me skinnier fat. We are truly leveraging food as, as fuel, as the building blocks for our entire body of health. Because you want to know what requires micronutrients? Motherfucking everything.
Everything. Does your hormone function, your hormone balance, your gut function, your ability to detoxify and clear shit out of your body, your energy, like all of it. The entire show runs on micronutrients. So if you are restricting your appetite in your diet to the point that you're not getting those micronutrients, like, that's going to catch up with you eventually for sure. So be very, very, very intentional with getting lots of variety. Even if you're not eating as much, make sure you are packing a powerful punch with what you are eating. Nutrients are more important now than ever. If you're on a GLP1, this is like a little bit of a sidecar conversation.
Loss of muscle mass. This is something that we hear a lot about with GLP1s, but it' more due to fast weight loss instead of the GLP1s themselves. It's not the GLP1s that are making you lose muscle mass, which is really what the research is showing. It's the quick weight loss. So when we lose weight, let's say you go on a low calorie diet, like without GLP1, so you just limit your calories, you will lose 20 to 30% of your lean muscle. Okay. We just know that dropping calories, you're going to lose lean muscle unless it's a slow weight loss. If you can lose less than 2 pounds of body fat per week, you're going to be less likely to lose your lean muscle.
If you're losing it faster than that, you're going to be more likely to lose more lean muscle. So if you are on a GLP1 and you're losing muscle mass, it's probably more of a dose issue, meaning you're on too high of a dose, it's crushing your appetite, you're dropping weight fast and you're going to dump muscle mass. And I don't need to go on a whole tangent and a whole tear about why muscle mass is important. Just trust me on this one. It's important. There's other podcasts where I've gone into why it's so important. But if you're on a GLP1, you gotta protect your muscle mass. So make sure you are prioritizing protein.
You're probably going to lose the appetite for it. So you have to prioritize this. Make sure you are strength training. So at least three times a week, lift weights, progressive overload. We need to constantly be challenging our muscles in order to get our muscles to grow. So really, really emphasize and focus and prioritize that. And if you just have no appetite and you're not eating, understand, you will lose muscle mass. That's just how it works.
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Now, I queued this up at the beginning of the show, but I do want you to really pay attention to these signs of malnutrition. So as nutritionists, we are trained to look for these in our clients or patients. These would be signs that you've actually lost too much weight. And this is why I say get somebody on board, whether it's a practitioner or a coach or a partner or a friend. Somebody who has your best interest at heart and is not afraid of saying the hard things out loud to you, to your face. Listen.
It's hard for us to see our own growth or our own change or our own metamorphosis. This is something that we have to constantly work on with clients because we're so hard on ourselves, right? So we tend to see ourselves through more of a negative light. We tend to focus on how far away we are from our goal versus how far we've come. That's just kind of how our brains are set, set up to work. And so you might start losing weight, and you might not even be aware of how much weight you've lost or how much your body composition has changed. So these are the things that I really want you or somebody who loves and cares about you to look out for noticeable wasting or depleted fat stores. So specifically at the temples, at the collarbones, and at the thighs, these are the, like, the three places that we would be scanning for a of lot. Like, if you've lost your fat stores there, that is an indication of malnutrition, hair loss.
So a lot of people will talk about GLP1s and their hair falling out, but also brittle hair, weak nails. Those can also be signs of malnutrition. Low body temperature if you're always feeling cold, low heart rate, low blood pressure, poor immunity, where you're getting frequent infections all of the times. Fatigue and weakness can also be signs of malnutrition. And then also mood change shifts can be a sign of malnutrition as well. Now, I do just want to focus on mood for a hot second because I've been talking about how these GLP1s reduce your appetite. They also reduce that hedonic urge to eat. So this is like eating for pleasure, the drive to eat for comfort or reward rather than physiological need.
