What We Got Wrong About GLP-1s (And What's Actually Right)

Key Takeaway

Treat any weight-loss intervention as a muscle-and-metabolism preservation plan, not a shortcut. Starting today, schedule two or more weekly strength-training sessions, prioritize protein at each meal, and track a baseline metabolic marker such as fasting insulin with your clinician. If you are considering or using a GLP-1, do not self-prescribe or escalate dose casually: work with a qualified clinician, use the lowest effective dose, and monitor body composition, nutrition, symptoms, and lifestyle adherence together.

Episode Overview

Dr. Mark Hyman and Dr. Tyna Moore revisit GLP-1 medications with a more nuanced view: they may improve metabolic health and help some people break difficult cycles, but they are not stand-alone treatments. The discussion emphasizes individualized dosing, resistance training, protein intake, clinical monitoring, and caution around poorly supervised telemedicine or gray-market drugs.

Full Transcript

Transcript of What We Got Wrong About GLP-1s (And What's Actually Right) from The Dr. Hyman Show. Auto-generated from episode audio; may contain minor errors.

My thoughts on this issue have changed over time . I was skeptical at first, but I changed my stance. The most important fact we have all realized through this whole process is that metabolic health is the key to everything. These peptides improve overall metabolic health. And if your metabolic health improves, you can see various benefits in all aspects, regardless of whether you lose weight or not . I am seeing really good results regardless of weight loss . Yes, GLP -1 has a direct mechanism of action .

It acts on immune cells and binds to receptors throughout the body. There are also direct effects that I do not fully understand yet . Yes, since many doctors prescribe GLP-1, I think this mechanism is really important for people to understand GLP-1. GLP-1 will bring real benefits to humanity. The problem is how we utilize it . Hello, Tina. It is nice to see you back on the podcast . I am glad to see you again. How have you been? thank you. I am also really glad to be here.

I'm glad to see you again, too. Yes, that's good. Last time we talked, we covered the various controversies surrounding GLP-1 in detail. We discussed many things that were hot topics in the news or actual clinical settings at the time, such as efficacy, side effects, microdosing, and cost issues . However, GLP-1 has already been on the market for several years and is being used by millions of people . Now, we would like to know the pros, cons, and problems of GLP-1, as well as its potential benefits other than weight loss .

Now that two years have passed, what changes are actually taking place ? I remember that when you appeared on the broadcast on April 24, you discussed GLP-1 in depth . I am curious about what changes have occurred since then . One of the most important points in this conversation was the issue of dosage . Prescription GLP-1 drugs such as Ozempic, Wegobi, Jeffbound, and Munjaro are manufactured in high doses and cause serious side effects . Looking at the data , 60 to 70 percent of people experience gastrointestinal side effects, and 4 percent experience very serious side effects .

If you consider that 40 to 50 million people take this medicine , the rate is quite high. 4% of 40 to 50 million people is by no means a small number . Has there been any change in this way of thinking over the past few years ? Now, let's take a closer look at the emerging research findings regarding this area . Everything was completely turned upside down after that broadcast . Suddenly, people started bombarding me with questions, and since then, my life has been completely topsy-turvy .

It was really exciting, in a good way. That was exactly the point I was trying to convey in that conversation . I couldn't explain it in full, but overall, it was a functional medicine approach. So, it seems that many people were confused because they did not properly understand this comprehensive approach . Now that two years have passed, I have become even more convinced that maintaining the lowest possible dosage is essential . Regardless of the target dosage , for example, switching to regular use or a method close to regular use is good, but what I consider most important right now is improving my lifestyle habits .

That is something we both agree on as well . You must put everything into practice, but keep in mind that this is only part of a comprehensive treatment plan, not the whole thing . It means it is not a monotherapy. That is exactly what I intended to emphasize from the beginning, but you know how people think, right ? He only listened to what he wanted to hear and said, "Oh, a micro-zing? That's a miracle. It'll work for me, too ." That's what I think . And yet, you don't do anything else, do you?

So now, a few years later, I say, "Everyone, you still have n't listened to me. You have to do everything, and the micro-zing is just one of many tools ." I want to say that. I think this perspective is really important in understanding GLP-1. Many doctors just prescribe. There are many places online that print prescriptions. If you receive a prescription and medication via telemedicine , you have to handle it yourself . I think this is medical malpractice. I believe that if these drugs are prescribed without being combined with proper nutrition, training, education, and strength training, it will actually have a counterproductive effect on the user and cause more problems in the long run .

Muscle mass and lean body mass tend to decrease, and especially in the case of high-dose users, weight often returns when use is stopped . If that happens, your metabolism slows down, and you fall into a vicious cycle where you need fewer calories to maintain the same weight . Therefore, I believe that the basic principles of lifestyle habits have already been briefly mentioned before addressing recent new issues . People need to understand how the prescribed dosage of the medication works, and then I would appreciate it if you could explain how it works when taken in the small dose you recommend .

In terms of the importance and impact of lifestyle changes, namely diet, exercise, strength training, and protein intake, hormones are endogenously produced in our body's intestines, L cells, and brain, and receptors exist throughout our body . The standard medicinal dose is a considerably high dose for most people and is designed to slow gastric emptying and inhibit gastric motility . In addition, hormones act on the brain to influence the transmission of satiety and hunger signals , ultimately helping people eat less and lose weight . Of course, there may be differing opinions on this matter, but based on the data I have examined, I believe there are factors that affect overall metabolism in addition to weight loss .

In other words, it balances signal transduction peptide hormones, but this may vary depending on the individual and dosage. Ultimately, I believe that this balance improves insulin resistance and, as a result, helps with weight loss. Simply eating less is not enough . It's not like I'm starving, either. It is a combination of various factors . Taking high doses can cause a rapid increase in gastric motility, which may impair digestive function , and this is not good. The risk of pancreatitis actually exists. Pancreatitis caused by gallstones moving into the pancreas actually exists.

I have seen many such cases in my clinical experience as well. I have seen many patients with elevated pancreatic enzyme levels. There were many patients with high amylase and lipase levels. It is surprising that there are so many patients with elevated pancreatic enzyme levels, even though not many of my patients are taking this medication . However, please do n't dig too deep, and stop me if I speak too long-windedly. Anyway, it seems we are looking at two different groups . Well, actually, there are three. These drugs were generally developed for patients who are obese and suffer from type 2 diabetes, and these patients come to the hospital with their immune systems already significantly weakened, don't they ?

However, if high doses of medication are administered on top of that , I do n't think it will be a successful treatment. I agree as well. I think it is medical malpractice and completely unethical to provide only a single therapy without offering all the necessary treatments to these patients . But honestly, most doctors do n't do strength training. Most doctors don't do it. I saw a lot of doctors like that this morning as well. I went to exercise this morning too. Ah, I see. You did a great job.

me too. I knew it. I thought, ' That doctor must be exercising too.' You can't maintain your youth at your age without strength training. People ask, ' What's the secret?' If you ask me, I answer 'the gym'. " That's all there is to it. The sound of groaning at the gym . Well, it's a healthy and good lifestyle . And I think the middle group that has been receiving so much help since our conversation—with this peptide and the assistance of doctors providing a comprehensive and integrated approach—are probably those who need to lose around 30, 40, or 50 pounds .

They are having metabolic problems due to being overweight . It could be postpartum, having had multiple children, or their metabolic health might have been disrupted in the process . Whatever the reason , these people are practicing everything the right way and are getting good results . It is a truly harmonious relationship . And for these people to succeed in weight loss, I think they need a standardized dosage or a dosage close to that. And the group I was trying to talk about, as I... you know, when I presented the idea...

it was too early for them . As you know, the world was n't ready to accept what I was trying to present, and for this concept to work, I had to explain functional medicine in great detail. I [discussed] the concept of microdosing..." I intended to introduce it, but it is a truly minute amount—literally minute. These people have clearly never used drugs before . They don't even know what microdrugs are. My intention was to administer just a tiny fraction of the initial dose to people whose metabolisms are already optimized and who are already doing everything well .

