Brittany Meeker (00:02)

Hello, welcome back to our podcast, Hormone Harmony, today we are diving into part two of our discussion on semaglutide. Last time we covered the basics of what semaglutide is and how it works. Today we are answering some common questions for our listeners with again the amazing Dr. Bimisa Augustin on our Thrivelab team.

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Dr Bimisa Augustin (00:26)

All right, hello everyone. I'm Dr. Bimisa Augustin, Family Nurse Practitioner, I'm Director of Clinicians at Thrivelab. It's good to see everyone. Brittany, my sister from another mister, missed you. It's exciting to do this again. Let's start with a quick recap. So Brittany, what is semaglutide and how does it work?

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Brittany Meeker (00:46)

Right, so let's start off with the basics. So it is an injectable, and I say injectable, patients, what the heck? How big? How often? It is a very small insulin-sized needle. I have an example here. And so this is kind of what the size of the needle looks like. Think of an insulin syringe. You will be injecting this subcutaneous, which means the fatty part of the body, once a week. And so the beautiful thing of it is that it regulates blood sugar and suppresses appetite. And so when that happens, you are slowing down the digestive process. And so we have found great outcomes for patients with any sort of baseline comorbidities or goals for weight loss. So Thrivelab now is offering all patients, regardless if you are a hormone patient or not, we are wanting to assist you with that start of your plan. It is $175 a month. Now, after you are injecting, what happens is your body can kind of get sluggish and used to that dose. We have to keep the body guessing, right? So we'll start titrating that dosing, increasing the dose as time goes on. Baseline starting $175 when you hit that maintenance dose or titration dose it can be $175 to $250. It's really depending on the dose that you start on, continue on, and then when it is maintained on. So there is like a three week protocol. And so with that being said, as time goes on, it does get better with outcomes with weight loss, but we have really found when you're balancing hormones and you add in semaglutide, the benefits are exceptional. So it is something now that is on our platform for all patients, which is super exciting.

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Dr Bimisa Augustin (02:35)

So even before we delve into like some of the Q and A from some of our patients, I actually have a few that literally in the beginning stages of using semaglutide, they lost 10 to 15 pounds and in a healthy way. So it's an amazing GLP one to use for weight loss, especially for the ones that do qualify for it.

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Brittany Meeker (02:53)

Absolutely, absolutely. you know, there's been so many questions, right, Dr. B, about, you know, is this going to help with my hormone diagnosis? Can I take this with other medications? Like so many questions and what a great way to again be on here part two with you and review them. So the one thing that's really come to me that I've heard, which is interesting, does semaglutide increase pregnancy rates?

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Dr Bimisa Augustin (03:21)

Okay, while there's no direct evidence that semaglutide increases pregnancy rates, managing weight and blood sugar levels can often improve overall reproductive health, which might be indirectly helped with fertility.

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Brittany Meeker (03:38)

You mentioned like, you know, reproductive health, I can't help but think of PCOS, right? Polycystic ovarian syndrome, where these patients have insulin resistance, these patients have concerns with fertility. These patients are already finding that they're having issues with just hormones in general. So would semaglutide help them with PCOS or is there a correlation?

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Dr Bimisa Augustin (04:05)

So actually, yes, semaglutide can be beneficial for women with PCOS by aiding in weight loss and improving insulin sensitivities, which is crucial to managing PCOS symptoms.

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Brittany Meeker (04:15)

Yeah, I have found some patients of mine with PCOS are curious about semaglutide, just getting weight loss going, especially because it's always been an issue for so long. And with that effects of high testosterone, it can really cause some stubborn weight. So I love that. Now, what about the kidneys? Because I know we want, you know, with our platform, get labs in the future, kind of look at everything as a whole, because we're functional health, we want to take care of you from head to toe. So we will have labs and kidney function is something we do look at. So does semaglutide affect kidneys? I know I've been asked that I'm sure you have too.

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Dr Bimisa Augustin (04:55)

I have. And it does not have a known negative impact on kidney function at all. However, patients with like a pre-existing kidney condition, they should consult with their healthcare provider before starting any medication.

