Tuesday Apr 01, 2025

EP04: GLP-1 Gotchas for Practitioners

GLP-1 medications are everywhere right now and for good reason. They suppress appetite, support weight loss, and help manage type 2 diabetes. But what happens when we overlook the ripple effects they can have on the body?

In this first episode of Functional Medicine for Real-World Impact, host Tracy Harrison walks through four clinical “gotchas” every practitioner should keep in mind when patients are using GLP-1 agonists. She starts with one of the most common and disruptive complaints: nausea. For many patients, it’s not just the medication. It’s an underlying issue like histamine overload, subclinical hypothyroidism, or nutrient insufficiency that makes the symptoms worse.

Tracy also raises a critical question: Are we giving GLP-1s to patients who are already insulin resistant... or already hyperinsulinemic? If so, we may be increasing their risk for hypoglycemia, emotional reactivity, and unintended shifts in body composition.

Then there’s the issue of gallbladder health. Slowed motility may reduce appetite, but it can also make existing hepatic biliary congestion worse, especially for those with fatty liver or metabolic disease. Are we screening for this before starting treatment?

This episode challenges practitioners to look closer, ask better questions, and avoid assuming that symptom reduction equals success. Medications can be helpful, but only when paired with a deeper clinical lens and a commitment to long-term, real-world health.

Episode Breakdown:

00:00 Understanding GLP-1 Medications

01:02 Nausea and Dysmotility

05:01 Histamine Overload

08:04 Hypothyroidism and Dysmotility

10:01 Vitamin B6 and Magnesium Deficiency

11:27 Malnutrition Risks

17:00 Hypoglycemia Concerns

20:41 Hepatic Biliary Congestion

25:10 Responsible Use and Dosage

27:00 Importance of Empowering Patients

Links