As you know, we are struggling as well . We have autoimmune diseases, histamine issues , and all sorts of other problems. We can even experience metabolic issues. I have seen people with a lot of muscle mass but who are thin experience a severe deterioration in their cardiovascular or metabolic indicators . There are likely various reasons, such as stress, genetic factors, and epigenetic factors. So, what I was trying to do was ask, "Could n't we utilize this for people like this as well?" That was what I was doing .

Consider the different administration strategies and nearly different approaches among the three groups . To be honest, low-dose naltrexone was closer to the direction I had in mind . If the body lacks GLP-1 for whatever reason, and I believe there is a functional deficiency of GLP-1, then... According to a study published last year, statin drugs were shown to reduce endogenous GLP-1 production by 50% . That is an interesting result. It might explain why statins increase insulin resistance and significantly raise the risk of diabetes. This could be the mechanism.

That is interesting . Yes. I was thinking of a method where, as is generally done in functional medicine , if someone is physiologically deficient in a specific hormone, that hormone is replenished. Not administering high doses, but supplementing with small amounts . Yes, it is not pharmacological treatment . It is just administering small amounts . That is how I came to that conclusion . I think people found it difficult to understand that idea, or to grasp what I was trying to convey . Low dose Taking naltrexone as an example , this is how I explain it to my patients .

If it is opioid addiction (I will omit the details), it is a problem with opioid receptors or opioid-like receptors, and this regulates the immune system . If the immune system is not functioning properly, administering a very small amount of naltrexone helps the body utilize what it has better and improves its function. My thinking on the microdosing strategy was exactly similar to this . The idea is that if you replenish what the body needs little by little, the body's systems can function better . You know that leptin, ghrelin , and other signaling peptide hormones work together with GLP-1 .

Because all of these work together, our bodies need GLP-1. Anyway, in this podcast, I intended to convey three different concepts . I think many people are now open to the fact that GLP-1 can be effective to some extent . Previously, there was a strong atmosphere of opposition to GLP-1, and online There were many sensational articles that even scared people. Before listeners lose focus during this episode, I feel I must discuss muscle loss . Remember how I mentioned in the last podcast that the JAMA study showed up to 40% loss of lean body fat ?

When people hear "lean body fat loss," they all assume, "Ah, that 40% is muscle mass, " but that is incorrect information. Regarding lean body fat and the hypothesis I formulated at the time, I wondered, "What if fat were deposited in the liver and muscles ?" That was the point . That is interesting. When metabolic function declines, this phenomenon appears very characteristically. We now know that lean body mass measured by DEXA includes all soft tissues excluding bone and fat . Therefore, when measuring lean body mass , interstitial fluid, tendons, ligaments, and muscles must all be considered .

Muscle mass accounts for only about 25 to 40 percent of total lean body mass . However, this figure was exaggerated, causing everyone to get scared. Various research results have been released, and by synthesizing data from mouse experiments and humans, we can see that muscle mass does not decrease significantly. It is at a level comparable to that of a low-calorie diet or bariatric surgery . Excessive muscle loss does not occur. GLP-1 is not a mechanism that destroys muscle. Rather, it is highly likely to play a role in protecting muscles in various ways .

That is interesting. The same applies to bones. The decrease in bone density we observe is a phenomenon that occurs as muscle mass decreases due to weight loss. When muscle mass decreases, gravity weakens, and when gravity weakens, the downward pressure applied to the bones It decreases. Therefore, if weight is lost too quickly or muscle mass decreases too much, the tension or pressure applied to the bones decreases, causing bone density to start to decline. However, this is not a mechanism directly related to GLP-1 . I wanted to clarify this point .

In short, you are saying that the decrease in muscle mass and lean body mass is the same phenomenon that occurs when losing weight without strength training or sufficient protein intake . If you do not protect your muscles during the weight loss process, the same results occur. And the amount of loss is not excessive. GLP-1 does not attack muscles. There is no separate mechanism that destroys muscle. In other words, the reason for losing weight without exercise is related to protein intake. This applies to everyone losing weight in any way, whether through calorie restriction or other diets—unless you increase your protein intake and combine it with strength training .

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Visit rhonutrition.com and enter the Feynman code to receive a 20% discount on all products . Search for "hyman" on rhonutrition.com . I have many in my diet I pay attention to this. To maintain my health, I need to consume unprocessed, natural foods, which is why I like Sitopia's Clean Sea Food Boxes . They are delivered flash-frozen , tested for microplastics and mercury, and packed with a variety of seafood rich in bioavailable Omega-3s . You can enjoy the full nutritional benefits of seafood without worrying about the toxins unfortunately commonly found in the ocean these days .

My favorite is the Sitopia King Salmon, which is rich in bioavailable EPA and DHA, and there is a huge amount in one box. You can get more nutrients from just one meal than most people take in a week of supplements . Honestly, it tastes much better than pills. If you order your first box at sitopia.fish and use the code Hyman, you can receive free shipping . Before we begin, I would like to mention that today's conversation is about examining a perspective in the field of medicine that is still actively debated.

While discussing new evidence and criticisms of current psychiatric practice, treatment decisions, particularly regarding antidepressants or other prescription medications, are always... You must make a decision in consultation with your medical team. The guest's opinions are her own and reflect her interpretation of the available evidence. My purpose in conducting these conversations is to explore diverse perspectives, examine scientific evidence , and encourage thoughtful discussion , not to provide individual medical advice . Therefore, if you are currently taking medication, please do not stop or change your treatment based solely on this conversation .

Instead, please use this episode as an opportunity to start an informed conversation with your medical team . I hope that through these discussions, curiosity, critical thinking, and joint decision-making will be fostered between patients and medical professionals—specifically their doctors. Now, before wrapping up, if today's conversation on Lyme disease was helpful, please be sure to listen to the next interview with Dr. Richard Horowitz, one of the world's leading experts on Lyme disease . Beyond Lyme disease itself, he explores why so many people suffer from chronic illnesses .

We will examine his groundbreaking M-S-I-C framework for understanding chronic diseases, the biggest causes of chronic inflammation, and how the body actually heals We will find out what is needed. It will be released this Wednesday, so be sure to check it out. Here is a preview . If you enjoyed today's episode , do not miss the next interview with Lyme disease expert Dr. Richard Horowitz . We will explore why so many people suffer from chronic diseases and examine the hidden causes of chronic illness from a completely new perspective on inflammation, recovery, and healing .

It will be released this Wednesday , and until then, here is a preview of what will be covered. And one thing we have all realized throughout this journey is that we need you to defend us, who have been raising our voices for you and me . I do not know how long ago this began, but metabolic health is the key to everything. And these peptides improve overall metabolic health. When metabolic health improves, you can see various benefits in every aspect . Regardless of weight loss , truly amazing effects are appearing.

There is also a direct mechanism of action for GLP-1 . It acts on immune cells and on receptors throughout the body . It also exerts direct effects that are not yet fully understood. However, In short, when metabolic health improves, many diseases that people thought they had no choice but to live with suddenly disappear. The world is astonished by this fact, but I simply think, "Yes , this proves my lifelong research ." Cam, this is a really important message, so please double-click here for a moment .

I have a hypothesis, and I would like to hear your opinion. It is that if metabolic health is improved by any means, the same results can be obtained. In other words, I am not sure what kind of special, magical effect it has . GLP-1 has no significant effect other than providing a slight help to people improve their metabolic health. I believe that if people use food like medicine and are provided with lifestyle improvements through appropriate exercise and nutritional supplementation, they would see almost the same effect as GLP-1 .

Of course, I do not know if this is true, but it is my hypothesis . The reason I say this is because I have seen a study on bariatric surgery . It was a randomized controlled trial, but I am not sure exactly what the design was. I don't think the second group actually underwent surgery, but one group underwent bariatric surgery while having diabetes... One group received it , and the other group received the same dietary restrictions as after surgery . In other words, they were provided with the same food that bariatric surgery patients are supposed to eat .

