Q & A with Dr. Davina Soernssen FNP-BC, DCNP
Question: What exactly is GLP-1 anyway?
Answer: Glucagon-like peptide-1 (GLP-1) and its cousin Glucose-dependent insulinotropic polypeptide (GIP) are small peptides known as incretins that promote the release of insulin from the pancreas to decrease blood sugar. When pharmacologically combined in the drug well known as Mounjaro they are a "double wammy".
Question: What are the key benefits of GLP-1 receptor agonists in the treatment of diabetes?
Answer: GLP-1 receptor agonists are a class of medications used to treat diabetes by enhancing the availability of GLP-1 produced and secreted by intestinal cells and brainstem neurons upon food consumption. They offer several benefits, including improved blood sugar control, weight loss, reduced risk of hypoglycemia (low blood sugar), and potential cardiovascular benefits. They work by mimicking the effects of GLP-1 in the body, promoting insulin release and decreasing glucagon, which helps regulate blood sugar levels.
Question: How is GLP-1 related to appetite regulation?
Answer: No doubt, in the right patient, semaglutide is a game changer with dramatic results when used alongside a functional medicine approach with food as medicine! GLP-1 agonist can help in the beginning to get that client over the hump of habit change. When GLP-1 is released after a meal, it acts on the brain to signal fullness and reduce food intake. This effect can help control body weight and reduce overeating, making it a valuable target for weight management and obesity treatment.
Question: Are there any natural ways to increase GLP-1 levels in the body?
Answer: Absolutely! There are natural ways to enhance GLP-1 secretion. Believe it or not, your gut is responsible for making important neurotransmitters using chemical reactions required by vitamins and minerals. Did you know that more than 80% of serotonin and 30% of the body’s dopamine is produced by the intestines? In fact, gut dysbiosis is directly related to weight gain, depression and malnutrition.
The Skinny on Semaglutide (GLP-1 agonist AKA Ozempic) is that eating a balanced diet with a focus on fiber-rich foods, such as green leafy vegetables, will stimulate GLP-1 release. Additionally, regular exercise has also been shown to increase GLP-1 levels, whereas eating sugar and processed foods suppress these levels by destroying gut biome and increasing inflammation.
Question: What are the potential side effects of GLP-1 receptor agonist medications?
Answer: Common side effects of GLP-1 receptor agonists may include nausea, vomiting, diarrhea, and abdominal discomfort. These side effects often improve over time as the body adjusts to the medication. However, it's important to discuss any side effects with your healthcare provider. In some cases, there can be more serious adverse effects, like pancreatitis, gallbladder disease, acute kidney injury, diabetic retinopathy allergic reaction, increased heart rate and even thyroid cancer, so it's essential to follow your doctor's guidance when taking these medications.
Answer: Yes. Despite multiple reports of people regaining weight after discontinuing this medication (Wilding, J. P. H. et al., 2022) GLP-1 agonists are not meant for long term use (Butler, P. C., Dry, S., & Elashoff, R., 2010). In fact, long term use can lead to hair loss, depressed mood, and endocrine dysfunction among other complications. However, at the Med Spa at Clinical Edge our belief system is to get to the underlying cause of one's inability to lose weight so that weight loss is sustainable. Semaglutide may not be right for everyone; each person is unique and requires a personalized treatment plan. More importantly, Dr. Davina Soernssen digs deep to get to the root cause of one's inability to lose weight using a functional medicine approach.
Warnings and Contraindications:
"Semaglutide is contraindicated during pregnancy and in patients with a personal history of pancreatitis or a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia 2A or 2B. In addition, for patients taking semaglutide concurrent with insulin or an insulin secretagogue (eg, a sulfonylurea), blood glucose should be monitored, and a dose reduction in the insulin or the sulfonylurea may be necessary to avoid hypoglycemia. Rare cases of angioedema and anaphylaxis have been reported with semaglutide. Patients with diabetic retinopathy should be monitored for complications and avoided when possible (Perreault, L., 2023)."
References:
Butler, P. C., Dry, S., & Elashoff, R. (2010). GLP-1-Based Therapy for Diabetes: What You Do Not Know Can Hurt You. Diabetes Care, 33(2), 453-455. https://10.2337/dc09-1902
Perreault, L. Obesity in Adults: Drug Therapy. In: UpToDate, Post TW (Ed), Wolters Kluwer. https://www.uptodate.com (Accessed on October 28, 2023.)
Wilding, J. P. H., Batterham, R. L., Davies, M., Van Gaal, L. F., Kandler, K., Konakli, K., Lingvay, I., McGowan, B. M., Oral, T. K., Rosenstock, J., Wadden, T. A., Wharton, S., Yokote, K., & Kushner, R. F. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity & Metabolism, 24(8), 1553-1564. https://10.1111/dom.14725
This is so fascinating. More tools in the arsenal!