Every Ozempic Side Effect, Explained

This content material initially appeared right here. Republished with permission.

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By Ross Wollen

Medically Reviewed by Sean Hashmi, MD

Ozempic and different medicine within the GLP-1 receptor agonist household have quickly change into well-known for dramatic weight reduction, however each few weeks it additionally appears we hear that social media customers are shining a lightweight on one other new Ozempic facet impact. These reactions embrace hair loss, fierce gastrointestinal misery, uncommon (however extreme) abdomen paralysis, and a few distinctive Ozempic unwanted side effects in females. A few of these secondary results have been scientifically verified, whereas others are nonetheless simply anecdotal.

GLP-1 drugs could cause all or any of those signs.
On a regular basis Well being

A short word: This text makes use of the model identify Ozempic to check with semaglutide, the drug’s energetic ingredient. Semaglutide can also be marketed underneath two different names, Wegovy (when bought for weight reduction) and Rybelsus (within the type of a tablet relatively than an injection). Different associated medicine, corresponding to liraglutide (Victoza) and tirzepatide (Mounjaro, Zepbound) could trigger a number of the similar unwanted side effects.

Abdomen Issues: Nausea, Diarrhea, Vomiting, Belly Ache, and Constipation

These uncomfortable gastrointestinal troubles make up Ozempic’s most typical and most mentioned unwanted side effects by far.

Whereas a majority of customers don’t understand these pains, a really substantial minority do. In accordance with the U.S. Meals and Drug Administration (FDA), placebo-controlled trials of Ozempic discovered the next charges of unwanted side effects from the 1 milligram (mg) dose:^[1]

Gastrointestinal Aspect Results of Ozempic (1mg)

All instructed, 30.8 % of adults reported a gastrointestinal symptom.^[1] However that was solely the 1 mg dose, half of the utmost. The numbers had been a lot greater in a trial of semaglutide (Wegovy) at 2.4 mg in folks with out diabetes:

Gastrointestinal Aspect Results of Wegovy (2.4mg)

At this, the very best dosage of semaglutide accessible, an unimaginable 74 % of individuals skilled at the least one gastrointestinal dysfunction, although it’s value noting that just about 50 % of those that took a placebo additionally had some tummy troubles.^[2]

For some, the gastrointestinal misery is simply an excessive amount of to deal with, and they should cease taking Ozempic solely. As a blogger for New York journal’s The Minimize put it, “You may undergo hell in your post-Ozempic physique.” The creator spoke to a 42-year-old girl with diabetes who endured “fixed nausea” and “power-puking” for weeks, earlier than lastly weaning herself off the drug.^[3] In a pivotal trial, 4.5 % of Wegovy sufferers stopped taking the remedy as a direct results of gastrointestinal problems — almost 1 in each 20.

What’s the easiest way to take care of these nasty issues? On a regular basis Well being’s community website Diabetes Each day has a complete article on the topic.

Experiences from the Diabetes Each day discussion board counsel that these unlucky results are strongest within the days instantly after injecting the once-weekly remedy. Sufferers are additionally almost certainly to expertise issues once they begin on the drug or once they step as much as a better dosage; the unwanted side effects generally fade away because the physique will get used to the medication.

Ozempic Burps

A foul-smelling burp isn’t precisely probably the most debilitating of unwanted side effects, however it may be relatively disagreeable. As reported in The Atlantic, and mentioned in lots of YouTube and TikTok movies, some folks taking Ozempic discover themselves emitting nasty sulfurous smells once they belch.^[4] There’s broad settlement that the burps odor like rotten eggs.

Solely a minority of semaglutide trials have recognized burping, or “eructation,” as a facet impact. Anecdotal stories counsel that the burps, like different gastrointestinal points, are worse when sufferers start taking their medicine or step as much as greater dosages.

Bloating and Farting

These uncomfortable unwanted side effects had been reported in medical trials as “belly distension” and “flatulence.” Bloating and farting complaints are much less widespread than the gastrointestinal results mentioned above, they usually have but to catch on as scorching subjects on social media, but it surely’s good to know that Ozempic and associated medicine could improve their probability.

