Blindness, Stomach Paralysis, and Suicide – What Are the Real Risks on Wegovy and Zepbound?
GLP-1 agonists, such as Wegovy and Zepbound, have become increasingly popular in recent years. However, it's important to understand the potential risks associated with these medications.
In this episode, we will examine reports of serious side effects, including blindness, stomach paralysis, and suicide. We will delve into the data, analyze the underlying science, and identify the factors contributing to these risks. Additionally, we'll cover the common side effects of GLP-1 medications and what users should be aware of.
Blindness Risk with Semaglutide: What You Should Know
Lately, there's been a lot of talk about a sudden blindness condition called NAION (non-arteritic anterior ischemic optic neuropathy) that's potentially linked to semaglutide, known by its brand names Ozempic and Wegovy. This news has even caught doctors by surprise, with some deciding to stop prescribing the medication just to be safe. Understandably, the idea of an irreversible blindness side effect is pretty scary, so it's important to take a closer look at the data to understand the real risk.
The study in question was conducted at a neuro-ophthalmology clinic in Boston, a place that deals with severe eye issues, including sudden blindness caused by NAION. They reviewed the records of around 17,000 patients, focusing on those with diabetes or obesity who were taking semaglutide. Here’s a breakdown of what they discovered:
Diabetes Patients: Among those taking semaglutide, 17 developed NAION, compared to 6 who weren’t on the medication.
Obesity Patients: In this group, 20 on semaglutide developed NAION, versus 3 not taking the drug.
While these numbers suggest a higher incidence of NAION in patients on semaglutide, it’s important to remember that NAION is incredibly rare. In the general U.S. population, it affects about 2 to 10 people per 100,000, translating to a 0.002% to 0.01% risk.
Contextualizing the Risk
To put this into perspective, even if semaglutide increases the risk threefold, we’re still talking about a very small number. Imagine two packed Taylor Swift concerts—about 100,000 people. Normally, 2 to 10 of those people might experience NAION in their lifetime. With semaglutide, it might increase to 4 to 30 people out of 100,000.
Remember, all medications come with risks, and it’s essential to consider the benefits too. Semaglutide is known to reduce the risk of heart attacks by 20% for those at high risk, and it helps with weight management, which can lower the chances of diabetes, cancer, and stroke. These are far more common and significant health concerns than NAION.
So, If you’re on semaglutide or considering it, it’s wise to talk with your doctor about your specific risk factors. People with conditions like sleep apnea, low blood pressure, or those on blood pressure-lowering medications might need to be more cautious. Staying hydrated and monitoring your blood pressure can help mitigate some risks.
For those using semaglutide simply for minor weight loss, especially with crash dieting, it might be worth reevaluating. The medication is designed for more serious health issues, and improper use can increase risks.
In summary, while the link between semaglutide and NAION is something to be aware of, it remains a very rare condition. The benefits of semaglutide, particularly for those at higher health risks, often outweigh this small potential risk. Always consult with your healthcare provider to make the best decision for your health.
GI Side Effects and Concerns with Semaglutide
There’s also been some chatter about severe gastrointestinal (GI) side effects linked to semaglutide, particularly a condition known as gastroparesis or severe stomach paralysis. Last year, the media reported on cases of this extreme side effect, but among my network of hundreds of prescribers, none had encountered it. Naturally, this raised questions about how common or severe this issue actually is.
Gastroparesis is a condition where the stomach takes too long to empty its contents, leading to nausea, discomfort, and sometimes severe nutrition issues. Semaglutide and similar medications work by slowing down gut transit, meaning food stays in your stomach longer. This can occasionally result in a mild form of gastroparesis.
Research shows that the risk of developing gastroparesis can increase threefold with these medications, which isn’t entirely surprising given their mechanism. However, severe, irreversible stomach paralysis seems to be more myth than reality. I couldn’t find substantial scientific data supporting the occurrence of permanent stomach paralysis due to these medications, and the media has been quiet on this front for the past year, suggesting it might not be a genuine concern.
Other GI Issues to Consider
While severe, irreversible gastroparesis appears unlikely, there are other GI issues to be aware of:
Bowel Obstruction: There’s a slightly increased risk of bowel obstructions, where there’s a blockage in the intestines, potentially requiring hospitalization or surgery. If you experience severe symptoms like not having a bowel movement for more than a week, it's important to contact your doctor.
