Gio - My Favorite Canary…

The Case of My Delightfully Tricky Husband (And Why GLP-1s Deserve Your Respect)

If you've been around our clinic for any length of time, you know one thing about my husband, Gio...

The man is my canary in the coal mine.

If there's an unusual side effect...

He'll have it.

If there's a strange reaction...

His body will find it.

Honestly?

I'm grateful.

Because every time his body teaches us something, our patients benefit.

This week was one of those lessons.

Two Years Ago...

We started microdosing GLP-1 medications.

Not because we wanted to lose weight.

But because I was fascinated by the growing body of research showing these medications may help improve:

• Insulin resistance

• Chronic inflammation

• Metabolic health

• Fatty liver

• Cardiovascular risk

• And perhaps even reduce the risk of neurodegenerative disease in some populations.

Many of my mold patients struggle with insulin resistance and leptin resistance after years of chronic inflammation, so improving metabolic signaling is often an important piece of their recovery.

Semaglutide Didn't Love Gio...

We started with semaglutide.

Tiny doses.

Very slowly.

Unfortunately...

Gio experienced:

• Reflux

• Nausea

• Constipation

And yes...

The infamous "turtle head poop phenomenon."

So we switched him to tirzepatide, which he tolerated much better.

Then He Did What So Many Patients Do...

After months of doing well...

He decided it was time to increase his dose.

Sound familiar?

His thinking was simple.

"I've tolerated this dose forever..."

"I'll probably tolerate a little more."

Except...

GLP-1 medications are incredibly powerful.

And your metabolism changes while you're taking them.

Sometimes your body becomes more insulin sensitive as inflammation decreases, weight changes, and metabolic health improves.

The dose that seemed appropriate months ago may not be the dose your body needs today.

Suddenly...

Over the course of one week...

Gio had three significant episodes of hypoglycemia.

Not just:

"I'm getting a little hungry..."

I'm talking about:

Shaking.

Sweating.

Feeling faint.

One episode occurred while he was driving and was severe enough to make us rethink his entire dosing strategy.

Fortunately, he recognized what was happening before it progressed further.

Here's the Really Sneaky Part...

My husband has spent years battling insulin resistance.

Ironically...

His body doesn't give him much warning when his blood sugar starts dropping.

Instead of saying...

"Hey buddy...maybe grab a snack."

His body skips straight to:

"I might pass out now."

Not ideal.

Especially when you're driving.

Why I Respect GLP-1s

I absolutely love these medications.

But I never underestimate them.

They are not just weight-loss drugs.

They are powerful metabolic hormones.

GLP-1 receptor agonists help your body respond more appropriately to meals by:

• Increasing glucose-dependent insulin secretion after eating

• Reducing inappropriate glucagon release

• Slowing gastric emptying

• Increasing satiety

• Reducing post-meal glucose spikes

Tirzepatide goes a step further by also activating the GIP receptor, producing even greater improvements in glucose regulation and insulin sensitivity for many people.

For the right patient...

They're incredible.

But they deserve respect.

Why I Use Them in Mold Patients

One thing I see over and over again is that chronic inflammatory illness doesn't just affect the immune system.

It affects metabolism.

Years of inflammation can contribute to:

• Insulin resistance

• Leptin resistance

• Weight gain

• Fatty liver

• Elevated inflammatory cytokines

• Mitochondrial dysfunction

When insulin stays elevated for years...

Cells stop responding.

The pancreas makes even more insulin.

Fat storage increases.

Inflammation worsens.

Energy production suffers.

It's a vicious cycle.

Leptin—the hormone that helps regulate appetite and energy balance—can also become dysregulated, making it harder for the brain to accurately interpret the body's energy stores.

Improving metabolic health can be one important piece of helping patients recover.

The Biggest Mistake I See...

People start a GLP-1.

They're not hungry.

So...

They stop eating.

Please don't do that.

Your appetite has changed.

Your body's nutritional requirements have not.

Protein is still essential.

Muscle still needs amino acids.

Your brain still needs fuel.

Your mitochondria still need nutrients.

Skipping meals because you "aren't hungry" can leave you under-fueled and, in some cases, contribute to low blood sugar—particularly if you're taking other glucose-lowering medications or have gone long periods without eating.

Our New House Rule

If you're taking a GLP...

Protein first.

Every morning.

No negotiating.

No waiting until you feel hungry.

No pretending coffee is breakfast.

Fuel the engine before it starts sputtering.

Are You Insulin Resistant?

Some common signs include:

• Weight around the midsection

• Sugar cravings

• Crashing after meals

• Brain fog

• Difficulty losing weight

• Elevated fasting insulin

• Elevated triglycerides

• Low HDL cholesterol

• Fatty liver

• High blood pressure

• Elevated fasting glucose or A1c

Many people are insulin resistant long before they ever develop diabetes.

Learn the Warning Signs of Low Blood Sugar

Know these symptoms:

• Shaking

• Sweating

• Rapid heartbeat

• Feeling faint

• Blurred vision

• Confusion

• Difficulty concentrating

• Sudden weakness

Although GLP-1 medications alone have a relatively low risk of causing hypoglycemia, the risk can increase in certain situations, such as prolonged fasting or when combined with insulin or sulfonylurea medications.

The Happy Ending

Gio's dose came back down.

He's eating consistently again.

He's doing great.

Although...

The man still puts up one heck of a fight when I insist that the treatment plan includes...

A piece of Lindt white chocolate.

You'd think I was asking him to eat broccoli.

I keep reminding him...

There are worse prescriptions to receive.

🍫❤️

The Bottom Line

GLP-1s are among the most exciting metabolic therapies we've had in years.

But don't mistake "I'm not hungry" for "My body doesn't need fuel."

Your appetite may be quieter.

Your metabolism is still working.

Feed it well.

Your future brain, hormones, and mitochondria will thank you.

This post is for educational purposes only and is not a substitute for personalized medical advice. Never change the dose of a prescribed medication without discussing it with your healthcare professional.