Abdomen Paralysis (Gastroparesis)

Weight reduction medicine corresponding to Ozempic have been tied to a uncommon however elevated threat of extreme abdomen issues. In July 2023, CNN reported that some semaglutide customers had skilled gastroparesis, or abdomen paralysis, which in some circumstances didn’t get higher even months after discontinuing the medication.^[5] Dozens of lawsuits have been filed towards the producers of GLP-1 drugs, in response to Reuters, alleging that the makers didn’t sufficiently warn customers in regards to the threat of extreme unwanted side effects corresponding to gastroparesis.^[6]

Gastroparesis is a situation by which the abdomen empties too slowly or stops; it causes quite a lot of gastrointestinal signs together with bloating, belly ache, nausea, and vomiting.^[7]

Within the worst circumstances, gastroparesis could make it very tough to eat or drink something in any respect, resulting in a threat of dehydration or malnutrition.

Delayed abdomen emptying, the defining characteristic of gastroparesis, is a recognized consequence of Ozempic and associated medicine. This delayed emptying partially accounts for a few of Ozempic’s constructive results, serving to to cut back starvation and provoke weight reduction. It is usually accountable for much less extreme unwanted side effects, corresponding to gastrointestinal discomfort.

Fortunately, extreme and chronic gastroparesis seems to be very uncommon. The symptom was not recognized in any of the drug’s part 3 trials, which enrolled 1000’s of individuals to judge semaglutide’s security.

Short-term Intestinal Paralysis (Ileus)

Abdomen paralysis isn’t the one extreme gastrointestinal facet impact that customers have reported.

In late September 2023, the FDA up to date the official Ozempic label to warn customers of a possible threat of ileus, a sort of intestinal blockage.^[8] In accordance with the Cleveland Clinic, ileus happens when “the muscle contractions that transfer meals by your intestines are quickly paralyzed,” trapping meals throughout the intestine. The signs resemble these of a bodily bowel obstruction, together with bloating and constipation, and the situation can result in dehydration.^[9]

Ileus is probably going a uncommon facet impact — it wasn’t recognized in earlier medical trials, which evaluated semaglutide in 1000’s of individuals. In its up to date steering, the FDA famous, “As a result of these reactions are reported voluntarily from a inhabitants of unsure dimension, it isn’t all the time attainable to reliably estimate their frequency or set up a causal relationship to drug publicity.”

Ozempic Face and Ozempic Butt

“Ozempic face” could have been the primary Ozempic facet impact to go viral. Quickly after, the sample repeated itself when claims of “Ozempic butt” hit headlines. In every case, customers complained that the drug had given some a part of their our bodies a shocking and unlucky flabby look.

There’s nothing to fret about. There is no such thing as a proof that Ozempic or some other related drug immediately impacts your look. Consultants appear to agree that Ozempic face and Ozempic butt are purely brought on by weight reduction. The identical flabby outcomes can and can happen whenever you drop a few pounds the old school approach, or by different medical strategies corresponding to bariatric surgical procedure.

It seems that not all weight reduction enhances your look. Whenever you lose a whole lot of weight, you may additionally lose some healthy-looking fats that you just’d desire to maintain in locations like your face or butt. Fast weight reduction can even result in saggy pores and skin: The pores and skin is an adaptable and elastic organ, but it surely can’t snap immediately again right into a taut form. Profitable dieters have struggled with these points since lengthy earlier than Ozempic got here on the scene.

Ozempic Breath and Dry Mouth

Dangerous breath is often a matter of oral hygiene.^[10] Meals particles and micro organism within the mouth can create foul odors. Although in some circumstances dangerous breath (halitosis) can sign a extra substantial medical situation, specialists appear unworried that Ozempic breath is a severe signal.