Pancreatitis: This condition, characterized by severe abdominal pain radiating to the back, can be increased by up to eight times with semaglutide. While still rare (affecting less than 1% of users), it’s a serious side effect. If you've had pancreatitis before, it's generally advised to avoid these medications.
Always discuss any severe or persistent side effects with your healthcare provider. They can help determine if continuing the medication is the best course of action or if alternative treatments might be more suitable.
Examining the Risk of Suicide with Semaglutide
Another serious concern that’s come up with semaglutide (Ozempic and Wegovy) is the potential for suicidality—people having thoughts or actions related to suicide while on the medication. This worry, which started circulating from Europe about a year ago, understandably caused quite a bit of alarm.
The good news is that the data doesn't back up an increased risk of suicide with these medications. While some weight loss drugs in the past have been linked to higher risks of suicidal behavior, we closely monitor newer options like semaglutide. So far, the extensive data we have doesn’t show a higher risk of suicidal thoughts or actions.
It's important to remember that suicidal thoughts are unfortunately more common than many realize. Given how prevalent these thoughts are in the general population, if semaglutide were causing an increase, we’d likely have seen clear evidence by now.
Even though it seems semaglutide doesn’t up the risk of suicidal ideation, keeping an eye on your mental health is still crucial. Depression and suicidal thoughts are serious and deserve proper attention. Always be aware of any changes in how you’re feeling and reach out for support if you need it.
Based on what we know right now, it seems unlikely that semaglutide is linked to a higher risk of suicide. Still, staying on top of your mental health is important, so keep monitoring and addressing any concerns you might have.
Common Side Effects of GLP-1 Medications: What to Expect
What can we really expect from using GLP-1 medications? Knowing what potential issues might arise will prepare you better for the experience.
So, here are the common side effects:
Nausea: This is the most frequently reported side effect, affecting about one in four people. Despite being common, most people find it manageable, and only about 3-5% of users in studies stop the medication due to nausea. Remedies like ginger, Tums, or prescription anti-nausea medications can help. The nausea often improves as your body adjusts to the medication, and starting with a lower dose can help minimize this effect.
Constipation: As these medications slow down gut transit, constipation is a common issue. Staying hydrated and increasing fiber intake can help. Consider supplements like Metamucil or Psyllium husk if needed, or consult your healthcare provider for personalized advice.
Diarrhea: This side effect is less common with semaglutide but is seen more frequently with tirzepatide (Zepbound or Mounjaro). Higher doses can increase the likelihood. Adding fiber to your diet might help, but if diarrhea is severe, persistent, or accompanied by fever or blood, contact your healthcare provider.
Vomiting: Occasionally, nausea can lead to vomiting. If this happens, consider an anti-nausea medication and eat smaller, more frequent meals to minimize symptoms. Again, this usually improves with time.
Injection Site Reactions: Some people might experience mild rashes or irritation at the injection site. This is typically minor but should be monitored.
Fatigue: This can be due to reduced nutrition or dehydration, but some people report fatigue even when they are well-hydrated and eating adequately. It’s worth discussing with your healthcare provider if you experience persistent tiredness.
Hair Loss: Rapid weight loss can sometimes lead to hair loss, which is a known side effect of significant weight changes.
Low Blood Pressure: Some people may experience dizziness or low blood pressure. If you notice these symptoms, especially if they are persistent, talk to your doctor.
Gas and Bloating: These symptoms can be bothersome but often improve over time. Probiotics and identifying any trigger foods might help manage this issue.
Most side effects associated with GLP-1 medications tend to improve as your body adjusts. Despite these common issues, the majority of people find the medications manageable and continue using them without having to stop. If you experience any severe or persistent side effects, don’t hesitate to consult your healthcare provider for guidance and support.
In summary, while GLP-1 medications like Wegovy and Zepbound come with some potential side effects, many users find them manageable, and the benefits can be significant.
For more insights on these issues and tips on managing GLP-1 medications, catch our latest episode. It's packed with useful information to help you navigate these concerns effectively.
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