However, there was absolutely no difference in terms of weight loss, metabolic indicators, or anything else . It was purely because of the food . To borrow Bill Clinton's words , "It's food, you fool." So, while I'm not sure how much it helps with weight loss, it certainly can be considered a kind of aid . It can be helpful for people struggling and can also help break the vicious cycle of addiction . This is because the vicious cycle of various metabolic problems is difficult to break .

But aside from weight loss, are there any particular advantages to these products? As you mentioned, if metabolic health improves, cardiovascular disease, dementia, hormonal health, immune health, inflammation levels, and the risk of diabetes all improve; it also improves mood, brain health, and mental illness . This is n't magic, is it? So, I would like to hear your thoughts . I do think so . Let me give you a few examples . First, these products act on immune cells. Immune cells There are receptors that act specifically on mast cells.

Therefore, I have witnessed these products acting on mast cells and showing significant improvement . Mast Cell Activation Syndrome. To explain for those listening , this syndrome is basically a condition where patients exhibit severe allergic reactions to everything and their histamine levels become extremely high. It is truly painful. These patients cannot take anything . However, my fellow doctors are using very small amounts of tircepate—only 1/100 or 1/50 of the initial dose . Administering such a tiny amount of tircepate suddenly stabilizes the patient's inflammation, allowing other treatments or procedures to begin .

Previously, symptoms actually worsened. These patients were very sensitive . Doctors frequently use very small doses of tircepate to stabilize the immune system in patients with Systemic Inflammatory Response Syndrome (SIRS), Lyme disease, and others . "I received thousands of messages over the past few years saying , 'I was able to stop taking antidepressants in just a few weeks .'" I also quit gambling. It was the content that..." Hmm, a research result just came out; I saw it this morning while getting ready . That's really amazing , Mark.

They compared people who took GLP-1 with alcoholics or other drug users, and it was reported that not only did they show significant improvement while taking GLP-1 ( research results on alcoholism and smoking cessation are also coming out, which we briefly mentioned last time) , but the effect lasted for about 30% to 40% , or even up to 39% . This means that the improvement effect was maintained even after stopping GLP-1 use. So, it seems like GLP-1 changes the brain structure in some way . It affects the dopamine pathway .

I'm not sure how good or bad the effect will be depending on the dosage, though . That is another research topic. Anyway, it seems like various mechanisms are at work. That is a truly amazing research result. There is something I really want to tell you. Many people have contacted me via DM . I believe I am in a truly special position. This is because hundreds of thousands of followers send me messages about this issue. I have hundreds of thousands of followers across various platforms, and many of them say that their eating disorders are disappearing .

These are patients with bulimia, anorexia, and compulsive anorexia. Whether it is a microdose or a dosage tailored to each individual, they say it actually completely eliminates anorexia . It does not cause anorexia. There are also a few cancer patients among them, and some are using it for cancer treatment . I think it is truly amazing and exciting that doctors, especially oncologists, are using and approving this for patients in conjunction with cancer treatment. Overall, they are seeing better results. Their quality of life is improving, their mood is better, and it doesn't completely suppress appetite.

It depends on the dosage, but it doesn't eliminate appetite entirely. Rather, I think it helps maintain appetite . So, I think this product is really good. In my opinion It seems to act on the brain in some way, producing a dual effect . I don't know exactly how it works, but it appears to offer unique benefits to brain functions related to addiction control, and it also seems to help with immunity. This immunity-boosting effect is really interesting, but perhaps we haven't fully understood yet exactly how this substance affects the immune system ?

We generally know that inflammation decreases when metabolism improves . Visceral fat is closely related to metabolic health , so is it simply due to inflammation , or is there another mechanism ? I'm not sure. However, I do know for sure that this substance acts on fat cells . I strongly recommended that the MCAS patients I know try microdosing. Please, let me know what is happening . "That's what I said. Everyone who played the jing on the microphone..." Why did I only realize this now? My life has completely changed.

He said that . And now they can endure the world . You can live like ordinary people in the world. I still control my diet , but drinking a glass of wine does n't completely ruin my life. It means being able to lead a normal life . You can also eat fermented foods again. The important thing is that you can eat fermented foods again . And this means that these people can eat the high-histamine foods they had to avoid again . Usually, these are the foods that bring us optimal health .

You consume these foods in small amounts, right? Yes, that is the case, or it may vary depending on the standard dosage . Another important point is that a study published last year revealed genetic differences among people. In other words, some people respond very differently to GLP-1 depending on their genes . Some people do n't react at all. That is why there are non-responsive people . Some people feel more nausea than others . So, I think this is exactly what I was trying to say in 2024 .

I think we are all... really different, and we need to consider various dosages . Some people do not respond to semaglutide, but tyrzepatide is effective and can completely change their lives. However, some people don't react at all . It really varies so much that I think the dosage still needs to be tailored to each individual . A small amount for one person might be the right amount for another . It depends on the situation . Dietary habits, overall metabolic health, and the amount of exercise also have an impact .

However, that does not mean this medicine replaces other treatments, but rather that it is used in conjunction . As you mentioned, improving lifestyle habits is also important. When I look at my patients, it seems many of them overlook this aspect . It starts with good intentions, but once GLP- 1 starts working… I think we could call this a kind of ultimate 'find out by tinkering' peptide. Because for some people, it relieves the inflammatory response so severely that they say, "Now I can eat gluten, digest carbohydrates, and do everything again!" It makes me feel that way.

However, ultimately, there is a concept called 'resistance' in medicine , which means developing resistance to drugs . yes that's right. Resistance to the drug develops very quickly . This peptide is known to be exactly that kind of thing . So, at some point, the problem reappears . So, this isn't a cure-all. You still need to improve your lifestyle habits , and if you continue to take it indiscriminately, it will eventually lose its effectiveness . However, I think this can be a tool that sustains life for people who maintain good lifestyle habits, as well as for those who do not.

I'm not sure . I think it has various meanings. Shall we talk about application fields? Hmm, it seems I went a little ahead, so let's go back for a moment . I would appreciate it if you could explain to those who do not know exactly what peptides are or how new drugs like GLP-1 work. Most people are unaware that peptides are substances normally produced in our bodies, but can be deficient for various reasons, such as taking statins . So, how do peptides actually work? GLP-1 is a peptide produced in our body.

It was first discovered in humans, but was later rediscovered in the venom of Gila monsters. I live in the highlands of the Sonoran Desert, so I have seen Gila monsters . It's pink and very pretty. Anyway, what they found was a Gila monster . It's not like lizards only need to eat a few times a year . So the research team isolated exendin-4 from lizard venom and found, "This was what allowed the lizard to go without eating ." He said that. GLP-1 is not like this.

Then, after studying humans, I thought, "Ah, humans have a similar mechanism." That's what I said . So, "Mark, have you heard about that? You know the rumor that oh, Gempick is extracted from lizard venom ." To those who say that, I have n't heard such things. I was completely unaware of all the nonsense floating around on the internet. I started blocking people who send such videos . I can't watch it. I can't bear to see it. Yes, I try not to pay attention to such noise and focus on the core .

It's about focusing on the mission. Our bodies produce hormones in the intestines and brain , and these hormones circulate throughout the body, performing various functions . And as far as we understand, we think we have just begun to understand these hormones, including leptin and ghrelin. It is still limited to a very basic understanding. However, this drug belongs to that class, and as I mentioned, it affects the intestines, brain, and appetite . It also acts on insulin to improve insulin signaling and helps insulin send signals at the appropriate time .

The drug itself is a peptide. Peptides are chains of amino acids. A peptide chain is a protein. Just like what we learned in 5th-grade biology . It has a very simple structure , but pharmaceutical companies have modified it to increase the half-life of this molecule— no, the amino acid chain, that is, the peptide . GLP-1, which is naturally produced in our bodies, is absorbed and eliminated very quickly, and this drug is eliminated from the body within 5 to 7 days . So I modified it slightly.