How does Ozempic trigger dangerous breath? One attainable rationalization is Ozempic’s tendency to trigger dry mouth (xerostomia). Saliva helps to cleanse the mouth, and an absence of saliva can enable micro organism to fester, develop, and get smelly. Although dry mouth was not initially reported amongst semaglutide’s recognized unwanted side effects, it has been extensively mentioned in social media and clinicians have printed stories of utmost circumstances.^[11]

“Keto breath” can also clarify some circumstances of Ozempic breath. This facet impact is widespread when folks change to a keto food plan, which strictly limits the variety of carbohydrates you’re allowed to eat. Keto breath, which tends to have a fruity aroma, is brought on by acetone, a by-product of ketosis. It’s possible that some Ozempic customers have unintentionally adopted a ketogenic consuming sample on account of their diminished appetites — consuming 50 grams or much less of carbohydrates per day can set off ketosis.

Hair Loss

Ozempic could cause hair loss. Whereas it isn’t listed as a facet impact on Ozempic’s FDA label, hair loss is listed on the FDA’s label for Wegovy, basically the identical remedy. Three % of individuals within the drug’s pivotal trial reported hair loss (3 instances as many as those that used a placebo).^[2]

Like Ozempic face and Ozempic butt, nevertheless, that is merely a standard consequence of fast weight reduction. Dramatic weight reduction, regardless of the way it’s precipitated, usually causes hair loss. This science is well-established. For instance, a research of crash dieters printed in 1974 discovered a number of circumstances of “profuse hair loss.”^[12] And greater than half of people that obtain bariatric surgical procedure expertise hair loss, too.^[13]

The excellent news: One research discovered that “hair loss stopped and new hair steadily grew out in all sufferers.”^[14]

Hopefully, the minority of Ozempic customers who lose some hair on the drug may have the identical good luck.

Ozempic Aspect Results in Females

So far as analysis goes, most of semaglutide’s unwanted side effects are widespread to each men and women, and there’s no particular interplay between GLP-1 medicine and feminine hormones. However there are particular Ozempic unwanted side effects that particularly have an effect on girls.

Ozempic Infants

We could also be experiencing an Ozempic child increase. Throughout social media, girls are crediting shock pregnancies to their GLP-1 remedy.

Although there’s no strong information on the phenomenon, specialists agree that Ozempic has quite a few completely different options that would account for elevated fertility. Weight problems itself has lengthy been recognized to trigger subfertility and infertility, so the dramatic weight reduction related to Ozempic may simply improve a girl’s possibilities of conceiving.^[15] The impact could also be even stronger when weight reduction and metabolic enhancements assist enhance or alleviate a situation like polycystic ovary syndrome (PCOS).

There’s additionally an opportunity, nevertheless, that Ozempic may intrude with the contraception tablet. At the moment, there isn’t any scientific proof that this occurs, however a associated drug within the class, tirzepatide (Mounjaro, Zepbound), carries warnings on its FDA labels that it “could cut back the efficacy of oral hormonal contraceptives attributable to delayed gastric emptying.” Sufferers are suggested to modify to a non-oral type of contraception or so as to add a barrier technique, corresponding to condoms.^[16]

Ozempic Breasts

First, there was Ozempic face, then, there was Ozempic butt. Lastly, complaints of “Ozempic breasts” hit headlines within the spring of 2024.

Girls who’ve misplaced weight with Ozempic and different GLP-1 drugs are complaining that their breasts have a saggy or deflated look. However there isn’t any proof that Ozempic has a selected impact on breast tissue. Fairly, any change in breast form is sort of definitely because of the fast and substantial weight reduction that these medicine so steadily trigger. Girls who’ve misplaced weight with different strategies have seen the identical concern.

Tiredness and Fatigue

There are stories that Ozempic could cause fatigue — mainly, tiredness or exhaustion that isn’t improved by sleep. The FDA label for semaglutide (Wegovy) stories that 11 % of trial individuals skilled fatigue, a bit bit greater than twice as usually as those that used a placebo.

It’s unclear why Ozempic would trigger fatigue, though one very believable rationalization is the truth that it causes folks to eat a lot much less meals. Ozempic causes excessive weight reduction by encouraging customers to eat at an excessive calorie deficit. You’re placing much less gas into your physique, basically crash weight-reduction plan. Is it any marvel that Ozempic may sap your vitality?