So eating not because of true hunger, because your body needs it, but because it's bringing pleasure or comfort. And so the GLP1s can impact dopamine in positive ways. This can reduce food noise. A lot of people will say that, like, I just don't have the cravings that I used to. I'm not thinking about food all of the time. And that's why I can feel like freedom for a lot of people. It can also reduce the drive for alcohol consumption, which is another positive. But it can also lead to just kind of like feeling flat, lackluster with, with mood.
And so that's something to pay attention to. And that might be another dosing thing too. Like if it's crushing your mood, I would definitely talk to your prescribing physician about whether or not that dose is appropriate for you. And then the last thing I will say here about other things you might see is when you dump a ton of weight at once, you also potentially can dump a ton of toxins. I often will talk about fat as protection, and it's protection in a, a multitude of ways. It can be actual insulation protecting you from the cold. It can be emotional and energetic protection. Not really the point of today's show, but definitely worth a little bit of a head nod.
I have seen that be a big driver of weight loss resistance. And when you use a tool like a GLP one to strip away the fat, those issues don't just go away. It's part of what we talked about in last week's episode. But fat is also protection because it's essentially sequesters toxins away from your vital organs, which I always just think of that as like such a beautiful thing. I really do believe that the body's always working in our favor. It's always working to protect us. And it's just like a very cool thing that the body has the ability to do. So it will move toxins away from your vital organs and into your fat stores.
But then think about what happens when you dump a bunch of fat really fast. These toxins have to go somewhere. And so they can essentially actually flood and overwhelm your detoxification system. And if your detox pathways are under functioning or impaired in any way, shape or form, which is very, very common in modern day, then you can actually get sick. You can actually feel a lot worse. I just want you to know, if you do have weight to lose, I would recommend supporting detoxification first. So there's a lot of things that you can do before starting a GLP1 to set yourself up, up for success once you're on a GLP1. And that is really why I recommend getting your health house in order first.
So I'm going to share an example of what that can look like. This is a client that we worked with in our practice and she eventually did start Zepbound. So we really helped her get to a place where she could start Tirzepatide. She was under the guidance of a doctor, so the doctor was prescribing that. And before we got into that, she was like, I'm considering this, this, but I really want to make sure that I'm doing everything in my power before I lean on that. And I want to make sure that I'm doing everything in my power to make that a successful experience if I do choose to do that. So she came to us. Her chief concerns were bloating, weight loss, resistance, joint pain.
She had some stuff going on with her gut and a lot of food sensitivities and then severe fatigue in brain fog. Other concerns were skin inflammation. She had a lot of histamine, like allergy type reactions and flares like tightness of throat. She would get headaches, dandruff and drive skin. Not her chief and primary concerns. But it was something that was going on. And so what we did is we ran basic lab work. We found low ferritin, low vitamin D.
Her CRP was higher than we like to see it. Her insulin was at a 15.6. That's pretty high. And in our estimation for fasting insulin, she also had elevated white blood cells and neutrophils. We pulled a hormone lab on her, we did a GI map stool test, definitely found some stuff there. H. Pylori with virulence factors. So when we see H. Pylori elevated with virulence factors, that usually tells us like it's more likely to cause problems.
And especially with that low fetin, if H. Pylori goes unchecked for a while, it can lead to low iron, low ferritin stores. She had dysbiosis, there was some inflammation on. She wasn't digesting her food properly. She had below detectable limits for akkermansia, which is a really important keystone species that makes the gut healthy and strong, but also has a big, profound impact on metabolic function, including insulin signaling and blood sugar control. And then we pulled an HTMA and saw that she definitely had low mineral status, low sulfur. That is huge and crucial component of detoxification.
So we knew right out of the jump based on everything was going on, we needed to support detoxification, support gut health, and make sure that she was digesting and absorbing all of the food that she was eating because her diet was really, really, really good. So we brought in support for these findings. And her joint pain and her hip pain really started to get so much better. She was at the point where she was like, like, do I have to get a hip replacement? She'd go for a walk and have to turn around. And she was early for 40s, by the way. I didn't say that she was in her early 40s, but she still is. This was a recent client, so she's still in her early 40s. I don't know why I said it that way, but she's not working with us anymore because she's feeling so great.
