Discover a simple yet powerful strategy to help you stick with your GLP-1 weight-loss journey. In this episode of What’s Up, Doc?, Dr. John Bender and Janessa Hanna dive into how compounding Semaglutide or Tirzepatide with Vitamin B6 alleviates nausea, while B12 and L-carnitine tackle the fatigue that often accompanies ketosis.
Learn how these additions ensure guaranteed absorption, improve tolerability, and keep you on track toward your weight care goals.
Ready to optimize your GLP-1 therapy? Schedule a consultation with Miramont Wellness Centers’ weight-care team: https://miramont.us/glp-1-weight-loss/
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Welcome to What’s Up doc. A podcast by Miramont Wellness Centers in Fort Collins, Colorado, hosted by Dr. John L. Bender, MD and CEO of Miramont Wellness Centers. Our mission at Miramont is to empower your community and yourself to achieve healthcare and wellness aspirations anywhere in life. Hello and welcome back to a wonderful and exciting session of What’s Up doc. I’m your host, Dr. John Bender. And I’m Janessa Hanna And we are here to discuss some of the more recent changes happening in the worlds of GLP-1 What are glucagon-like peptides? Well, these are those skinny shots that put people into ketosis. The two most common that we’re seeing compounded are Semaglutide Tirzepatide. Up until mid-May of 2025, there was a national shortage of these medications and compounding was being performed by and large across the country. Now there are some new rules put into place after a, a court order and some guidance from the FDA. So let’s take a moment to visit about that. Some people do not tolerate GLP-1s Can you believe that Janessa? I know it is, it is sad, but luckily we have the new option. Well, what are some of the more common side effects that you see with GLP-1s? Yeah, so most commonly I hear of nausea or like, we’d like to call it queasiness acid reflux and kind of be increased a little bit on these medications, constipation, fatigue, all of those are very common side effects. So recently I spoke with one of our clinical pharmacists and I said, what can we do to help patients with this queasiness? Because some of them are just not tolerating the brand name products that are out there on the market and they’re not losing weight. They’re getting the worst of both worlds, no ketosis, and they’re, they’re having side effect. It turns out a very simple additive B6, vitamin B6 when compounded with tirzepatide or semaglutide and then injected weekly can oftentimes make the difference for allowing someone to tolerate these medications, get them into ketosis so they’re losing weight and be able to tolerate the side effect. Right. And it’s very exciting because, you know, some people really struggle to lose weight. These medications are sometimes the only answer for them, and if they are having a hard time tolerating it, then that makes it kind of tricky. So we’re very excited about these new options to help people tolerate their medication to get through to their goals. One of the, the genius parts of B six, did you know Janessa, that that is a medicine commonly used by obstetricians for morning sickness? So it’s safe in pregnant women, for example, safe for a developing baby, it’s a vitamin. It’s common in, in many multivitamin supplements. And you might say, well, why can’t you just take a multivitamin? Well, the amount of B six in this injection is going to be quite a bit more potent. It’s getting directly into your system, bypassing the gut. And so we see higher concentrations also, some people might vomit a pill if they’re that nauseated. If you do an injection of the B6, we don’t have to worry about you losing the B6 for that particular reason. And so it’s, it’s guaranteed absorption. It’s just a very sophisticated, handy way to deal with that particular complication. You know, the other concern people have is fatigue. Can we talk a little bit about the fatigue from the brand name GLP-1s that are out there? Absolutely. We see a lot of fatigue because your liver puts, put you in te ketosis, which can sit on your transit, have your gut, which can make you tired. And that is really tricky for those, you know, for our emergent workers like firefighters, EMTs, nurses. And it’s also trivial for our truck drivers. And when you’re that tired, you’re driving or your, you know, helping other people, it’s really hard to do your job and and to try to stay awake. That’s one of the concerns that we’ve had with the fatigue aspect for sure. You, you’ve hit the nail on the head. You know, most people on these medications are, are working. They have jobs they have to do and it can be difficult if you’re in ketosis. The brain likes glucose. We’ve talked about that in previous podcasts. And when you’re living off of ketone bodies like beta hydroxybutyrate, the, the brain doesn’t feel as good. And so again, I spoke with our clinical pharmacist and said, what can we do about the fatigue that we’re seeing? And they recommended adding L carnitine and B12, B12 is cyanocobalamine, it’s a vitamin again that is very popular. Some people inject it for fatigue, generally not covered by insurance, but it’s, it’s an inexpensive remedy. L-carnitine is also an active compound that that helps with fatigue and helps restore some energy to the body, during ketosis. It’s safer than maybe some other things that, that we’ve come across and it compounds nicely. This is a remedy that in certain circumstances would allow for compounding to be delivered to a patient. And we now have L-carnitine in B12 available with both our Tirzepatide and Semaglutide products. Yes, we do. And it’s very exciting also adding the B12 and L-carnitine into your Tirzepatide or semaglutide will make your medication actually colored. So it’s easier to see when you’re drawing it up, which is also a benefit for some people as well. You know, you’re so, you’re so right about that genesa. ’cause we do have some folks, you know, if their eyesight’s not very good or they can have difficulty telling, is it a bubble, is it liquid? This medication’s expensive, we don’t want it to be wasted. And having just a little bit of that red tint can make it so much easier for people to see if they’re 0.2 or 0.4 or 0.6 mls when they’re doing their dosing on the syringe. Absolutely. Well, that’s all the time we have. We appreciate you joining us. Again, I’m Dr. John Bender. And I’m Janessa Hanna And we’d like to thank you for joining us with What’s Up Doc. See you next time.
