Semaglutide

Semaglutide

Semaglutide

Semaglutide is a drug that’s used to treat both type 2 diabetes and obesity. 

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Description

Does Semaglutide Work for Diabetes?

Semaglutide is primarily a diabetes drug, and is approved by the Food and Drug Administration (FDA) for this purpose. The drug has been studied for its efficacy at lowering blood sugar in hundreds of medical trials as we highlighted in our recent Ozempic review article.

meta-review published in the Diabetes, Obesity and Metabolism journal analyzed data from 7 clinical trials on semaglutide and type 2 diabetes. The researchers found that the drug reduced HbA1c levels (a marker of blood sugar) by 1.01% and 1.38% at relatively low doses.

A separate clinical trialpublished in 2018 found that semaglutide reduced the blood sugar spike after a meal high in dietary fats consumed by obese patients.

An extremely thorough medical review published in the well-respected Drugs journal cited 96 individual medical studies and found that the average range of treatment effect for semaglutide compared to placebo for blood sugar reduction was -0.4% to -1.6%.

We can conclude from the available medical research that semaglutide is effective for treating type 2 diabetes, although its effect on blood sugar appears to be relatively modest.

Does Semaglutide Work for Weight Loss?

This drug is approved for weight loss in both diabetic and non-diabetic patients.

Semaglutide is typically prescribed at a higher dose for weight loss than for type 2 diabetes. The injectable weekly dose used for weight loss is 2.4 milligrams (mg) while the injectable weekly dose used for diabetes ranges between 0.5 and 2 mg.

A clinical trial on injectable semaglutide’s weight loss effect was published in the New England Journal of Medicine in 2021. The aim of the trial was to assess whether the injections could help overweight and obese patients lose weight.

Half of the trial participants received semaglutide injections and the other half received a placebo injection. Both groups also made healthy lifestyle changes like reducing their overall calories consumed.

The semaglutide group lost significantly more weight than the group receiving placebo injections. The average body weight loss in semaglutide patients was 14.9%, while the average body weight loss in placebo patients was only 2.4%. This equates to a weight loss of 37.25 pounds for a patient with a baseline weight of 250 pounds.

How Does Semaglutide Work?

Semaglutide is in a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1RA). These compounds help normalize glucose levels by activating GLP-1 receptors in the pancreas which causes insulin release.

According to a medical review, GLP-1RA medications may also block the release of a hormone called glucagon which is commonly elevated in type 2 diabetics. Glucagon causes the body to increase blood sugar levels, so the combination of limiting this hormone and increasing insulin combine to be effective for blood sugar reduction.

In regard to weight loss, semaglutide may be effective because it reduces hunger and increases the sense of fullness. The medication delays gastric emptying which causes patients to feel full longer.

Semaglutide Dosage

The weekly dosage of injectable semaglutide ranges from 0.25 mg to 2.4 mg, according to the FDA label linked earlier in this article.

According to the Rybelsus FDA label, oral semaglutide is available at doses of 3 mg, 7 mg and 14 mg.

Doctors will typically prescribe a medication like semaglutide on the lower range of the dosage scale to see how a patient reacts. If the medication is effective, they can remain at a lower dosage which may confer a lower risk of side effects. If the patient is unresponsive, dosage will typically have to be titrated up over time.

Semaglutide Side Effects

The side effects of semaglutide and their severity will likely depend on whether a patient uses an oral or injectable form of the drug.

The FDA label for both forms of semaglutide contains a “black box” warning indicating increased risk of thyroid tumors in some patients. This is the most severe type of warning issued by the FDA, and is used to reference side effects which may be severe or life-threatening.

The studies suggesting potentially increased tumor risk were animal studies, not human studies, but we would still strongly recommend that patients speak with their doctor about this side effect before using the drug. It may be advisable for patients with a personal or family history of thyroid disorders to choose a different medication, but only a doctor can advise such.

Thyroid tumors are a rare potential side effect of semaglutide. The more common side effects are milder.

medical review on the safety of semaglutide documented the following side effect rates: nausea occurred in upwards of 20% of patients, vomiting occurred in a range of 4% to 11.5% of patients, and diarrhea occurred in 4.5% to 11.3% of patients. Older patients experienced more side effects.

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    Semaglutide is effective for treating both type 2 diabetes and obesity.

    Its clinical trial results for treating obesity are more impressive in our opinion than the diabetes results. 

    Semaglutide User Reviews

    What a miracle! 9 months later and I’m down 40 lbs, my a1c dropped from 8.1 to 5.6, and I have virtually no symptoms from the drug other than fullness. The symptoms in the beginning did not last long either.