It isn't exactly the same as the biological components, but it has been slightly modified. It's quite similar. I think it is about 93% or 94% biocompatible . Semaglutide is pure GLP-1. Semaglutide is also called Ozempic and Mounjaro. Ah, oh, it was Zempik and Wegovy . yes . It is the same medicine, and it was made by the same pharmaceutical company . One is an FDA-approved weight loss drug , and the other is an FDA- approved treatment for type 2 diabetes . And tyrzepatide is a dual agent.

You use GLP-1 and GIP together. GIP performs various functions to help regulate blood sugar in our bodies , and it is known that GIP promotes fat oxidation and helps reduce fat accumulation . Tyr Zepatid is that very medicine, and there is also the letter Zepbound. Again, it is the same company and the same molecule, just that it received FDA approval twice. And there is a new drug , which is Retatrutide. Ah, wait a minute. It seems that the ratio of GLP-1 to GIP in Tyr Ze Patid is about 1:5 .

Based on my research, I might be slightly wrong, though. So people say, "Look at all the benefits shown in GLP-1 studies . Especially if you look at the research results on GLP-1 over the past few decades—not just the drug called tyrzepatide— tyrzepatide contains much less GLP-1 than GIP. The ratio is different. And Retatrutide is a triple agonist; since it also has glucagon activity, I thought it could help maintain muscle mass . Although it hasn't been clearly demonstrated by research results yet , it has been shown to have excellent weight loss effects and a significant impact on fatty liver .

That is a truly surprising result. However, Retatrutide contains very little GLP-1, and its main components are primarily GIP and glucagon. But it hasn't been released to the market yet, right ? Yes, it is currently undergoing Phase 3 clinical trials. I saw this morning that they are aiming for a launch around 2027. They are trying to classify this drug as a biological agent rather than a general classification . If that happens, it won't be available for dispensing, and they could drastically raise the price . But I [am] selling this drug on the black market..." I've seen people.

The black market is like a lawless zone . You can obtain it, but you can't tell what kind of drug it is, whether it was produced safely , if the dosage is effective , or if it contains contaminants . Let's talk about this part again later . Anyway, these things are really interesting. Hmm, I took a step back to think about it for a moment . People must have heard a lot about the side effects . I've done a lot of research on this issue recently, and the concept of weight loss and muscle loss seems plausible to me.

In fact, I had that thought myself. Regarding weight loss... if you don't do strength training or consume protein, muscle loss occurs. Another problem is weight regain. According to data from various studies, including the Step One clinical trial, people who lost a lot of weight regained two-thirds of what they had lost within a year of stopping. The cardiovascular improvement effects also returned to their original state . The same phenomenon appeared in Surmont 4, a clinical trial for the first administration of tyrosine . It is effective while taking it, but it seems that a kind of rebound effect occurs after stopping .

What are your thoughts on this ? Yes, entirely. I agree . A study published last November compared two groups: a group taking GLP-1 and a group improving their lifestyle . The lifestyle improvement group did not take GLP-1. Weight regain occurred in all groups, so I believe weight maintenance is a crucial factor. Oh, I mentioned this during my last appearance, and people got really angry at me. Actually, losing weight itself is relatively easy. What is much harder is maintaining the weight you lost . I think only about 5 to 10 percent of people who experience weight loss actually manage to maintain it .

Weight keeps coming back . Fat cells have a memory. And our bodies set a target weight and try to return to it. As you mentioned, when weight decreases—that is, when fat is lost—leptin levels also drop. Leptin and ghrelin regulate appetite, which is why maintaining weight becomes so difficult. Also, the weight set point becomes fixed depending on how long that weight is maintained. Yes, it is possible. That is why GLP-1 class drugs like tirazepatin and semaglutide actually caused faster weight rebound . The fact that newer incretin drugs caused faster weight rebound than older drugs implies that the more complex the peptide, the more dangerous it is.

The longer you take the medication, the faster your weight returns. The faster you lose weight, the faster the rate of regain. However, this is already a well- known fact regarding weight loss. It was the case even before GLP-1 was introduced. Therefore, I believe the best approach is to lose weight slowly, at low doses, and in the right way, and to use this opportunity to completely change your lifestyle and put everything necessary into practice . Doctors also seem to be aware of this point . Dose adjustment strategies are necessary, and some people may need to take the medication for the rest of their lives .

There will certainly be people who need to take the medication for life . On the other hand, there will be people who can stop taking it . Related research is not yet sufficient. Recently, research combining GLP-1 with strength training is underway. Still Although there are no proper research results, according to a study published by the same research team a few years ago, combining strength training with weight loss helps with weight gain . The weight loss effect lasts for quite a long time. It is truly amazing.

I have quite a few patients like that, too. They are people who really struggle with weight issues. After prescribing low-dose GLP-1 to them, I tell them, "You must exercise consistently, get DEXA tests every month, and consume sufficient protein ." I told you that. And they are actually doing that. What is really amazing is that while your weight decreases, your muscle mass actually increases and you lose more fat . For example, if you lose 4.5 kg of fat and gain 2.3 kg of muscle, the weight loss is only 2.3 kg, but your body composition changes completely .

It is really interesting that such results are possible even using this type of compound . However, what I am really struggling with is exactly this part. Are these drugs safe in the long term ? It's good that prices seem to be going down, but they are still expensive. In many cases, insurance does not cover it unless you are a diabetic patient . So it seems like we are in a gray area where we don't know exactly what happens when people take this drug for 10, 15, or 20 years.

Is it really necessary for people ? "If you want to maintain the metabolic improvement effects and avoid the rebound effect like most people, you must take GLP-1 . Before GLP-1 appeared, I was really worried about the overall metabolic health of our country and the negative impact we were having on the world. I think you probably felt the same way . Losing sleep at night, thinking, 'This is a disaster .'" Our society is completely metabolically ruined. "That's what I thought. So I wrote as many as 20 books on this topic .

Yes, that's right. We are in a really serious state. But with the onset of COVID-19, I thought, ' This is going to be absolute chaos .'" That is what I thought. Because COVID-19 had a particularly greater impact on people with metabolic problems . I think we are in a predicament . Because of all this, infertility rates are skyrocketing, but nobody wants to talk about that problem . We are not even properly replacing the population necessary for survival . There will be countries that disappear soon because population replacement is not properly carried out .

So, I'm not sure what the cause is . I don't know if it was due to toxicity , metabolic health , or a combination of all these factors, but we needed an escape, didn't we ? I think that is precisely the ability to take risks. Some people are heading down a path of certain destruction . They are already living miserable and proper lives, but it will eventually lead to ruin or premature death . However, many people are regaining their lives. I often share stories like this with people .

Now, consider this to be the level of risk tolerance . Even so, we will take every possible measure . It is unavoidable. We will have to work really hard . However, there is one tool that will make this process much easier and more efficient . I will leave the long-term risks to the patient. We don't know for sure yet. But we have been using liraglutide and exenatide for a long time , and it is certain that no one has died of cancer because of these drugs .

The data looks very good, doesn't it? The effect may vary depending on the dosage . The reason I like Gina's way of thinking is precisely because she pursues personalized treatment . Instead of a uniform dosage or an excessive physiological dose , we administer only what is necessary . I believe that side effects such as gastrointestinal side effects, gallbladder problems, pancreatitis, and diabetic retinopathy will also decrease. Sudden vision loss is quite frightening for people . Well, I think all of these things are due to nutritional deficiencies .

If you reduce the dosage and know how to take it properly, you can avoid many of these problems. Am I right? Yes, and if you make a consistent effort, you can maintain a low dosage It probably will . I believe that is the truth. If people become lazy, start drinking again, and eat out frequently, their weight loss will plateau, so they will have to increase their dosage. This is especially true if they genuinely want to lose weight. It is the same with everything else . I always make a promise to my patients.

