Semaglutide is a medication that has gained attention in recent years for its efficacy in treating type 2 diabetes and obesity. It is commercially available as Rybelsus for oral intake, Ozempic self-administered injections for the treatment of Diabetes Mellitus, and Wygovy self-administered injection for the treatment of obesity (BMI 30 kg/m² or greater) or overweight (27 kg/m² or greater with at least one medical comorbid condition such as hypertension, diabetes, or high cholesterol. As with any pharmaceutical treatment, it’s essential to be aware of potential side effects that may accompany the benefits of these medications called GLP-1 receptor agonists. In this blog post, we’ll describe some of the risks and side effects of semaglutide, shedding light on the possible impacts it might have on those who use it. Remember, always consult a healthcare professional before starting or stopping any medication. It should also be mentioned that semiglutide administration is started at a lower dose and gradually increase in a process called dose escalation to the full therapeutic level and both the weight loss effect of the medication and the side effects may vary depending on the dosage and the duration of treatment.
1. Nausea and Vomiting
Nausea is the most commonly reported side effect of semaglutide, with around 44% of people using Wegovy, experiencing nausea during clinical trials resulting in 6.8% of patients permanently discontinuing treatment as the result of adverse reactions. Vomiting was reported by 24% of the patients, diarrhea by 30%, constipation 24%, abdominal pain 20%, headache 14%, fatigue (tiredness) 11%, indigestion 9%, dizziness 8%, abdominal bloating 7%, flatulence 6%, loud burping 7%, low blood sugar (hypoglycemia) 6% and other side effects. To minimize the side effects, healthcare providers typically adopt a gradual dosage increase over a few weeks.
In managing potential nausea and vomiting from semaglutide, adopting certain lifestyle adjustments can be helpful. Eating smaller meals, avoiding high-fat foods, and remaining upright after eating are recommended strategies. However, it’s essential to seek immediate medical attention if these side effects are accompanied by severe stomach pain that may or may not spread to your back, as this could be a sign of pancreatitis, a rare but serious side effect.
Semaglutide may lead to diarrhea in some individuals, which can be bothersome. It is believed to be a result of the drug’s effects on gut motility and digestion. Approximately 9% of individuals using it for Type 2 diabetes and 30% of those employing it for weight loss reported this symptom during clinical trials. If diarrhea becomes severe or chronic, consult a healthcare provider for further evaluation.
3. Hair Loss
Rapid weight loss has been linked to hair shedding or loss, which could be a contributing factor to reports of hair loss during treatment with Wegovy or Ozempic. In clinical trials of Wegovy, approximately 3% of participants reported experiencing this side effect.
The type of hair loss observed, known as telogen effluvium, is generally temporary in nature. As your body adapts to the medication, any hair loss you may experience from Wegovy or Ozempic may gradually improve over time, however this process may take several months.
Since these medications impact appetite, it becomes important to ensure you are receiving adequate vitamins, minerals, and protein. Insufficient nutrition can also contribute to hair loss. To address this, it’s advisable to consult a healthcare provider, who can assist you in maintaining proper nutrition throughout your treatment journey.
Headaches are among the potential side effects (14% with Wegovy) that can occur with semaglutide use. While the precise mechanism behind these headaches is not entirely clear, it is thought to be connected to the medication’s influence on blood vessels and neural pathways. In most cases, headaches experienced by individuals taking semaglutide are mild and transient. However, if you find that your headaches persist or worsen, it is crucial to consult a healthcare professional for further evaluation and guidance.
Your doctor can assess the severity and frequency of your headaches, as well as explore any other potential contributing factors. Depending on the assessment, they may suggest appropriate measures to alleviate the discomfort, such as over-the-counter pain relief or lifestyle adjustments. Open communication with a healthcare provider allows for a comprehensive evaluation of your symptoms and ensures that any concerns regarding headaches are addressed promptly. Taking proactive steps to manage headache symptoms can improve your overall treatment experience with semaglutide and promote your well-being throughout your journey with the medication.
5. Abdominal Pain
Abdominal pain or discomfort (20% with Wygovy) is another potential side effect that may arise from the use of semaglutide. While the severity of this side effect can vary from person to person, it is not uncommon to experience sensations of bloating or cramping along with the abdominal discomfort. If you encounter mild or occasional discomfort, it may subside as your body adapts to the medication. However, if the pain becomes severe, or if it persists and becomes bothersome, seeking medical advice is essential.