Dizziness

Dizziness has additionally been reported in a slim minority of Ozempic customers. It’s attainable that Ozempic dizziness stems from the glucose-lowering results of the drug — dizziness is a standard symptom of hypoglycemia. Even sufferers who will not be vulnerable to extreme hypoglycemia (sometimes those that don’t use insulin or sulfonylureas) could really feel dizzy whereas experiencing transient low blood sugar episodes.

Extreme Muscle Loss

It’s inevitable that weight reduction will contain some muscle loss. That is thought of wholesome and pure.

Some specialists, nevertheless, consider that Ozempic and associated medicine are inflicting a shocking and worrying quantity of muscle loss.

We solely have a modicum of fine information on this query. Physique composition analyses of volunteers in two trials discovered that semaglutide customers misplaced about 40 % lean mass and 60 % fats.^[17] That is extra muscle loss than researchers count on to see. A evaluate printed in 2017 acknowledged that folks utilizing different strategies to drop a few pounds are likely to lose solely 20 to 30 % lean mass.^[18]

In February 2024, The New York Instances reported that the producers of GLP-1 medicine are taking the issue critically, and have begun to develop mixture drug therapies that would assist customers of Ozempic and associated medicine protect lean mass.^[19]

Within the meantime, specialists agree that it might be sensible for customers to interact in strength-building workout routines to assist protect muscle mass throughout weight reduction. Consuming sufficient protein can also assist.

This potential facet impact can also be a great reminder that Ozempic is inappropriate for individuals who shouldn’t have a great medical cause to drop a few pounds.

Aid From Meals Noise, Need to Drink, and Addictive Behaviors

Many Ozempic customers are amazed to seek out that they’re partaking in much less addictive and compulsive conduct. In some way the drug seems to cut back our damaging tendency to overindulge in actions like consuming, procuring, playing, and even biting our nails.

The science right here remains to be in its infancy, however it seems that one of many causes Ozempic is ready to stem starvation cues is by performing immediately within the mind.^[20] We all know that Ozempic doesn’t simply assist you to really feel full sooner, it really lowers your longing for meals, switching off the meals noise that compels some folks to perpetually fixate on their subsequent snack or meal. And it appears as if the drug reduces your longing for different issues, too.

Consultants have recognized for years that GLP-1 receptor agonists may need these behavioral results. In a research of exenatide (Byetta), mind scans confirmed that the drug lowered exercise in “essential mind areas for drug reward and dependancy.”^[21] It additionally calmed down the mind’s dopamine circuitry. A number of medical trials are actually underway to discover the potential of GLP-1 medicine as anti-addiction remedy.

We’re years away from the day that Ozempic or any associated drug might be prescribed as a remedy for addictive or compulsive conduct. However within the meantime, it may assist customers with extra than simply compulsive consuming.

Suicidal Ideas

Authorities well being authorities in the US, and European Union initially signaled concern that semaglutide and different GLP-1 medicine had been inflicting ideas of suicide and self-harm.

An intensive evaluate of the proof, nevertheless, seems to have set these considerations to relaxation. In January 2024, the FDA introduced that it couldn’t establish a “causal hyperlink” between GLP1 medicine and suicidal ideas or actions.^[22] In April, EU regulators made an identical announcement.^[23]

At the moment, the official FDA labels for Wegovy and Zepbound proceed to warn that there’s a threat of suicidal ideation, however the company clarified in its announcement that the warning relies on proof from “older medicines used or examined for weight reduction.”

Elevated Coronary heart Fee

There’s been comparatively little on-line chatter about this facet impact, which is famous on Ozempic’s FDA label. In medical trials, decrease doses of Ozempic “resulted in a imply improve in coronary heart charge of two to three beats per minute.” Some sufferers have discovered the expertise uncomfortable.

The FDA advises sufferers to “inform their healthcare suppliers of palpitations or emotions of a racing heartbeat whereas at relaxation.” Those that expertise “sustained” will increase in resting coronary heart charge ought to discontinue the remedy.