We are embarking on a journey together. I am a cheerleader, not just someone who dispenses medication. We are trying to completely change the patient's life , and I believe we can succeed if patients understand this from the beginning. That is the key . It is impossible to say that you don't need to exercise while taking GLP-1 . You must get a prescription, and you must strictly follow it. Getting people to stick to the prescription is the difficult part. That is correct. It is a really hard job.

And you need to properly understand what kind of situation you will be in . You cannot start without preparation. You really need to prepare thoroughly . If you overdose, it is easy to suddenly lose your passion for life and fall into anhedonia, where you do nothing. According to research results on patients taking high doses , patients They say that activity levels decrease . That is probably the reason. You fall into a state of lethargy, and even a slight excess can become a major problem . That is why it is really important to work with a professional who can monitor you, encourage you to exercise, and provide the necessary resources .

That is a very important point. Most people take prescription medication, you know . As you mentioned, does that dosage dull people's range of emotional expression , dull their sense of joy, and cause numbness—that is, anhedonia ? I wonder if this is really a dosage issue or a problem with the drug itself . I think it is a dosage issue. Even a slight reduction in dosage causes sudden changes. In fact, I have seen cases where it plateaus at high doses , and I have heard other doctors say the same thing.

When it plateaus at high doses , if you reduce the dosage, weight starts to drop again . So, there is an optimal dosage. There is a truly specific optimal dosage for each person. I was talking to my best friend recently; he started with microdosing. To lose weight properly, he had to raise the dosage to a moderate level. And that is only natural. That's right. She's really doing everything , but she sent me a message saying, "I ate just a little." "That's what he said. So, I increased it a little from 7.5 mg to 8 mg .

Just a tiny bit. But suddenly, he lost all his energy . He said he couldn't think of anything, hated everything, didn't want to go anywhere , and did n't want to do anything. So I said, 'You took too much, and your soul is being crushed .'" It's like the medicine is crushing the soul . Reduce it a little. "That's what I said. But that does n't mean you should neglect exercise, maintain your physical condition, and cut back on wine a little. That is the reality. So, it means you can't control everything.

Ultimately, you have to put all the pieces together . Have there been any concerning issues we should be aware of in recent years ? And are there any new insights related to that ? Or do similar problems still remain? No, some very good data has come out recently, so let's talk about that. First, let's talk about NAION. Vision loss—yes, that's right. It's ocular stroke. It stands for Non-Arterial Anterior Ischemic Optic Neuropathy . I'll need to check my notes and reread the exact terminology . According to a study published in JAMA Ophthalmology in July 2026, the incidence rate was found to have increased by about 0.03 percentage points .

That's a very slight increase. What I wanted to emphasize in this study was that the majority of the subjects were people who already had diabetes. So when you and I did a podcast about this issue, I mentioned this when the issue first arose. As you are likely aware, but for the benefit of our listeners, people who have suffered from diabetes for a long time have a severely damaged entire vascular system . In such a state, if blood sugar is lowered too quickly with medication, or if it is lowered too quickly and too strongly—for instance, if the dosage is too high or strong—the blood vessels can spasm.

The blood vessels are unable to cope properly. The dosage must be increased gradually. You should not administer a high dose suddenly. Therefore, I believe this is a signal that warrants very careful observation. I am not dismissing those research results, but to reiterate, they merely serve as evidence supporting the point I have consistently emphasized: we must review individual medication plans, administer the necessary amounts cautiously and stepwise, and monitor the patient's condition. Since we do not want a situation where blood sugar drops rapidly , it is important to gradually restore the patient's condition to a normal and healthy state .

I mentioned the JAMA study published in 2024 , but it was actually published in 2023, and the results looked quite poor . However, upon closer analysis, that study [in] It presented a relative risk reduction rate rather than an absolute risk . In other words, it showed a relative risk reduction rate, not an absolute one . A similar phenomenon of figures changing and being exaggerated appeared in the 2021 intervention cases as well. In any case, if you look closely at that study, there were only two cases of pancreatitis among semaglutide users .

Two cases of pancreatitis occurred out of over 600 people , and we know that pancreatitis is a real risk that can occur . Also, 71 cases of pancreatitis occurred among approximately 4,000 patients, which is also a noteworthy result . However, a new study published in the Journal of Gastroenterology in 2025 was conducted more systematically, and no significant increase in pancreatitis, intestinal obstruction, or cholecystitis was found . While this is an interesting result, it does not mean that it does not occur at all; it simply means that it was not at a statistically significant level.

Therefore, to add to that , if you continue to consume high-fat foods while simultaneously experiencing extreme appetite suppression, causing you to stop eating or significantly increase your food intake... If you reduce your intake, gastric motility will decrease, and gallbladder function will also decline. It is highly likely that such individuals already have impaired gallbladder function and a high risk of pancreatitis. Most patients already have problems with various organs, including the bile ducts, stomach, and pancreas . Their bodies are already under stress . However, even if they reduce their food intake instead of eating a lot of high-fat, greasy foods, their bodies are still unable to process it properly .

Ultimately, this can lead to pancreatitis. Yes, as I said before, this is clearly a signal and worth paying attention to . You are seeing it, too . I have heard many stories from my followers who have experienced this, or from loved ones who have gone through it . Therefore, there is even more reason to do it right . There is a right way to do it and a wrong way to do it . One of the most powerful ways to improve your health is to cook at home yourself.

When you cook your own food, you can directly manage the quality of the ingredients , the oil used, the amount of sugar and processed foods, and even the cooking utensils . And the last part is much more important than people think. Many cooking utensils... over time Depending on the product, it features a chemical coating that can peel off, especially when cooking at high temperatures . That is precisely why I use Made In stainless steel cookware . It has no coating whatsoever, is made of high-quality stainless steel, and is designed to distribute heat evenly and allow for better temperature control, whether you are stir-frying vegetables, grilling fish, or cooking meat .

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Mitochondria are the energy generators of almost every cell in our body. However As we age, mitochondrial function begins to decline, and when cells lack energy, we begin to feel its effects. This is precisely why I became so interested in managing mitochondrial health . One of the tools I personally use is Timeline from Mitopure. Timeline contains Urolotin A, a unique postbiotic nutrient known to support mitophagy . Mitophagy is a natural cell regeneration process that helps maintain healthy mitochondria . Simply put, it aids in the body's mitochondria regeneration, allowing cells to produce energy more efficiently .

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I came to understand just how complex it is to deal with people who have metabolic health issues . Yes, I believe that if people follow my approach, they can reap most of the benefits in various aspects, such as functional medicine, improving gut health, understanding food as medicine, and resetting the metabolic system through a low glycemic index diet. I have accomplished all of this . I have seen cases where autoimmune diseases, dementia, diabetes, heart failure, and fatty liver were treated and improved . All of this is possible.

However, it requires considerable effort, and not everyone can do it. I believe these things will truly benefit humanity . The question is how we utilize them. Okay, that is all. Now, I would like to take a closer look at the differences between men and women taking these compounds , their effects on postmenopausal women, and their impact on fertility . Formerly known as Polycystic Ovary Syndrome (PCOS) There are serious infertility issues related to the disease, but there are also many other problems related to metabolic health. It is now called Metabolic Reproductive Syndrome instead of Polycystic Ovary Syndrome , and I really like this name.

This is because I have always argued that this is a metabolic issue, not an ovarian one . People often misunderstand this as a gynecological disease , but that is not actually the case . Anyway, what are your thoughts on these hormone-related facts and the phenomena observed in these cases ? I consider this a serious problem . One in seven couples is infertile, which is a really big issue . Fortunately, I am very glad that metabolic health is improving. Male testosterone levels are rising, and female reproductive capacity is also improving.