So the joint pain started to improve significantly. She can actually go for walks. She saw much better energy. She was waking up less throughout the night. So she would wake up pretty much every single night in the middle of the night. She had improvements to brain fog, improvements to gut health. So after a few months of us working to get her to a place where she just felt better, but she still wasn't moving the needle on her weight. And that had been ongoing for years.
So four to five years prior, she had put on significant weight, I think 40 to 50 pounds of weight out of nowhere. And despite all of the interventions she had done, despite all of the building out her health house, she just was not seeing improvement in this. So we got her to a stable place with her health where she's like, I'm feeling good, I'm eating good, my energy's better, my brain fog is gone, my joint pain is gone. Like, I feel good, the weight isn't budging. And at that point, that is when she brought in the zepbound. That is when she brought in the tirzepatide. She did start at 2.5 milligrams, standard starting dose from her doctor. She went up, up to 5.0 after a few months.
And she noticed that her appetite was decreasing, like, too much. She's somebody who's very in tune with her body. She confided in me, she said this was the exact right time to start a GLP one, because I feel really confident with everything I'm doing for my health, but I also feel really confident emotionally and that I can read and understand and listen, listen to my body and knows exactly what it means. So she was at 5.0 milligrams, her doctor was going to increase her to 7.5. And she went into her doctor's office and she was like, I'm not going up. I don't need to go up. I know my body, I'm going to stay here. Her doctor advocated against it and said we should go up to 7.5.
This is how we do it, this is how we dose, this is how it goes. And she advocated for herself. This is why I think education and understanding is so, so, so, so, so important. And we can take more of a qu unquote naturopathic approach to these GLP1s and meet the individual with where they're at and what they're looking for and how they're responding versus say this is standard dosing, ergo, this is what we will do. So it's just so, so, so, so proud of her for advocating for herself, for communicating that. I wanted to share that story because I want to inspire you to do the same thing. I mean, this is whether or not you're on date a GLP one. Always advocate for yourself.
You know yourself best, you know your body best, you know how you're responding best. And if she had just gone with the higher dosing, she probably would have seen a lot of the side effects that we just discussed together. So staying on a 5.0 milligram dose for a few months, she was able to completely get off her blood pressure medication that she was on and maintain normal blood pressure. She has lost weight. She doesn't own a scale, but she would guess based on how her clothes fit. She has lost 25 pounds. She feels back to baseline. She feels comfortable in her own skin.
She's like, I've never felt more comfortable in my own skin. Her energy is good, her sleep is good. Her bloating is way down. She feels more connected to not just her body but also her belly. She feels less puffy, she's retaining less water and just, just her goal is to keep feeling how she's feeling. She's like, I feel so good. I just want to keep feeling this way. So this is where I think using a functional root cause approach combined with a GLP one can be a really, really, really effective strategy and it can be a useful tool when used skillfully.
So I'm certainly not anti GLP ones. I'm not anti these medications. I'm not also like 100% all in for everybody everywhere. I think we have to be really mindful. I think we have to have a big understanding of how these things work and what the potential side effects are. I think we have to be agents of our own change and advocates for ourselves and we should really understand the dosing and that we can get benefits on smaller doses, whether that's a micro dose or just a lower standard dosing. So that's it, you guys. That's my whole spiel for now anyway.
I know I talked a lot, so I hope that this was informative. I hope that this was helpful. If you know somebody that could benefit from this conversation, definitely send it their way. I would love for folks to listen to this before they start a GLP one, or even when they're on one and maybe not feeling so hot. So as I learn more about this stuff, as we get more experience in the clinic, I will continue to share more and more with you guys. And in the meantime, I love you. Thanks for being here and I'll check you next week.
Thanks for joining me for this episode of the Funk’tional Nutrition Podcast. Please keep in mind this podcast is created for educational purposes only and should never be use as a replacement for medical diagnosis or treatment. If you got something from today's show, don't forget, subscribe, leave a review, share with a friend and keep coming back for more. Take care of you.