Ozempic GLP-1 Pitfalls and Natural Weight Balance | The American Chiropractor | JANUARY 2025 (2025)

y Lynn Toohey, PhD

The recent craze over weight-loss drugs Ozempic and Wegovy (higher dose of the drug) led to headlines such as, “Weight-Loss Drugs Taking Hollywood by Storm.” However, they also led to headlines such as, “We Wouldn’t Have Ozempic Without Gila Monsters — Their Hunger-Regulating Venom Inspired Weight-Loss Drugs.”1 The forerunner to these drugs — exenatide — generated this headline close to 20 years ago: “Diabetes Drug Made from Lizard Spit Approved.”2

That’s right; these drugs were made from the venom of the Gila lizard because the reptile’s saliva contains the intestinally secreted peptide GLP1, and for some reason, it is more stable in lizards than humans. GLP1 stands for glucagon-like peptide, and it acts to increase insulin secretion from the beta cells of the pancreas, suppress glucagon production, and regulate blood sugar/appetite. So, it is no surprise that GLP1 analogs such as Ozempic and Wegovy work as weight-loss drugs.

Ozempic belongs to a class of drugs that generated $21billion in sales in 2023. However, these drugs have side effects, including gastrointestinal upset and nausea. In addition, if patients go off these drugs, rapid return of lost weight can be expected because an insufficient amount of GLP1 is still circulating in the body. Additionally, increased incidences of hair loss and arrhythmias are subjectively being reported.

How about addressing weight balance by supplementing with nutrients that encourage the natural production of GLP1 from the enteroendocrine cells of the human small intestinal lining that act to provide an adequate level of GLP1? Supplementation does not produce side effects, and healthy enteroendocrine cells also foster the release of a plethora of other healthful peptides necessary to maintain proper functioning of all signaling pathways involved.

Other peptides include:

  • GIP (gastric inhibitory polypeptide)– Also known as glucose-dependent insulinotropic polypeptide, which stimulates insulin secretion.

  • VIP (vasoactive intestinal peptide)– Various functions in the digestive, cardiovascular, and nervous systems.

  • CCK (cholecystokinin)– Slows gastric emptying and stimulates pancreatic enzyme and bile release.

It is impossible to cover all the secreted peptides here, which amount to over 100 and include almost every neurotransmitter made in the brain.3

Many factors interfere with our natural production of GLP1, such as the things that lead to a leaky gut (compromised intestinal lining), such as dysbiosis, prescription drugs, anti-inflammatory OTC drugs, toxic exposure, etc. However, one of the most healing agents for the gut is the amino acid glutamine because it is the major fuel source for the enteroendocrine cells.

Knowing that glutamine provides this major fuel, you would expect to find scientific evidence that glutamine increases GLP1, and that is the case.4 You would also expect that there is scientific evidence glutamine would have a positive support effect on weight balance, and that is also the case.5

Other nutrients are important to the integrity of the small intestinal cells and the enteroendocrine cells embedded in the small intestinal lining. For instance, N-acetyl glucosamine can increase the mucous lining of the small intestine, providing a physical, protective barrier. When this barrier is compromised by nonsteroidal agents like ibuprofen (which block the good prostaglandins that make mucous), it can create ulceration and decrease peptide secretion from the gut.

Zinc is a helpful nutrient because it is necessary for microbiota interactions that affect the intestinal lining.6 Other helpful nutrients include alpha lipoic acid, ginkgo biloba (circulation support), probiotics, and prebiotics, such as Jerusalem artichoke.

Prebiotics provide food for probiotics and allow them to flourish in the microbiome. When probiotic supplements contain prebiotic components, they are termed synbiotics. Research revolves around singling certain strains of probiotics, but experts agree that when it comes to the general health of the microbiome, diversity is key. A composition of varied good bacteria and prebiotics is the best route.

Pre- and probiotics are critical to microbiota interactions and enteroendocrine secretions. Since they are so important to peptide secretions such as GLP1, one would think that a search would turn up evidence that probiotics are excellent weight support, as was indeed the case. In fact, probiotics have some very exciting research behind them in this area.