    Zell

    6 months. -65 pounds. Hypertension gone. Pre Diabetes gone. Sleep apnea gone. Lower leg skin breakdown gone.

    Philly

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    B12 Methylcobalamin Injection

    B12 Methylcobalamin Injection

    Methylcobalamin –

    B12 Injections

    Increase energy levels & reap multiple health benefits with a naturally-occurring form of vitamin B—all at a fraction of the cost of infusions.

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    Description

    B12 INJECTION BENEFITS

    Do More, Age Less

     Effective in fighting fatigue & enhancing natural energy

    Encourages higher quality sleep

      Improves cognitive function

      Helps regulate mood

      Promotes healthy skin & nails

      Boosts metabolic function

      Shown to help prevent cardiovascular disease

    Strengthens bone density & overall skeletal health

    Background & History
    • B12 is an essential vitamin the body needs but cannot produce
    • First accounts of B12 supplementation date back to 1849
    • Up to 15% of Americans are deficient in B12
    • Nutrient deficiencies & gut-related health issues increase likelihood of B12 deficiency
    • Contains methylcobalamin B12, a naturally-occurring form (unlike cyanocobalamin) vital to central nervous system function
    • Intramuscular injection delivers B12 directly into the bloodstream, unlike other methods (e.g. pills)

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    Important safety information & common side effects

    The most common side effect of B12 injections is irritation at the injection site. If this occurs, consider changing placement on the body or use injections less often.

    For a complete list of possible side effects, click here.

    Do not use B12 injections if you are currently pregnant, breastfeeding or plan to become pregnant or breastfeed.

    Note: The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

    FAQs

    Why should I choose an injection over an OTC supplement?

    Injections have better bioavailability than oral supplements as they bypass the digestive system completely, providing a direct supply of B12 into the bloodstream to fuel your body. Oral supplements might work for some, however, as we age, our ability to break down oral supplements often decreases.

    How much B12 is administered per injection?

    The solution contains 1000mcg of B12 per mL/cc.

    How often do I administer the injections?

    Start by injecting 1ml/cc 1-2 times per week. If desired, you can slowly increase up to 2ml/cc 1-2 times per week, or as prescribed. Should you ramp up to 2ml/cc, contact our team to adjust your ongoing Rx.

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    LDN

    LDN

    LDN

    LDN – Low Dose Naltrexone

    Low Dose Naltrexone, commonly referred to as LDN, is as its name would suggest: a low dose of naltrexone

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    Description

    Background & History

    Naltrexone (at higher dosages) has been FDA approved for over 30 years. It is FDA approved for two conditions:

      It is FDA-approved to assist with substance dependence at a standard dose of 50-150mg
      It is FDA-approved for weight loss in combination with Bupropion, at a dose of 32mg

      Naltrexone is an oral medicine thatat high doseshelps control cravings for opioids and alcohol; it also helps to diminish withdrawals due to these substances

      Low Dose Naltrexone (LDN) refers to prescribed doses below 10mg per day (4.5mg/daily is most common)

      At low doses of 10mg per day or less, LDN is shown to reduce chronic inflammation, autoimmunity, obesity, fatigue, and chronic pain

      Used successfully for over 40 years with an outstanding safety record

      Hundreds of clinical studies show LDN to be a safe and effective treatment for many inflammatory-related diseases

    Longevity Benefits
      • Lowers ESR (erythrocyte sedimentation rate), a marker of inflammation in the body
      • Increases natural endorphin levels
      • Strong clinical evidence in reducing chronic pain
      • Reduces fatigue and brain fog
      • May improve overall mood and feeling of well-being
      • May reduce food cravings
      • Encourages weight loss in some patients
      • Reduces chance of autoimmunity
      • Modulates the immune system

    Note: LDN has not been approved by FDA for these uses, but there are multiple studies that have shown these benefits (see below). Learn more about “off label” uses.

    What symptoms is LDN most likely to help with?

    LDN is known to help with variety of chronic inflammation related / auto-immune conditions, such as:

    • Fibromyalgia
    • Rheumatoid arthritis
    • Thyroid Dysregulation
    • Anxiety
    • Multiple Sclerosis
    • Crohn’s and Ulcerative Colitis
    Why does LDN have potential benefits for a variety of symptoms?

    There are several theories for why LDN is effective:

    • LDN lowers chronic inflammation
    • LDN stimulates the body to naturally produce more endogenous opioids, which has variety of positive benefits (including beneficial effect on the immune system)
    • LDN increases production of endorphins 2x
    LDN and Longevity

    Based on the mechanisms of action and previous research, we hypothesize that Low Dose Naltrexone lowers chronic inflammation and modulates the immune system, which may prevent the onset of various chronic conditions and may delay the development of age-related health issues. Given that LDN may promote immune cell proliferation, wound healing, and reduce inflammation, it’s highly likely that LDN will be shown to have longevity benefits.