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Brittany Meeker (05:11)

Absolutely, yeah, because there's so many different indications that could happen with other medications. What I love about the semaglutide is it's already like something our body produces. It's just some of us don't produce as much as others. So we're just kind of fueling the system, kind of like how we do with hormone therapy, which is fascinating. I mean, there's still so much research being shown on this medication. But what I have found is some patients who are on it and they work out, you know, they're worried about, okay, am I going to like start losing muscle mass? I'm here to like get muscle definition and stamina and be strong in the gym. I mean, is this medicine just going to completely plummet my muscle gains that I want to be having in the future? I mean, what are your thoughts on that?

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Dr Bimisa Augustin (05:54)

Okay, so that's a famous question too about, you know, muscle wasting. So there's no significant evidence that suggests that semaglutide can cause muscle loss. Okay, you need to maintain a balanced diet and incorporating strength like training exercises that can help prevent muscle wasting.

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Brittany Meeker (06:12)

We find too, when we're not fueling our muscles with calories, our muscles aren't going to keep growing. They're like a little plant. We have to keep watering them and feeding them and making sure they're well maintained. If you don't, like my plants, it won't grow. So we just need those calories to fuel the muscles. So I love that. And you know, another thing too, if we're, we're, you know, not affecting our muscles. Like what about our hair? Have you had any kind of feedback on that or research stating otherwise that it can cause hair loss?

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Dr Bimisa Augustin (06:46)

Okay, so hair loss is not a common side effect of semaglutide at all, not in my research anyway. If patients do experience hair loss, it is essential to discuss it with their healthcare provider to rule out any other causes.

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Brittany Meeker (06:58)

Absolutely, and I find too, like food is fuel and that's where we get our vitamins. And if you're not eating enough and you're not taking a multivitamin and you're not getting enough nutritious foods, hair will start to become affected. And so something I'll tell my patients too, Dr. B, and I'm sure you as well, I mean, amino acids, omega-3s, a multivitamin, those are really good to have on board with semaglutide to be sure that you are getting those good supplements and vitamins to prevent anything like that from happening. So we can just kind of make sure that we have things on board to prevent that from happening if it does. Speaking of other physical concerns besides muscles and hair, what about this ozempic face everyone's talking about of looking kind of like a skeleton?

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Dr Bimisa Augustin (07:46)

Goodness. Okay. Ozempic face often, it refers to facial changes due to rapid weight loss. I mean, we've all seen it, such as the sagging skin. And some people can actually end up with that, right? So, but maintaining like gradual weight loss, meaning healthy weight loss, not something where you're doing it and it's quick to cause that, type of, staying at a slow pace, okay? This is a marathon, not a sprint. Okay, and proper skin care can help mitigate those effects.

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Brittany Meeker (08:18)

Absolutely. I find that there's this wedding coming up or this event and it's like I have to lose 50 pounds in so many months. You can do it with semaglutide but you gotta be a little there and you don't want the Ozempic face, right? Speaking of that, because there's this craze on semaglutide and I want to be on it, everyone wants to be on it. I mean it does have a lot of great benefits, but what about long term? I mean is there any sort of concerns on staying on it for over six months or whatever that time frame looks like?

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Dr Bimisa Augustin (08:53)

Well, the long-term effects are actually still being studied, but it has been shown that basically semaglutide is safe and effective for like extended use, while managing weight and blood sugar.

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Brittany Meeker (09:04)

I know too, like the goal is this is more of an assistance for patients. I mean, we want them to eventually get off of it because we want to get them to the goals and kind of make those lifestyle changes. So when a patient gets off of it and they start to regain it, what happens if a patient starts regaining the weight after stopping? I mean, what are your recommendations?

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Dr Bimisa Augustin (09:26)

So if they do start to regain after semaglutide use, they can restart semaglutide. Absolutely, but they need to be under the care supervision. So healthy lifestyle habits, and that is crucial to maintaining weight loss.

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Brittany Meeker (09:40)

And I think something too for our patients, I know we're really good about letting our nutrition coach on our Thrivelab platform assist them. I mean, the prescription in general is super helpful, but maintaining and having those implemented lifestyle changes is huge. And so again, on our platform with our nutrition coach, letting them be involved with their care and guidance when they're on the medication, when they get off of it. So it's really effective for long-term outcomes, which is exciting. You know, that's another thing too, of like looking at lifestyle and doing different activities to help optimize this medication regimen. Do they have to work out? I mean, do you have patients work out on this treatment? What do you like recommend when they're on semaglutide?