There are even groups on Facebook dedicated to the topic of "Manjaro Babies." There are people who get pregnant while taking GLP-1. Of course, opinions regarding safety are still divided . I think I saw a related policy report released a few weeks ago , but I don't remember exactly and have n't checked it again. The point is, among those who became pregnant while taking this medication The report stated that there were no reported cases of side effects, and the children were normal and healthy. Of course, since we cannot conduct studies on pregnant women, I cannot say for certain, but there is an increasing number of cases where people who were originally infertile or had underlying issues are conceiving and giving birth.

That is why I think this medication is really good. I believe it is particularly effective for conditions such as Polycystic Ovary Syndrome (PCOS) or Polycystic Ovary Syndrome (PMOS). However, what I have observed while treating several young female PMOS patients is that if they are in a state of androgen excess and are already experiencing hair loss or other related problems, it is crucial to administer GLP-1 agents slowly and cautiously. This is because GLP-1 can further exacerbate existing problems. For example , if GLP-1 is administered to patients with hypothyroidism , hormone deficiency, or hormonal imbalance, they may experience discomfort during the adaptation period .

However, ultimately, many patients experience improvements in their thyroid health and PMOS symptoms. To one young female patient I treated... I observed that hair loss worsened and androgen-related symptoms deteriorated after the administration of a small dose of semaglutide. She found it truly unbearable . It seemed she had no intention of continuing any further . Of course, there were tasks and basic work that needed to be done, but they did n't go well. I have seen cases like this a few times. So, what I want to say is, "I don't know why, but she simply could n't endure it." My hair has started falling out .

" There are people who receive messages like that. And there was a study—it was small in scale, and I don't remember clearly whether it was conducted on mice or humans—but the results showed that GLP-1 can slightly worsen symptoms of androgen excess. I do n't know if it is temporary or not, but I think it would be good for medical professionals and patients to be aware of it . Because some people struggle really hard at the beginning of treatment, asking, 'Why isn't it working for me?'" That is what they think.

Well, I do n't think it's suitable for everyone . However, overall , yes, I think it could be of great help in solving infertility problems . I think it is really effective, especially for middle-aged women . It is something I am going through right now . I suddenly started gaining belly fat , and people say, "It's because middle-aged women have less muscle mass due to menopause ." Everyone tries to blame that, but actually, it's not like my metabolism is slowing down . I entered menopause in the best physical condition of my life .

I was training hard to compete in my first kettlebell competition . I had muscle mass that was in the top 1% among women my age . Even though I was in really good health, abdominal and visceral fat started to develop. Not long ago, I had a very informative conversation with Kiran Krishnan, a microbiologist and gastroenterologist, and he mentioned that hormonal changes in middle age have a tremendous impact on the gut microbiome . It also has a significant impact on lipopolysaccharide levels; it is said that if these levels increase, fat cells expand and enlarge.

So, the biggest cause of this change is the intestines . The really interesting part is, now, try putting a generous amount of whipped cream on top. What is really surprising is that as you take increasingly higher doses of GLP-1, intestinal bacterial overgrowth (SIBO) worsens. It seems like many people come to the hospital with SIBO. SIBO occurs during the process of taking GLP-1 . I also experienced extreme stress, and even though I used micro-zing, my SIBO worsened. It's just like SIBO exploded. According to one study, the incidence of SIBO in GLP-1 users increased by as much as 45% .

I'm not sure if it had SIBO from the beginning, though. However, the irony is that SIBO increases LPS levels. LPS is a substance that causes obesity and type 2 diabetes. LPS is a toxin produced in the body and is a type of lipopolysaccharide (LPS). Intestinal bacteria are absorbed and cause inflammation. This inflammation causes insulin resistance, eventually leading to a vicious cycle of weight gain, diabetes, and the like . This mechanism is quite well known. That 's interesting. The possibility is that drugs used to treat obesity and type 2 diabetes may actually cause obesity and type 2 diabetes .

Therefore, I believe an integrated approach is essential . You need to treat your gut health . I have improved the metabolic diseases of many people through gut health treatment . It is really effective. 100%. So, Tana, shall we talk about the things to consider before starting GLP-1 therapy and the blood tests or metabolic markers to check before a prescription ? The first thing I noticed about GLP-1 therapy is that test results start to change before weight loss begins, or even when weight loss is not the goal .

In any case, administering a very small or minute amount can produce a significant effect. So I would like to verify these figures. I would like to check fasting serum insulin, glycated hemoglobin, reactive proteins, and inflammatory markers . Of course, blood tests and metabolic tests are also performed. We also check liver and kidney function from the beginning to ensure there are no abnormalities or problems. If malnutrition is a concern, nutrient supplementation will also be considered. Research results claiming that GLP- 1 can cause brain damage are circulating on the internet, but it is not actually brain damage.

These patients are at high risk of thiamine and vitamin B1 deficiency , and due to high-dose administration, they fall into malnutrition, which eventually leads to Wernicke's encephalopathy and suffer serious complications . There are many people with severe vitamin B1 deficiency problems . Therefore, people need to consume vitamins , check nutritional indicators and vitamin and mineral levels, and take multivitamins to supplement deficient nutrients. Of course, you must also check lipid and thyroid levels to ensure that everything is normal. I think it is important for middle-aged women and men to check their hormone levels .

I conduct comprehensive examinations on everyone . I fully agree with what you said. I believe that most people should take these tests , and that is precisely why I co-founded Function Health . Function Health enables people to receive in-depth blood tests covering all the items you mentioned, such as nutrition, hormones, thyroid, cardiovascular, metabolic indicators, kidney indicators, and fatty liver, at a very affordable price . Function Health offers these tests for just $1 a day . It is held twice a year. And I think it is important for them to track and monitor changes as they conduct the tests .

I think it is really important . Okay, now let's talk about new treatments and next-generation therapies . In addition, we will take a closer look at the microdosing framework . Pharmaceutical companies themselves seem to be aware that the dosages of existing drugs are too high , and they appear to want to provide the possibility to adjust the dosage through various formulations or vials or pens that allow for dosage adjustment . Could you tell me about the current situation, future prospects, and how I should think about dosage adjustment ?

There are many people who illegally purchase drugs online, through pharmacies, or via telemedicine, but this is highly likely to be unsafe . Therefore, could you explain what people should do when they do not want to take the full dose , and what they should think about microdosing ? Are you wondering what to do to find the right approach ? The dosage depends on individual genetic factors, all the things just mentioned, and the goal . What are the short-term goals , and what are the long-term goals ?

The microdosing method I first introduced was about one-fifth to one-tenth of the standard starting capacity. And bodybuilders are well aware of this concept, right ? Bodybuilders can be considered the original biohackers . They understand this concept . It is about finding the minimum effective dose required to bring about the change we want . For example, if your goal is not weight loss but to control inflammation or improve joint pain, psoriasis, psoriatic arthritis, eczema, acne, etc., the minimum effective dose is important. And I realized that the required amount varies completely from person to person .

You asked about men and women, and I think men need a higher dosage . Women... generally tend to be more sensitive, but it might simply be due to their weight. It could also be due to the overall physique . And hormonal status is also important. Although it was a small-scale study , a study comparing tyrzepatide and GLP- 1 showed better results in patients receiving HRT . The weight loss effect became more pronounced . There was also a small-scale study conducted a few years ago, which I think I mentioned last time.

Although it was a very small study , the weight loss effect of GLP-1 was better in patients receiving HRT. Therefore, I believe the patient's overall environment is very important. And let me make it clear that I never intended microdozing as a weight loss strategy . However, microdosing is being promoted for that purpose , and some companies are deceiving middle-aged women by claiming it is microdosing when in reality they are administering standard doses . It is simply that you start with the same dosage as general patients .

Patients with diabetes or obesity are sometimes advised to undergo microdosing when they first start , which is a type of introductory strategy. It is considered a kind of fraud, just like a drug dealer offering the first dose for free . In my comment, "I am doing the jing even with a microphone ." Some people refute this, but I say, " No, you are at the third stage compared to the standard dosage . It is not microdose." He answers as follows. Then the doctor said, "They told the patients, 'We followed Dr.