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    What clinicians have more recently discovered is that at much lower doses (1/10th), LDN has completely different effects.

    Low Dose Naltrexone was shown to have remarkable benefits in the clinical setting as well as in clinical trials. So much so, that:

    LDN has an outstanding safety record (even at the approved large doses, let alone at 1/10th of the dose).

    Research & Studies

    Cancer Risk

    A case report and discussion published in Cureus: “Clinical trials have proposed a unique mechanism(s) allowing LDN to affect tumors including non-small cell lung cancer (NSCLC) at the cellular level by augmenting the immune system.”

    A mouse study in Science Direct showed “Low-dose naltrexone inhibits colorectal cancer progression and promotes apoptosis…”

    ​A review article in International Immunopharmacology concludes “Methionine enkephalin (MENK), was reported to modulate cell growth, MENK was identified as an opioid growth factor (OGF) that interacts with the OGF receptor (OGFr) and regulates cell proliferation…LDN increases production of MENK.”

      Multiple Sclerosis

    A retrospective study published in the Journal of Clinical Psychopharmacology evaluates links between LDN and quality of life in 215 MS patients “77% of patients had no side effects at any time under LDN…60% of patients reported less fatigue while taking LDN…Three quarters of patients endorsed an improvement in quality of life.”

      Fibromyalgia

    Two prospective pilot studies found that “naltrexone is a well-tolerated and likely effective treatment option in the community setting [and] may be an effective, safe, and inexpensive treatment for fibromyalgia.”

    A cohort study showed additional support “Low-dose naltrexone reduced fibromyalgia symptoms in the entire cohort, with a greater than 30% reduction of symptoms over placebo.”

    A randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels observed a significantly greater reduction of baseline pain in those taking low-dose naltrexone than in those taking placebo.

      Crohn’s and Ulcerative Colitis

    A study of Crohn’s Disease patients published in the American Journal of Gastroenterology showed that after 4 weeks on 4.5mg LDN, 81% of patients exhibited a response to therapy and 67% achieved a remission (P < 0.001). Improvement was recorded in both quality of life surveys with LDN compared with baseline. No laboratory abnormalities were noted. The most common side effect was sleep disturbances, occurring in seven patients.

      Inflammation

    A 10-week crossover trial published in Biomedicines discovered “that LDN was associated with reduced plasma concentrations of pro-inflammatory interleukin cytokines, as well as transforming growth factor (TGF)-α, TGF-β, tumor necrosis factor (TNF)-α, and granulocyte-colony stimulating factor (G-CSF).”

    Clinical Rheumatology published a review of multiple studies stating their findings that naltrexone “reduces the production of reactive oxygen species and other potentially neuroexcitatory and neurotoxic chemicals…and reduces ESR (erythrocyte sedimentation rate) a common marker of inflammation.”

      Weight Loss

    A study on hyperandrogenic women found “that using Naltrexone actually helped to lower fasting insulin levels by up to 40%.”

    ​Another study of obese women showed that “Naltrexone may help to increase Growth hormone levels” which in turn helps develop lean body mass and increase ability to burn fat.

    ​Naltrexone in combination with Buproprion “is more effective in inducing weight loss than Bupropion alone.”

    Fertility

    A study of women with ovarian failure “who were treated with LDN resulted in a 74% pregnancy and live birth rate.”

    How It Works

    LDN Works on a Cellular Level to Increase Longevity

    Endorphins are polypeptides made by the pituitary gland and central nervous system to moderate the production of neurotransmitters, such as serotonin and dopamine. Endorphins primarily help us to reduce pain and inflammation, promote autophagy, and cellular clean up.

    In individuals with diagnoses such as depression, fibromyalgia, cognitive degeneration, and autoimmunity, consistent findings show chronically low levels of endorphins—specifically, low levels of an endorphin called the Opioid Growth Factor (OGF). OGF is an endorphin produced in most cells in the body to both influence and regulate cell growth, as well as immunity. When low levels of OGF endorphins exist, it is likely for individuals to develop immune system disorders. Low Dose Naltrexone (LDN) has been shown to increase OGF levels in the body, resulting in positive outcomes for those suffering from the aforementioned diagnoses.

    How Does it Work?