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Dr Bimisa Augustin (10:29)

And that goes back to muscle wasting because if you don't maintain that strength by doing the strength exercises you're gonna lose muscle. So I tell them yes workout, have a regimen, you know two, three times a week. And it doesn't have to be anything heavy but make sure that you are maintaining that healthy lifestyle while you know using this medication to lose weight so you don't lose muscle.

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Brittany Meeker (10:49)

Right, right. There's nothing like some good old hormones on board when you're exercising, because that stamina's gonna go far. It's gonna go real far. And with this whole semaglutide withdrawal, and how can patients start to avoid regaining the weight? I mean, a lot of it is lifestyle, but I've heard of the term, Ozempic withdrawal. How can we prevent that from happening with our patients?

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Dr Bimisa Augustin (11:20)

Okay, so for those that don't know what Ozempic withdrawal is, it actually refers to weight gain after stopping the medication. Basically to avoid this, patients should continue with the healthy diet and exercise routine as regular. Nothing special, just continue with what you were doing before.

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Brittany Meeker (11:36)

Exactly right. Yeah, I tell patients, you know, sometimes I had one patient say it so beautifully. She's like, I like my semaglutide because it quiets the food noise. And that stuck to me. And I thought that is so well said. Because when we get off the Ozempic or semaglutide, the noise of food coming back and it gets really loud. But we have to stay on that path of those great outcomes and lifestyle choices that we made. That would be the biggest takeaway is definitely continuing what you were doing when you were on the injection to, know, like you said, healthy diet, good exercise routine. You know, with that being said, what about patients who are taking it, who don't need it? I mean, are there people that are abusing the fact that this is offered and not really needing to be on it and if so like who is that?

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Dr Bimisa Augustin (12:31)

So unfortunately, yes, there are. And oftentimes it's more for vanity. It's not for the health of losing weight and having a better quality of life.

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Brittany Meeker (12:42)

We are more than happy to help you, let's safely do it. Because at the end of the day, we're advocating for you, right? We want to have your back and be a partner with you and make sure that we're having your best interests. So yeah, to avoid any unnecessary risks, we want to be sure that you are on it by a provider that is a prescriber and not kind of getting it under the table anywhere else. Yeah, I mean, that really kind of covers a lot of questions that comes to mind with my patients and I'm sure some of yours. Do you have any kind of questions that you've had ever, any final thoughts that can wrap up our Q&A session?

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Dr Bimisa Augustin (13:20)

No final questions, but I can say the success my patients are having that started at a higher BMI is, it's a great percentage. Okay. I don't have many that aren't doing very well. There are some that are having, you know, some of the gastric issues, but we address those. So staying under the care of your healthcare professional while on this medication is it, it is essential because of those types of risks.

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Brittany Meeker (13:46)

Right, and you know another thing that comes to mind too is the big glutaryl craze that we offer our patients on Thrivelab, the liver detoxification, heavy metals, the cleanse of the system. I tell patients, this is the holy grail. mean, full disclosure, Dr. B is my provider and she has gotten me some Glutaryl. It does all the things, skin, all of it. And so our patients that are on semaglutide, it's very beneficial to be on the Glutaryl because when you're having nausea and this GI issue, the subcutaneous cells has toxins and your body's leaking that. And so something that's so phenomenal is to have a Glutaryl on board while you're on the treatment. I tell patients at least 90 days because you using that treatment is going to rid a lot of those side effects of the toxicity from, you know, kind of having this weight loss. And so that's something I've implemented or Thrivelab has implemented for their patients with really having the GI side effects and symptoms. But other than that, just find that that's a good added on addition to patients. But I agree with you. Semaglutide is helping a lot of patients. And we think of comorbidities and outcomes. It's beautiful to not only hormonally help them, but also to physically with their confidence even further, which I mean, my goodness, talk about taking on life, right? So it's so beautiful to see. I would have to say, you know, if there's any more questions or if you want to start your journey with semaglutide, head to thrivelab.com and begin your journey with us. We have lots of great providers throughout the US and be more than happy to assist you and help you and Dr. B as always my sister from another mister that is not even closer to the truth. Oh my gosh, this is a great part 2. And I look forward to any future questions to review with you in the future.

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Dr Bimisa Augustin (15:25)

Absolutely. Thank you, Brittany. Go Thrivelab.

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