In 2021, “The role of probiotics in reducing body mass index and weight as well as changing the visceral abdominal fat area, waist, and hip circumference” was demonstrated in 14 clinical trials included in a systematic review. The researchers of that article went on to note that “an increasing interest in the gut microbiota has emerged as a target for therapeutic strategies in obesity and overweight due to its direct relation with the aforementioned health conditions and complications. Thus, the aim of this study was to evaluate the efficacy of probiotics as a therapeutic strategy in the management of obesity and overweight.”7

Additionally, a clinical trial tested pre- and probiotics in 45 obese subjects. The interesting design of the study was divided into three groups: diet (low carbohydrate and low calorie), prebiotics, and probiotics. Researchers discovered that all three groups showed a significant decrease in weight, BMI, and waist circumference.

Only the prebiotic and probiotic groups showed a significant decrease in fat mass and a significant increase in muscle strength. Results also showed a significant decrease in insulinemia and HOMA-IR (measures insulin resistance and beta cell function) in the prebiotic group compared to the diet-alone group. The probiotic group also showed a significant decrease in fasting blood glucose compared to the diet-alone group. A significant improvement in sleep quality was noted in the prebiotic group, with a significant decrease in depression, anxiety, and stress in all three groups. Overall, results confirmed a positive effect of pre- and probiotics for weight support.8

Microbiome testing can be helpful, especially if dysbiosis is suspected. Dr. Julia Malkowski, ND, DC, BSc, and clinical education doctor for Doctor’s Data suggests the GI360 panel that provides individualized biomarker data regarding microbiome dysbiosis, diversity, phyla abundance, key bacteria, and metabolites, such as short chain fatty acids (SCFAs). Dr. Malkowski notes observations of individuals on GLP1 medications demonstrating gut microbiome dysbiosis, reduced diversity, reduced phyla abundance, and key bacteria. Bacteria identified on the GI360 panel, such asAkkermansia muciniphiliaandBifidobacterium,as well as polyphenol consumption and short-chain fatty acids, play a role regarding GLP1 activity.

Nutritional Help:

Healthful digestive spices include ginger, turmeric, peppermint, and cinnamon; use as condiments, teas, or supplements. Beneficial foods include wild salmon, high-fiber foods (the best being organic vegetables), and fermented foods, such as sauerkraut, pickles, raw apple cider vinegar, and yogurt and kefir, if not dairy restricted.

Foods rich in proteins and healthy fats can trigger the release of GLP-1.9Avocados are high in fiber, have healthy fat, and increase peptide YY, which regulates appetite while reducing insulin levels. One study conducted in Jakarta, Indonesia, found that consuming vegetables before carbohydrates significantly affected glucose and GLP1 levels in individuals with type 2 diabetes, especially 60 minutes after eating.

Artichoke hearts are high in fiber, nutritious, and good prebiotics. Other good prebiotic foods are onions, leeks, asparagus, bananas, and garlic. The worst things that disrupt the gut are meds, specifically OTC or prescription painkillers and NSAIDS, along with sugar, trans fats, processed foods, artificial sweeteners, fast food, and excess sodium.

The no-calorie sweetener allulose possesses health benefits and induces GLP-1 release, activates vagal afferent signaling, reduces food intake/hyperglycemia, promotes glucose tolerance, and corrects arrhythmic overeating.10

The moral of the story is to be good to your gut so that your gut returns the favor by making everything it is supposed to make. Researchers are beginning to look at the importance of GLP1 as support for the heart, liver, nerves, musculoskeletal system, PCOS (polycystic ovarian syndrome), and much more.11,12

Dr. Lynn Tooheyorganizes seminars, acts as a nutritional consultant to Nutri-West (www.nutriwest.com) and authored the Functional Health Evaluation program that analyzes blood tests and DNA raw data (www.FHEcloud.com). Dr. Toohey can be reached at i-west.net with any questions.