Healthcare provider can assess the nature of the abdominal pain, inquire about any other symptoms you may be experiencing, and conduct a thorough evaluation to determine the underlying cause. Depending on their findings, your doctor may suggest appropriate measures to manage the discomfort or recommend adjustments to your semaglutide treatment plan. Addressing abdominal pain promptly can help ensure your comfort and well-being while using semaglutide, making your treatment experience more positive and effective. Openly communicating any concerns with a healthcare professional allows for a proactive approach to managing side effects and optimizing your overall health while on this medication.
6. Injection Site Reactions
Semaglutide is commonly administered as a subcutaneous injection, where the medication is injected just beneath the skin. It’s important to note that mild skin reactions at the injection site can occur in some individuals. These reactions may manifest as redness, swelling, or itching around the area of injection. While these skin reactions are generally considered normal and temporary, some people may find them bothersome or concerning.
If you experience any skin reactions that cause discomfort or raise concerns, it’s essential to discuss them with a healthcare provider. Your doctor can assess the nature of the skin reactions and determine if any specific measures or interventions are needed to manage the discomfort. In most cases, mild skin reactions subside on their own without any intervention. However, a healthcare provider can offer valuable advice on proper injection techniques, suggest alternative injection sites, or provide recommendations for soothing the skin, if necessary. Open communication with a healthcare professional fosters a proactive approach to managing side effects and ensures that you are well-informed and supported throughout your semaglutide treatment journey.
Feeling tired or fatigued (11% with Wegovy) is a reported side effect observed in some individuals using semaglutide. This fatigue may be attributed to the medication’s impact on metabolism or alterations in energy utilization within the body. If you find yourself experiencing persistent or severe fatigue while on semaglutide, it’s essential to consult your doctor. A healthcare provider can assess your symptoms, evaluate potential contributing factors, and address any concerns or underlying issues effectively. Identifying the root cause of fatigue is crucial in ensuring your well-being and optimizing your overall treatment experience with semaglutide. With open communication and regular monitoring, your doctor can tailor the best approach to manage any fatigue-related issues and help you maintain an active and healthy lifestyle while on this medication. Prioritizing your health and promptly seeking medical advice for any concerning symptoms ensures that you receive the support you need to make the most of your semaglutide treatment.
In some instances, semaglutide usage may lead to occasional episodes of dizziness or lightheadedness (8% with Wegovy). This side effect should be taken seriously, especially when transitioning from a sitting or lying position to standing up quickly, as it can potentially raise the risk of falls. It’s crucial to be cautious and take your time when changing positions to prevent any potential accidents. If you find yourself experiencing frequent episodes of dizziness or lightheadedness while on semaglutide, it’s essential to inform your healthcare provider. Your doctor can evaluate your symptoms, assess for any underlying causes, and determine the most appropriate course of action. Identifying and managing the root cause of dizziness can help ensure your safety and enhance your overall well-being during your semaglutide treatment. Prioritizing communication with your healthcare provider fosters a proactive approach to your health, allowing for timely intervention and appropriate support if needed.
Constipation is a potential side effect of semaglutide, resulting from its impact on gut motility. While not experienced by everyone, some individuals may find themselves facing this issue during their treatment. To address constipation, it’s essential to prioritize hydration and ensure you are consuming an adequate amount of dietary fiber. Staying well-hydrated can help soften stools and promote regular bowel movements, while a fiber-rich diet aids in maintaining bowel regularity. Including fruits, vegetables, whole grains, and legumes in your meals can be beneficial. However, if constipation persists or becomes bothersome, it is essential to seek medical advice. Your healthcare provider can assess your situation, explore potential contributing factors, and recommend appropriate measures or adjustments to help alleviate this side effect effectively. Open communication with your doctor ensures that any concerns about constipation are addressed promptly, allowing you to maintain a comfortable and positive experience while on semaglutide therapy.
While pancreatitis is a rare occurrence, it’s essential to be aware of its association with semaglutide. Pancreatitis is characterized by inflammation of the pancreas, and if you are using semaglutide and experience symptoms such as severe abdominal pain, persistent nausea, and vomiting, it could be indicative of this serious condition. In such instances, seeking immediate medical attention is crucial to undergo proper evaluation and receive timely treatment. Pancreatitis requires prompt medical management to prevent potential complications and ensure the best possible outcomes for your health. While the likelihood of experiencing pancreatitis is low, being proactive and vigilant about any concerning symptoms can lead to swift diagnosis and effective intervention, contributing to your overall well-being while using semaglutide.