Whereas this facet impact appears disconcerting, it’s value remembering that semaglutide and tirzepatide have overwhelmingly constructive results on coronary heart well being. Semaglutide was not too long ago authorized as a therapy for the prevention of coronary heart assaults, and preliminary research counsel that tirzepatide additionally imparts broad cardiovascular advantages.^[24]

Diabetic Retinopathy

Folks with diabetes ought to know that there’s some proof that Ozempic could improve the incidence of diabetic retinopathy, a type of eye illness that may result in imaginative and prescient loss. In accordance with Pharmacy Instances, certainly one of a number of pivotal research of semaglutide discovered an elevated threat of diabetic retinopathy,^[25] and the FDA has reported {that a} considerably greater proportion of Ozempic customers have DR as compared with customers of comparable medicine like dulaglutide (Trulicity) and liraglutide (Victoza).^[26] The connection is disputed, nevertheless, as one other giant research of semaglutide discovered no such threat.^[27]

If the connection is actual, it appears attainable that Ozempic’s unimaginable effectiveness explains its detrimental impact on the eyes. Opposite to all expectations, fast enchancment in glucose management can really worsen diabetic retinopathy. That is referred to as “early worsening,” as a result of the eyes will worsen earlier than the most important long-term advantages of higher blood sugar management change into evident.

A latest dialogue of the difficulty by specialists from the American Academy of Ophthalmology recommended that “early worsening” from Ozempic is each momentary and manageable, though it does name for elevated scrutiny from eye medical doctors.^[28]

There is no such thing as a proof that folks with out diabetes have any cause to fret about their eyesight on Ozempic.

Low Blood Sugar (Hypoglycemia)

Whereas Ozempic most likely doesn’t itself trigger hypoglycemia, its glucose-lowering impact can sharply improve the chances that different medicine, principally insulin or sulfonylureas, trigger hypoglycemia. If Ozempic lowers your baseline blood sugar stage, your outdated dosage of glucose-lowering remedy could now be greater than you want.

If in case you have diabetes and also you’re beginning a brand new GLP-1, it’s possible you’ll want to alter the dosages of the opposite diabetes medicine that you just use. Your physician can also ask you to be additional vigilant about checking your blood sugar. Should you’re not comfy altering your insulin-dosing practices by your self, you need to be able to contact your physician between visits to get steering on making changes.

Erectile Dysfunction

A research printed in February 2024 revealed that males with out diabetes who use semaglutide might be 10 instances extra more likely to expertise erectile dysfunction, (1.4 % complete, vs solely 0.14 % in a management group). The danger of hypogonadism (low testosterone) additionally sharply elevated.^[29] The report confirmed anecdotal proof on social media, the place some males have complained that the drug has lowered their intercourse drive or made it tougher to take care of an erection.

This outcome stunned the research’s authors as a result of weight reduction often improves erectile dysfunction.^[30] The science remains to be unclear, nevertheless, as different research have discovered that GLP-1 drugs can really improve testosterone ranges and enhance erectile dysfunction.^[31][32]

There are numerous therapies for erectile dysfunction, each pharmaceutical and pure.

Uncommon, Severe Aspect Results

Semaglutide additionally results in a small variety of uncommon however doubtlessly severe unwanted side effects:

• Pancreatitis This situation, by which the digestive enzymes assault the pancreas, could really feel like intense abdomen ache that radiates to your again.
• Kidney Failure Analysis signifies that some circumstances of semaglutide contribute to kidney illness.^[33] Dehydrating unwanted side effects, significantly diarrhea and vomiting, could improve this threat. Nonetheless, for most individuals the drug seems to have a constructive impact on kidney well being.
• Gallbladder Illness This will trigger extreme abdomen ache, yellowing of the eyes or pores and skin, fever, and “clay-colored stools.”
• Thyroid C-Cell Tumors Semaglutide’s FDA labels warn of the danger of growing thyroid most cancers, which has been noticed in research of rodents. A European well being authority, nevertheless, has introduced that it couldn’t discover any hyperlink in people.^[34]

There have additionally been some stories of allergic reactions to GLP-1 receptor agonists.

Ozempic is highly effective stuff: Should you’re experiencing a response that you would be able to’t clarify, please attain out to your healthcare supplier.

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