    LDN first binds to opioid receptors. In doing so, it helps to displace the body’s naturally-produced OGF. As LDN displaces OGF receptors, affected cells become OGF-deficient and, as a result, three vital processes occur:

    1. Receptor production is increased to try to capture more OGF
    2. Receptor sensitivity is increased to capture more OGF
    3. Production of OGF is increased to compensate for the perceived shortage of OGF

    Since LDN will only block OGF receptors for three to five hours, the body experiences a rebound effect—which greatly increases the production and utilization of OGF. Once the LDN has fallen off the OGF receptors and excreted, the increased number of endorphins bind to the now more-sensitive and more-plentiful receptors. As a result, these new and improved receptors assist in regulating cell growth— promoting healing, reducing inflammation, and increasing immunity and autophagy.

    https://weillcornell.org/news/what-you-need-to-know-about-low-dose-naltrexone 

    Their work with the drug, Naltrexone, is an outgrowth of an international partnership with the UK-based LDN Research Trust Charity. According to The Trust, Naltrexone is safe, non-toxic, and inexpensive, and has been used in the United States since the FDA first approved it in 1984.

    Ageless VIDEO – https://www.youtube.com/watch?v=Q9tIaHGRc24

    Most Common LDN Side Effects
    • Vivid dreams
    • Mild anxiety
    • Insomnia
    • Headache

    During the first three to five days of taking LDN, you may experience mild to moderate levels of the above side effects. Side effects typically diminish on their own by day five. To reduce the risk of side effects, the recommended protocol is to start with a ½ tab (2.25mg) for the first two weeks with a gradual increase to the 4.5mg dose.

    Note: Please stop taking any dosage of Naltrexone a minimum of 48 hours before any surgical procedure or medical diagnostic requiring sedation, such as surgery or a colonoscopy. If you are not sure if you need to stop Naltrexone, please ask your doctor ordering the test or procedure. Additionally, Naltrexone cannot be taken in conjunction with opioids/painkillers. If you need to stop taking Naltrexone for a surgery, and accompanying pain killers are prescribed, you may resume LDN only 48 hours after you take your last painkiller.

    For a full list of possible side effects, click here​.

    Note: The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

     

    Possible Drug Interactions

    Tell your doctor and pharmacist if you are allergic to naltrexone, any of the ingredients of LDN tablets, as well as any other medications. Ask your pharmacist or check the manufacturer’s patient information for a list of the ingredients.

    Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: amiloride (Midamor); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); beta-blockers such as atenolol (Tenormin), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, InnoPran); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Cartia, Diltzac, others), felodipine, isradipine, nicardipine (Cardene), nifedipine (Adalat, Afeditab CR, Procardia), nimodipine (Nymalize), nisoldipine (Sular), and verapamil (Calan, Covera, Verelan, in Tarka); cimetidine (Tagamet); digoxin (Lanoxin); diuretics (‘water pills’); furosemide (Lasix); hormone replacement therapy; insulin or other medications for diabetes; isoniazid (Laniazid, in Rifamate, in Rifater); medications for asthma and colds; medications for mental illness and nausea; medications for thyroid disease; morphine (MS Contin, others); niacin; oral contraceptives (‘birth control pills’); oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); phenytoin (Dilantin, Phenytek); procainamide; quinidine (in Nuedexta); quinine; ranitidine (Zantac); triamterene (Dyrenium, in Maxzide, others); trimethoprim (Primsol); or vancomycin (Vancocin). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Read more here.

     

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    Oxytocin

    Oxytocin

    Oxytocin Spray 

    When oxytocin was administered as a nasal spray it led to a decrease in repetitive behaviors and other improvements in men with autism.

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    Description

    Researchers at KU Leuven have now discovered that administering oxytocin to adult men with autism makes them more open to close emotional bonds with others. The hormone has positive long-term effects as well.

    A team led by Professor Kaat Alaerts (KU Leuven) recruited 40 adult men with autism spectrum disorder to take part in their study.

    “In a first stage, we examined the amount of oxytocin produced by the participants themselves. The subjects also filled out several questionnaires,” Professor Alaerts explains. “An analysis of the data revealed that the amount of oxytocin found in the subjects’ saliva was inversely related to their self-reported attachment issues.”

    In a second stage of the research, the team examined the long-term effects of administering oxytocin through a nasal spray. This experiment produced remarkable results: the participants who had been given oxytocin for four weeks experienced positive effects until up to a year later.

    The amount of oxytocin found in the subjects’ saliva was inversely related to their self-reported attachment issues.

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    Scientific research

    The healthy muscle tissue on the left is from a young mouse. The ability of muscle to repair itself decreases with age, as evidenced by the middle image of old muscle tissue, which shows a lower density of muscle fibers, increased scar tissue and inflammation. The addition of oxytocin to the blood of old mice rapidly rejuvenates the old muscle, as shown on the right. (Photos by Wendy Cousin and Christian Elabd, UC Berkeley)

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