Tina's protocol. The dosage is 1/10.'" They said, "... " " And they tell you what the maximum dosage is. However, since they only administer one-tenth of that maximum dose, they conclude it is a microdose. In my opinion, this is truly unethical and feels like fraud. Yet, this kind of thing is rampant everywhere, and from what I have found out, telemedicine companies often operate in this manner. It is truly frustrating . Also, there is a study published in May 2026—I don't know if you saw it—that investigated 49 online telemedicine GLP-1 websites.

The number 49 itself is shocking . This phenomenon has worsened since the last episode; 17 companies sold prescription drugs, 5 companies sold only brand-name medications, and 27 companies sold both prescription and brand-name drugs. Two companies required blood tests , and one company refused to prescribe based on internal data indicating a history of prescriptions already being filled at another website . And one company issued a prescription but later canceled it." Because the patient's photo and the reported weight do not match. Well, basically, 39% were asked about their weight loss goals.

I'm sorry , 39 out of 49 people were asked about their weight loss goals . And it continued like this. I don't think they selected these people properly. And only 13 people needed video consultations, and only 3 people needed phone consultations . So basically, filling out the form and receiving the GLP-1 test strip is all there is to it, and they are n't conducting a proper test. Not all telemedicine companies are like this . There are also really good companies . But yes, this is a really scary thing.

And as you mentioned, another option is the gray market, but I think that's completely insane . I don't know what to say. There are too many analysis results coming out, but I cannot provide an opinion because there is nothing in the bottle , there are contaminants, or LPS is being detected . That's right, it is a really worrying matter . Well, but the interesting thing is that Eli Lilly and Novo Nordisk have released vials . I don't know if you know this, but the week Eli Lilly launched the Jeff-Bound Vial, my Instagram account with 232,000 followers was suspended.

I think the content I was talking about was the problem. Really? Yes, but it might just be a coincidence . Anyway, those companies launched vials, and thanks to these vials, it seems that personalized administration has become possible . From what I heard from my colleagues, everyone uses it like this . It is used in various capacities, from microdosing and standard to half capacity. If the doctor prescribes this medicine from the pharmaceutical company in a vial , you can administer a low dose directly using a syringe .

So, it's not an automatic syringe. That's how it is, right ? Yes, so that means personalized administration is possible. So that people can use it easily . A related paper was published recently. A paper on GLP-1 microdosing was published in a diabetes journal in 2025 or late 2024 , but it was not a research paper but was published in the form of an opinion paper . That paper discussed personalized onboarding, but it approached it in a different way than the microdosing I envision . It is used to gradually increase the dose to an appropriate level for the patient , and if necessary, it can be started at a lower dose .

An Italian research team reported achieving significant success with personalized dosing . It seems that doctors also understand this point . It seems we are realizing that individual strategies tailored to each person are necessary because we all have different body types and physical conditions . Recently in the US, Mounjaro released not only a regular automatic pen but also a click-type pen , and this pen has adjustable capacity. A detailed chart for this pen is included in a diabetes journal article, and I understand that it is also available in Europe.

This is a method of adjusting the dosage based on the number of clicks . This is called the click pen method. There are many more options now than when we talked last time, and the prices have dropped significantly. The good news is that you can purchase it from a legitimate pharmaceutical company . You can purchase it at a lower price . Actually, it seems that medicines manufactured by pharmaceutical companies are more expensive than products sold in other markets, doesn't it? In my opinion, it depends on the situation .

The dispensing situation for GLP-1 preparations is currently so complicated that prices vary widely, and some companies, including telemedicine companies, are overcharging patients . So I don't think so . It seems Medicare recently launched a program that allows you to purchase it for $50 . If you purchase Jeff Bound vials through Lilly Direct, the price is significantly cheaper. It would depend on the dosage, though . Hmm, I'm not sure . However, some of the clients I work with are taking Jeff Bound with a doctor's prescription , and it seems to be more effective for weight loss than the medicine they prepared themselves .

Another method worth considering when weight loss plateaus is changing the injection site. Many people feel comfortable always injecting in the same spot . Places like the outer buttocks, thighs, stomach, and forearms . My friend told me this story recently: "I switched the injection sites and lost weight rapidly, which allowed me to reduce the dosage that had been difficult to manage ." That's what they said. Yes, there really are a wide variety of examples . We are also learning, and we are glad to be able to have such a beneficial conversation.

It is great that we can also share educational content so that patients can obtain the information they need . One of the things I always tell my patients is that our bodies are n't broken . It is just that it is not getting what it needs to function properly . That is exactly the core of functional medicine . It's not just about chasing after symptoms, but asking what is needed for the fundamental body system to function properly . One of the tools I consistently utilize in my daily life is sunlight and saunas .

I believe infrared therapy is one of the most underrated methods for recovery . My intentional use of the word 'induced' is in the same context as when discussing sleep and nutrition. It is not a luxury, but a condition our bodies can utilize. Sunlighten ’s differentiating factor is its Pulse IQ technology . This technology delivers red light, near- infrared, mid-infrared, and far- infrared wavelengths independently . Therefore, rather than simply heat mixed with various wavelengths, you can receive personalized, intensive care . If you are already paying attention to your diet and exercise, this infrared therapy is exactly what many people are missing.

Visit sunlighten.com and enter the code Hyman to receive up to $2,100 in discounts and free shipping . Have you ever experienced lying in bed exhausted, yet unable to fall asleep comfortably ? That feeling of having a cluttered mind, stiff muscles, and an inability to fully relax? These symptoms are often It stems from a deficiency in magnesium, an essential nutrient . Magnesium plays a crucial role in sleep, recovery, and stress management. It is vital for body regulation and muscle function . However, many people do not consume enough magnesium.

That is why I have been recommending BiOptimizers' Magnesium Breakthrough for years. Recently, BiOptimizers launched Magnesium Breakthrough Advanced 10, which contains 10 bioavailable forms of magnesium and an even richer amount of pure magnesium . This product helps with sleep, muscle recovery, and metabolic health. I make sure to include this product in my evening routine, especially during travel, training, and stressful times . You can receive a 15% discount by visiting bioptimizers.com/hyman and entering the code Hyman. It is a truly excellent product . Of course, magnesium continues to evolve, but I believe it is important for people to consult with experts who understand how to utilize these products in conjunction with their lifestyle habits.

It is essential to undergo accurate diagnostic testing beforehand to understand your metabolism, nutritional status, and hormonal health , It is important to consistently monitor DEXA scans, bone density, muscle mass, and other metrics . Otherwise, it is difficult to see sufficient effects with Magnesium Breakthrough alone . It is a truly dangerous path . I agree. Finally, I would like to ask you a few quick questions . Is that okay ? Yes, I am ready. Now, you just mentioned alcohol; you stated that it can help suppress cravings or addiction.

What is the relationship between alcohol and GLP-1 ? Is it okay to drink? Or should one not drink? How does it work? I believe it is best to quit drinking. Really. If gastric emptying slows down, alcohol stays in the stomach longer . As a result, the amount you usually drink differs from the amount you thought you could handle . Even someone who thought they could drive after a drink or two will no longer be able to do so . Furthermore, alcohol is also a poison. It damages mitochondria, and mitochondrial damage is one of the reasons why weight loss is difficult.

So, it is a contradiction. Weight loss If that is the goal, alcohol actually has a counterproductive effect. Do not take it with alcohol. Please look for another medication. Understood. Then, what are the common mistakes people make when using GLP-1 agents ? As we discussed, using GLP-1 as monotherapy . For example, taking it with Ozempic or other drugs . No, no, no, no, no. "That's what I should be saying." That is just one of the comprehensive treatments , and you must use all methods . Do you know what people misunderstand most about this medicine?