References

  1. Brueck, H. Business Insider. Mar 22, 2023.

  2. Newsweek April 29th 2005.

  3. Albrechtsen NJW, Rehfeld JF. On premises and principles for measurement of gastrointestinal peptide hormones. Peptides. 2021 Jul;141:170545. doi: 10.1016/j.peptides.2021.170545. Epub 2021 Mar 31. PMID: 33811948.

  4. Badole SL, Bagul PP, Mahamuni SP, Khose RD, Joshi AC, Jangam GB, Ghule AE, Raut CG, Khedkar VM, Coutinho EC. Oral L-glutamine increases active GLP-1 (7-36) amide secretion and improves glycemic control in stretpozotocin-nicotinamide induced diabetic rats. Chem Biol Interact. 2013 Apr 25;203(2):530-41. doi: 10.1016/j.cbi.2013.02.006. Epub 2013 Mar 4. PMID: 23466488.

  5. Laviano A, Molfino A, Lacaria MT, Canelli A, De Leo S, Preziosa I, Rossi Fanelli F. Glutamine supplementation favors weight loss in nondieting obese female patients. A pilot study. Eur J Clin Nutr. 2014 Nov;68(11):1264-6. doi: 10.1038/ejcn.2014.184. Epub 2014 Sep 17. PMID: 25226827.

  6. Scarpellini E, Balsiger LM, Maurizi V, Rinninella E, Gasbarrini A, Giostra N, Santori P, Abenavoli L, Rasetti C. Zinc and gut microbiota in health and gastrointestinal disease under the COVID-19 suggestion. Biofactors. 2022 Mar;48(2):294-306. doi: 10.1002/biof.1829. Epub 2022 Feb 26. PMID: 35218585; PMCID: PMC9082519.

  7. Tomé-Castro XM, Rodriguez-Arrastia M, Cardona D, Rueda-Ruzafa L, Molina-Torres G, Roman P. Probiotics as a therapeutic strategy in obesity and overweight: a systematic review. Benef Microbes. 2021 Feb 24;12(1):5-15. doi: 10.3920/BM2020.0111. Epub 2021 Jan 17. PMID: 33459204.

  8. Ben Othman R, Ben Amor N, Mahjoub F, Berriche O, El Ghali C, Gamoudi A, Jamoussi H. A clinical trial about effects of prebiotic and probiotic supplementation on weight loss, psychological profile and metabolic parameters in obese subjects. Endocrinol Diabetes Metab. 2023 Mar;6(2):e402. doi: 10.1002/edm2.402. Epub 2023 Jan 6. PMID: 36606510; PMCID: PMC10000630.

  9. Bodnaruc AM, Prud'homme D, Blanchet R, Giroux I. Nutritional modulation of endogenous glucagon-like peptide-1 secretion: a review. Nutr Metab (Lond). 2016 Dec 9;13:92. doi: 10.1186/s12986-016-0153-3. PMID: 27990172; PMCID: PMC5148911.

  10. Iwasaki Y, Sendo M, Dezaki K, Hira T, Sato T, Nakata M, Goswami CC, Aoki R, Arai T, Kumari P, Hayakawa M, Masuda C, Okada T, Hara H, Drucker DJ, Yamada Y, Tokuda M, Yada T. GLP-1 release and vagal afferent activation mediate the beneficial metabolic and chronotherapeutic effects of D-allulose. Nat Commun. 2018 Jan 9;9(1):113. doi: 10.1038/s41467-017-02488-y.

  11. Zheng Z, Zong Y, Ma Y. et al.Glucagon-like peptide-1 receptor: mechanisms and advances in therapy. Sig Transduct Target Ther. 2024;9:234.doi: 10.1038/s41392-024-01931-z.

  12. Gan J, Chen J, Ma RL, Deng Y, Ding XS, Zhu SY, Sun AJ. Action Mechanisms of Metformin Combined with Exenatide and Metformin Only in the Treatment of PCOS in Obese Patients. Int J Endocrinol. 2023 Dec 14;2023:4288004. doi: 10.1155/2023/4288004. PMID: 38131036; PMCID: PMC10735721.

Ozempic GLP-1 Pitfalls and Natural Weight Balance | The American Chiropractor | JANUARY 2025 (2025)
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