11. Gallbladder Problems
The impact of semaglutide on gallbladder function is an important consideration for those using this medication. There is a potential risk of developing gallstones while on semaglutide treatment. If you experience sudden and intense pain in the upper abdomen, it could be a sign of gallbladder issues, and it’s crucial to reach out to your healthcare professional promptly. Additionally, any noticeable changes in bowel habits should be brought to your doctor’s attention as well. Prompt communication with your healthcare provider ensures that any potential gallbladder-related concerns are addressed timely, and appropriate measures can be taken to manage the condition effectively. Regular monitoring and early intervention can help mitigate the risk of gallstone-related complications and safeguard your overall health while on semaglutide therapy.
12. Allergic Reactions
Although allergic reactions to semaglutide are infrequent, they can be potentially serious. It’s crucial to be vigilant and aware of the signs of an allergic response. If you develop symptoms such as a rash, itching, swelling, severe dizziness, or difficulty breathing after taking semaglutide, it could indicate an allergic reaction. In such cases, immediate medical attention is essential. Don’t hesitate to seek emergency medical care to ensure prompt evaluation and appropriate treatment. Your healthcare provider can assess the severity of the reaction and provide necessary interventions to manage the allergic response effectively. Timely action can be life-saving and help prevent any further complications. If you have a history of allergies or have experienced allergic reactions to medications in the past, be sure to inform your doctor before starting semaglutide or any new treatment to minimize the risk of potential allergic responses.
13. Thyroid Cancer
The study that triggered the European Medicines Agency’s (EMA) safety signal was featured in the publication Diabetes Care in February. The research revealed a concerning finding, stating that individuals using GLP-1 receptor agonists, such as semaglutide, for a duration of one to three years might face an elevated risk of developing various types of thyroid cancers. This discovery has raised awareness about the potential long-term effects of these medications on thyroid health and has prompted further investigation and vigilance among healthcare professionals and patients alike. It emphasizes the importance of ongoing research and monitoring to better understand the safety profile of GLP-1 receptor agonists in managing diabetes and their potential impact on thyroid cancer risk.
Mood changes, particularly symptoms of depression, have been reported by some individuals using semaglutide. It’s essential to pay close attention to your emotional well-being while on the medication. If you notice persistent feelings of low mood, sadness, or any other changes in your mental health, it’s crucial to seek guidance and support from your doctor promptly. They can assess your condition, discuss potential underlying factors, and determine the most appropriate course of action to address your emotional concerns effectively. Open communication with your healthcare provider ensures that your overall health is closely monitored and that you receive the necessary care to optimize your well-being while undergoing treatment with semaglutide. Remember, you don’t have to navigate these experiences alone, and seeking help can lead to better management and overall health outcomes.
15. Stomach Paralysis
The FDA has received reports of certain patients using semaglutide, encountering severe gastroparesis, commonly referred toas “stomach paralysis.” This condition leads to a significant slowing down of food digestion, potentially resulting in intense vomiting and nausea.
Pancreatitis is a rare but serious side effect associated with the use of certain medications, including semaglutide (Ozempic, Wegovy). Pancreatitis is characterized by inflammation of the pancreas, a gland located behind the stomach that plays a crucial role in digestion and insulin regulation. Symptoms of pancreatitis can include severe abdominal pain that may radiate to the back, nausea, vomiting, and fever. If you experience any of these symptoms while taking semaglutide, it is essential to seek immediate medical attention as pancreatitis requires prompt diagnosis and management to prevent potential complications. While pancreatitis is uncommon, being vigilant and aware of the signs can help ensure timely intervention and appropriate care if needed.
While semaglutide can be an effective treatment for type 2 diabetes and weight loss, it’s essential to be aware of the potential side effects that may accompany its use. If you find that you are experiencing severe or undesirable side effects from semaglutide, discussing your concerns with your healthcare provider is crucial. Here at the Weight Loss Surgery Center of Los Angeles we explore alternative treatment options or suggest a personalized approach that best suits your medical needs and lifestyle. Weight loss surgeries, such as gastric banding (Lap Band), gastric sleeve or gastric bypass, or other non surgical options like gastric balloon, may be viable options for individuals who are not satisfied with the side effects of semaglutide. Remember, open communication with healthcare professionals is key to finding the best solution for your health and well-being. Prioritizing your safety and overall quality of life should always be at the forefront of any medical decision-making process
Posted on behalf of Dr. David G. Davtyan MD, FACS, FICS