It means consuming muscle and bone. It's not true. Of course, if you don't exercise, you'll lose muscle and bone, but isn't that the same for any weight loss method ? are you okay. What should everyone know before taking this medicine? As you just mentioned, you need to consult with a reputable doctor who knows how to provide proper treatment . I mean a doctor who understands integrative functional medicine and formulates a comprehensive treatment plan . I think that is the key . Of course, not everyone can meet such a doctor, but at least go to the gym and exercise, and eat nutritious food.

Start from there. And who shouldn't take GLP-1 drugs ? I'm really worried. I currently live north of Scottsdale , and when I look at weight loss clinics, I see them treating older people who aren't even overweight. Actually, these are people who have absolutely no reason to lose weight. " It's the weight issue. As you age, being slightly overweight can actually have a protective effect. However, these women are taking GLP-1 because they are worried about being fat. My friend's grandmother fell, fainted, and was hospitalized after coming very close to fracturing her hip .

If you don't exercise regularly or maintain your muscles, your body is already prone to weakening , so taking GLP-1 on top of that makes it truly dangerous. I think this is absolutely insane and unethical. So, you are saying that even elderly people who are not obese need to be careful . And young women who are not obese should also be careful about taking it for appearance or weight loss . GLP-1 is not a drug for looks. I agree that people can cause problems. Hmm , is there a specific test that you wish doctors would pay more attention to regarding this issue ?

Hmm, serum insulin. Oh my, I knew it. Ah, I remember getting scolded by my colleagues for that . They..." "Why do they test everyone's serum insulin?" Do you think everyone has metabolic problems ? "He asked. I replied, "Yes, that is correct." That is why we are in this situation . "That's what I answered . It's really terrible. I've been getting insulin tests for 30 years , and while talking to the lab staff at our functional health partner, Quest, I asked, ' What percentage of the tests you receive includes an insulin test?'" " he asked.

Then he replied, "It is less than 1%." "I answered that. I said, 'No.'" "I said that . And then I spoke with the Dean of Alice Walton Medical College in Bentonville, Arkansas , who is an Indian-American doctor and also a fan of mine . While listening to my podcast, he said, ' You... "He said that. He is an OB- GYN and an oncologist , and he is the Dean of the Medical School, you know . She went to see her attending physician and asked, ' Could you prescribe some insulin?'" "I asked.

The doctor said, 'No, it's not necessary.'" "...she answered . Then she said, "But I realized that this is a problem for me." " he said. It was truly surprising that no one cares about such a simple, inexpensive, and easy test . If there is just one thing you need to remember from this podcast , it is that you must lower your insulin levels to below 10 , ideally below 5. And we are going to help you achieve that very goal . Yes. Hmm, what was the most surprising thing that happened to patients using these drugs, which have absolutely nothing to do with weight loss ?

Ah, well, addiction issues. It also reminds me of the eating disorders I mentioned . To give you an example from my own case , I was taking a small dose of tyrzepartide and wearing a continuous glucose monitor (CGM). My blood sugar was always dangerously low. You know how sometimes the device goes off an alarm because the blood sugar drops so low? But when I took GLP-1, my blood sugar returned to the normal range . Isn't that right? I heard that story too, and I asked many people, and they said they had similar experiences .

So, it has an almost paradoxical effect . Yes, that is correct. And Side effects like addiction or eating disorders are unexpected. Yes, that is a good point. It is an important aspect. Is there something that people easily overlook while taking these drugs but absolutely must pay attention to ? It is muscle, especially lower body muscles. If you are going to take GLP-1, you must also combine it with weight training . Women, in particular, must do lower body exercises because they need to protect their bones and muscles as they age .

The lower body is the body's largest energy consumer. It is the most effective workout. Everyone is completely obsessed with Demi Moore's arms, but ca n't I just build a dump truck? I need to build a butt. After all, the butt is what will prevent hip fractures . You have to push to the limit and progressively overload . So, you need to find someone to train you like that. I always talk about this on my social media and podcast, but it is really important. Right. Right. Right.

I did that this morning too . My butt hurts. Good. Hmm, what is it that people on the internet are completely wrong about GLP-1? Do you know? It means they make it with snake venom . That all prescription drugs contain snake venom . Doctors and chiropractors say the same thing—and since I am a chiropractor myself, I do n't mean to criticize—but I’ve heard that all prescription drugs contain snake venom . Okay, then, is there anything you would like to change about the current way medication is prescribed ?

Well, I think the current situation is like a lawless free-for-all. I hate to say this, but as a libertarian, I believe people should be able to obtain medicine without much difficulty, but right now, the situation seems like a complete mess because of the black market and telemedicine companies . Furthermore, the very concept of microdosing that I envisioned has been distorted and has been reduced to a mere means for weight loss. That was n't the original intention of microdosing, you know. That is exactly what the situation is like now.

So, I think the current situation is completely wrong . But Mr. Delson, you said that microdosing helps with weight loss, didn't you? And that is when taking only half the dose . What I mean is, for someone with an optimized metabolism, even half the dose [causes] inflammation due It can alleviate symptoms such as swelling or weight gain (10 to 15 pounds) caused by insulin resistance during menopause in middle-aged women . I believe it can be helpful, but for a typical middle-aged woman seeking weight loss with a small dose, it would be appropriate to consider the standard dose, half dose, or about three-quarters of the standard dose .

I am not talking about taking extremely small amounts. There are elderly people who take very low doses due to joint pain, but that is a completely different case. What is the biggest unknown area we are trying to find answers to? As you mentioned, what changes will occur in 20 years? That is what worries me. I think drugs like Quad will come out. There are five different agents, and in addition to the four agents, more sophisticated drugs are constantly being developed . However, there are many cases where people who have taken the maximum dose are still obese .

They may not have taken all measures, or they may have taken them all. I am not trying to judge, but the effects peaked, but they started gaining weight again and are now looking for the next drug . So. I think that in the future, many people, including us, will end up living lives dependent on medication, wandering in search of the next drug. Honestly, it is a scary thought. I agree. It feels like a lawless free-for-all. There is a famous quote from the New England Journal of Medicine that I always mention: you must use a new drug as soon as it is released, before side effects appear.

That is because there aren't enough drugs yet . Now, on the positive side, what is the most interesting GLP-1 related research right now ? It is cancer. The results of two recently published studies are truly encouraging . They show that GLP-1 has a potential effect in preventing breast cancer . Of course, it is a correlation, not a causal relationship. Although they are observational studies. However, as you mentioned, if you optimize metabolic health , as far as I remember… what was it… The year I got my medical license was 2008, and the Susan G.

Komen Breast Cancer Awareness Marathon was being held in downtown Portland. There were cute women wearing pink t-shirts and with quite big bellies walking around carrying Voodoo Donut boxes and a huge Starbucks I was drinking a Frappuccino . I was gathered in a room with naturopathic experts at a conference, looking out the window , when suddenly I thought, 'This isn't right. This is exactly the cause of breast cancer . It's because of metabolic health.' That thought crossed my mind. So, while I am looking forward to seeing how the results of this study turn out, I realized that ultimately, we must treat the root cause .

It is truly amazing. Tina, thank you for pinpointing the core issues in the complex fields of weight loss , metabolic health, and GLP-1, and for explaining this topic so clearly. GLP-1 is a truly important cutting-edge medical technology, but it also carries some risks . Therefore, using it properly is very important. I hope those listening to this broadcast find the right methods . Tina, where can people find information if they want to know more about your research and your thoughts on all of this ? Yes, thank you again for inviting me .

It was great to be able to talk like this. My goal is to share information one-on-one and communicate doctor to doctor. That is why I am planning to launch a community, and I am really looking forward to it . There, you can communicate directly with me and get answers to your questions . It is a community for middle-aged women, and its name is ' The Menopause Rebellion .' The address is I am school.skoo.com/doctor.tyna. I also host the podcast 'The Dr. Tyna Show'. Wherever you can find me, it is drtyna.com.

My website address is also drtyna.com. Great. Thank you. Thank you so much for helping me understand such a complex and difficult field. It was a pleasure being invited . If you enjoyed the last video, I am sure you will like the next one . Check it out here .

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