Amid the landscape of diabetes and weight loss treatments, GLP-1 receptor agonists are outpacing the competition. In particular, these medications aid in regulating blood sugar levels and curbing appetite. Unfortunately, not just anyone can take GLP-1 receptor agonists. In particular, if you’re thinking of taking them, then it’s essential that you know the risks and contraindications. These drugs may not be safe if you have certain health conditions.
In this guide, we take you through who should steer clear of GLP-1s and why. In addition, we’ll also cover how eligible people can use them safely.
What Are GLP-1 Agonists?
GLP-1 stands for glucagon-like peptide-1. Specifically, it’s a hormone your body makes after eating. In addition, it also helps regulate blood sugar and appetite.
Meanwhile, GLP-1 receptor agonists mimic this naturally occurring hormone. These agonists stimulate insulin release, suppress glucagon, and slow stomach emptying.
Popular GLP-1 drugs include:
- Semaglutide (Ozempic, Wegovy)
- Liraglutide (Victoza, Saxenda)
- Dulaglutide (Trulicity)
- Exenatide (Byetta, Bydureon)
Doctors prescribe GLP-1s for type 2 diabetes and weight management because of their benefits. In particular, these drugs can improve blood sugar levels and support sustainable weight loss.
However, not everyone is a good candidate because of contraindications.
Key GLP-1 Contraindications
Some medical conditions increase the risk of serious side effects. As such, there are reasons for some people to not take GLP-1, otherwise known as contraindications. If any of the following apply, then GLP-1s may not be safe for you.
1. Personal or Family History of Medullary Thyroid Carcinoma (MTC)
Animal studies have linked GLP-1s to thyroid C-cell tumors. Although these tumors are rare in humans, the risk may pose a serious threat.
As such, GLP-1 manufacturers list personal or family history of MTC or Multiple Endocrine Neoplasia Syndrome type 2 (MEN 2) as contraindications. People with MEN 2 experience tumors forming in glands that produce hormones. Consequently, the FDA includes this warning on all GLP-1 drug labels.
2. History of Pancreatitis
GLP-1s may increase the risk of pancreatitis or inflammation of the pancreas. While rare, it’s a serious condition. People with pancreatitis suffer from pain, nausea, vomiting, or a rapid heart rate. Make sure to look for signs like severe abdominal pain that radiates to your back.
If you’ve had pancreatitis before, then your risk may be higher with such contraindications. As such, doctors often advise against using GLP-1s in these cases.
3. Severe Gastrointestinal Disease
GLP-1 drugs slow how quickly your stomach empties food. Although this is good for blood sugar and hunger control, it is not for everyone.
For instance, if you have gastroparesis or other serious digestive conditions, then these contraindications can worsen your symptoms.
Also, people with chronic nausea, vomiting, or GI disorders may not tolerate GLP-1s well.
4. Pregnancy and Breastfeeding
If you know anyone who is pregnant, then GLP-1 medications are not recommended for them. Overall, there isn’t enough research to confirm safety for the baby. This is why pregnancy and breastfeeding are GLP-1 contraindications.
Hence, if you’re pregnant or planning to become pregnant, then talk to your doctor. The same goes if you are breastfeeding or plan to breastfeed.
Moreover, it is best to stop taking these drugs at least two months before trying to conceive.
5. Allergic or Hypersensitivity Reactions
Although rare, allergic reactions can happen when taking GLP-1 drugs. These side effects include rash, swelling, or even anaphylaxis, among other contraindications.
If you’ve had a reaction to a GLP-1 drug in the past, then you should avoid it or similar medications.
6. Type 1 Diabetes
Although GLP-1 drugs help control blood sugar levels, they are not approved for type 1 diabetes. To clarify, they do not replace insulin and don’t address insulin deficiency.
As such, using them for type 1 diabetes could lead to uncontrolled blood sugar or diabetic ketoacidosis.
Caution for Contraindications
Even if you don’t have clear contraindications, some conditions require extra care. Here’s a list of people who should be careful when taking GLP-1 drugs.
1. Kidney Problems
GLP-1s can cause dehydration from vomiting or diarrhea, stressing the kidneys. As such, your healthcare provider must monitor you closely if you have renal impairment.
2. Gallbladder Disease
Studies show that gallstones and cholecystitis share an association with GLP-1 use. If you have gallbladder problems or similar contraindications, then discuss alternatives with your provider.
3. Older Adults
Older adults may be more sensitive to weight loss and appetite changes. GLP-1s may also cause unintended frailty or weakness. Hence, monitoring and dosage adjustments may be necessary.
4. Mental Health Concerns
Some GLP-1 drugs for weight loss (like Wegovy) list suicidal thoughts as possible side effects or contraindications. Although a study has already confirmed that GLP-1 use is not linked to suicidality, it is still vital to remain vigilant.
As such, anyone with a history of depression or mood disorders should talk to a provider first. Moreover, mental health monitoring is essential.
Contraindications Screening
Before starting a GLP-1 drug, your doctor should review your full medical history.
This includes:
- Family history
- Digestive health
- Kidney and thyroid function
- Medications and supplements
In particular, blood tests and checkups may help catch early warning signs. In addition, monitoring makes these drugs safer and more effective.
As such, never start or stop a GLP-1 medication without medical advice. Always consider the contraindications.
If You Experience Side Effects
Overall, some side effects are common and manageable. Meanwhile, others require immediate attention. Here’s an overview.
Mild Side Effects:
- Nausea
- Diarrhea
- Constipation
- Headache
Thankfully, these often improve after a few weeks.
Serious Symptoms to Watch:
- Severe stomach pain
- Vomiting that won’t stop
- Swelling in your neck
- Difficulty swallowing
- Signs of an allergic reaction
Call your doctor right away if you experience any of these.
Conclusion
GLP-1 medications offer big benefits for many people. But they aren’t safe for everyone.
Specifically, conditions like thyroid cancer, pancreatitis, or gastroparesis make these drugs risky and are listed as contraindications. Hence, even if you don’t have a clear contraindication, careful monitoring is key.
Talk to your healthcare provider and ask questions. Moreover, share your full health history.
If you use GLP-1s safely, then they can be a powerful tool for the right patients.
Frequently Asked Questions
Can GLP-1 medications cause cancer?
There’s no proven link in humans. But animal studies showed thyroid tumors. As such, they are not recommended if you have a history of thyroid cancer.
Can I stop a GLP-1 drug if I get side effects?
Yes, but always talk to your doctor first because some side effects improve with time. Meanwhile, others may signal a serious issue.
What are the contraindications for phentermine?
People should avoid taking phentermine if they are pregnant, breastfeeding, or if they have glaucoma or an overactive thyroid. In addition, people with serious heart problems, high blood pressure, or a history of drug use should avoid phentermine use. Diet pill users must also steer clear of the medication.
What are the contraindications for metformin?
People with kidney problems, acute or chronic metabolic acidosis, congestive cardiac failure, or metformin hypersensitivity must avoid using metformin.
What are the contraindications for duromine?
If you are taking psychotropic drugs, have epilepsy, or are taking blood pressure medication, then you should avoid duromine.
What drugs should you not take with semaglutide?
Unless you’ve cleared their use with your doctor, you should not take aspirin and other drugs for appetite control. In addition, you should also not take with semaglutide medicines for colds, asthma, cough, or sinus problems.
Why do doctors no longer recommend metformin?
A study in 2018 showed that people taking metformin tended to experience digestive problems like flatulence and diarrhea.
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