Vol 34–All You Need to Know About Ozempic (Semglutide): Side Effects, Benefits & More

Quick Look 👀

1 oz of water to garden your health

1 Budding Tweet

2 Weeds to avoid

2 Websites to cultivate your garden

Random Musings

Reading Time: 6 minutes 14 seconds

This week's newsletter is brought to you by Ozempic (Semglutide).

I’ve only heard about it over social media, TV, at work… everywhere.

So I’ve decided to do a deep dive into this drug.

Who should take it?

what are the side effects?

Does it help with weight loss?

Action to water your health

Ozempic (Semglutide).

Official Website 

Official Manual 

How do you take Ozempic? Administered as a once-weekly injection under the skin (subcutaneously) at any time of the day, with or without food.

Indications (those who may take it):

• An adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is proven to lower hemoglobin a1c.

• Lowers the risk of major CV events such as stroke, heart attack, or death in adults also with KNOWN heart disease. The cardiovascular benefits have been studied specifically in people with type 2 diabetes, in a clinical trial called SUSTAIN 6 [1] and the results may not be generalizable to other populations.

• NOT for weight loss (although may help you lose weight)

Warnings & Precautions. There are several. Read the official manual for a complete overview. Please, if you are considering taking this or are already taking it, read it.

Contraindications (those who should not take it):

Personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome types 2.

Ozempic (Semaglutide) may cause medullary thyroid carcinoma (MTC) by activating the glucagon-like peptide-1 (GLP-1) receptor on the C-cells (parafollicular cells, responsible for producing the hormone calcitonin) of the thyroid, which may lead to an increased proliferation of these cells.

These studies have shown that GLP-1 receptor agonists can cause an increase in the number of C-cells in the thyroid gland and that this effect may be dose-dependent. These results were from animal studies, and we know that isn’t always directly applicable to humans.

• The SUSTAIN 6 study [1] Showed no cases of MTC, reported in the 3297 patients treated with Ozempic.

• MTC is rare (estimated incidence of 0.2 cases per 100,000 patient-years) and it is difficult to definitively rule out an association between GLP-1RA and thyroid malignancies.

• In the PIONEER program, which included a total of 5,933 semaglutide-treated patients, four thyroid malignancies occurred in semaglutide-treated patients, versus one in the comparator group [2].

Long way of saying, it's rare but not impossible.

Side Effects:

Most common: Nausea, diarrhea, vomiting

Other common side effects include constipation, abdominal pain, headache, fatigue, dyspepsia, dizziness, abdominal distension, eructation, hypoglycemia in patients with type 2 diabetes, flatulence, gastroenteritis, and gastroesophageal reflux disease.

Mechanism of action (how the heck does it work?)

Ozempic (Semglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist.

A receptor agonist. is a molecule that binds to and activates a specific receptor, mimicking the effects of the body's natural ligands (such as hormones or neurotransmitters that bind to that receptor).

In type 2 diabetes, there is inadequate production of insulin by the pancreas and/or resistance to insulin's action. As a result, glucose accumulates in the bloodstream, leading to high blood sugar levels.

Normally glucagon is released by the pancreas in response to low blood sugar levels (hypoglycemia) and acts to increase blood sugar levels by stimulating the liver to release glucose into the bloodstream.

But in people with type 2 diabetes, there is an abnormal release of glucagon in response to high blood sugar levels (hyperglycemia). This leads to an additional increase in blood sugar levels [3].

Glucagon-like peptide 1 (GLP-1) [4]. Is a hormone released from the gut in response to food intake and acts to reduce blood sugar levels by:

• Inhibiting the release of glucagon

• Slowing down gastric emptying

Ozempic (Semaglutide) mimics the action of GLP-1 by binding to and activating the GLP-1 receptor [4]:

• it reduces the release of glucagon

• slows down gastric emptying

• increases insulin release from the pancreas

• reduces the amount of glucose produced by the liver

• leads to weight loss by reducing appetite and increasing feelings of fullness

• reduces the risk of cardiovascular events in people with type 2 diabetes by reducing inflammation and fibrosis of the blood vessels.

Weight loss [5] [6]. Semaglutide 2.4mg (brand name Wegovy) given weekly via subcutaneous injection, has been FDA-approved for chronic weight management in patients with a BMI ≥ 30 kg/m2 or BMI ≥27 kg/m2 with comorbidities.

But how good is it?

• The STEP1 Study showed that participants in the semaglutide group lost a mean of 14.9% of their body weight (about 33 lbs) compared with 2.4% in the placebo group (about 5.3 lbs) after 68 weeks.

• The STEP2 Study showed that participants in the semaglutide group lost a mean of 9.6% of their body weight (about 21 lbs) compared with 3.4% in the placebo group (about 7.5 lbs) after 68 weeks.

• The STEP3 Study showed that participants in the semaglutide group lost a mean of 16% of their body weight (about 35 lbs) compared with 5.7% in the placebo group (about 12.5 lbs) after 68 weeks.

• The STEP4 Study showed that participants in the semaglutide group lost a mean of 7.9% of their body weight (about 17.5 lbs) after 68 weeks, while patients in the placebo group gained 6.9% of their body weight (about 15 lbs) following randomization.

That's impressive weight loss!

⛔ Important caveat! This medication works by suppressing appetite and increasing feelings of fullness and slowing gastric emptying, so when you stop taking it, you may find that your appetite returns to its previous level.

GLP-1 acts on the hypothalamus, a region of the brain that controls hunger and satiety, to reduce hunger and increase feelings of fullness. GLP-1 also increases the activity of the hormone leptin, which is also involved in the regulation of hunger and satiety. Leptin acts on the hypothalamus to reduce food intake and increase energy expenditure.

So yes, you may become dependent on this drug for life. If dietary habits, physical exercise, and other lifestyle changes are unchanged.

TL;DR

• Ozempic (semaglutide) is a medication used to improve blood sugar control in people with type 2 diabetes.

• It works by mimicking the effects of the hormone GLP-1, which helps to lower blood sugar and promote weight loss.

• Ozempic has been shown to be effective in helping people with type 2 diabetes lose weight, with studies showing mean weight loss of up to 15.8% compared to a placebo.

• The most common side effects of Ozempic include nausea, diarrhea, and vomiting.

• Ozempic has a black box warning for the risk of thyroid C-cell tumors, which is based on data from rodent studies and is not unique to this medication among GLP-1 receptor agonists.

• Ozempic is contraindicated for use in patients with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia (MEN) type 2.

• Ozempic may also provide cardiovascular protection for people with type 2 diabetes, with studies showing a reduced risk of cardiovascular events.

Budding Tweet

Like we discussed ozempic works by suppressing appetite, increasing feelings of fullness and slow gastric emptying.

So yes, when you stop taking it you will revert back to your normal eating habits. That is If you haven’t made any dietary or exercise changes.

You will gain the weight back.

You may also gain more weight! as shown in this tweet. The appetite-suppressing effect is lost, and now you have an increase in hunger and food intake.

Weeds to avoid

1️⃣ Don't let your high standards become an excuse for giving up. Make sure they are realistic. I’ve fallen for this so many times.

Have to find the perfect [x] before I start writing. Need to learn about everything about olympic weightlifting before I start.

2️⃣ Not self-reflecting about how you feel in the moment. Why am I angry? is it really because I have to go to work? or do I need to reflect on the type of work I am doing and chose something else?

Websites to cultivate your garden

Calendar in Review 2022: Reflect back on your calendar from 2022. Get a summary of your time spent in meetings.

If you have tons of meetings, this is an awesome (or not-so-awesome) way of seeing how many minutes you were in meetings.

Journal: I try to journal every morning. This app is beautiful and great UI. Has prompts as well.

Random Musings

1. Last week I finished my review on Nourished, a 3D printed multivitamin company. Highly recommend giving them a shot. I don’t have a special code but they always have some sort of discount on their website.

2. Going to eventually do a review on Nowatch, a watch that tell you the heart rate, temperature, breath rate, skin conductance, movement, and blood oxygen. it doesn’t actually tell you the time. instead it a gem. I don’t know how I feel about it. Kinda feels like a gimmick. But its somewhat innotiave in the watch category.

3. Mimetic Theory: is a concept that refers to the way human desire is often modeled on or influenced by the desires of others, leading to competition and even violence.

4. Ever wonder why you get caffeine headaches? Caffeine→stimulant→ constrict blood vessels in the brain. When you stop→the blood vessels can dilate, leading to headaches. But if you drink too much! can also cause dilation→ headaches.

You're an awesome human

Martin, CEO of braincrumbss

Stuff I created, that you might find helpful.

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2. This product is free. It is the most comprehensive tool for digital nomads who end up with diarrhea 💩. How to treat it, when to worry, and what to pack. Everything. I spend an embarrassing amount of time writing this. Yes, this was created from personal experience on an overseas trip 😮