Weight Loss Meds Linked to Another Debilitating Adverse Effect
Weight loss medications, celebrated for their impact on obesity treatment, have been implicated in elevating the risk of a chronic condition among individuals with type 2 diabetes.
GLP-1 receptor agonists, diabetes medications that mimic a hormone signaling fullness to the brain and reducing food cravings, were found to potentially elevate the risk of a persistent cough lasting at least eight weeks by as much as 25 percent.
Researchers at the Keck School of Medicine at the University of Southern California in Los Angeles conducted a comparative analysis of approximately 428,000 individuals with diabetes using a GLP-1 drug against about 1.6 million individuals using older or second-line diabetes treatments.
Initially, GLP-1s, marketed as Ozempic and Wegovy, gained approval for their ability to stimulate insulin release from the pancreas when blood sugar levels are elevated.
They also instruct the pancreas to decrease glucagon secretion, a hormone prompting the liver to release stored glucose into the bloodstream, consequently diminishing the liver's excessive blood sugar production, a significant issue in type 2 diabetes.
However, diabetes patients undergoing these obesity and diabetes treatments face a spectrum of negative health impacts, including a cough that persists for at least two months from the start of medication and potentially up to five years later.
These medications have additionally been associated with heightened thoughts of self-harm and suicide, nerve dysfunction, nausea and diarrhea, and the return of lost weight and associated health complications upon discontinuation.
According to the researchers, their study is among the first to highlight a possible connection between GLP-1RA use and chronic cough.
GLP-1s, such as Ozempic and Wegovy, function by promoting insulin release and suppressing glucagon secretion from the pancreas.
Impact of Chronic Cough
A chronic cough can be debilitating, often inducing sharp, stabbing musculoskeletal pain due to repeated, forceful contractions of chest wall muscles and the diaphragm.
Cough headaches are also recognized as a type of headache triggered by coughing, which can be brief and sharp or persist for hours. Health tracking apps like Shotlee can help monitor symptoms related to chronic cough.
Study Details
The study scrutinized data from over 2 million individuals with type 2 diabetes, with 427,555 patients specifically taking GLP-1 receptor agonists. These patients were compared to 1.6 million patients on other second-line diabetes medications.
Over 283,000 patients used DPP-4 inhibitors, which lower blood sugar without affecting weight; 321,508 used SGLT2 inhibitors, which eliminate blood sugar through urine and cause some weight loss; and 484,113 used sulfonylureas, which stimulate insulin secretion but contribute to weight gain.
The large cohort study, featured in JAMA Otolaryngology-Head & Neck Surgery, revealed a notable link between GLP-1 use and a new diagnosis of chronic cough, showing a 12 to 25 percent increased risk compared to other diabetes medications.
This association was even more pronounced in patients without a prior diagnosis of gastroesophageal reflux disease (GERD), a known cause of chronic cough where stomach acid flows back into the esophagus.
Researchers were surprised by this finding, having initially believed GERD would explain the connection.
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The researchers further challenged this explanation through a secondary analysis, repeating the comparison and excluding anyone with a prior GERD diagnosis.
The unexpected result was that the link between GLP-1s and cough not only persisted but strengthened. The researchers proposed that GLP-1s might induce chronic cough not through heartburn-induced esophageal irritation, but rather through laryngopharyngeal reflux (LPR).
LPR involves the movement of stomach contents, like acid and enzymes, up to the throat without causing typical heartburn. Researchers suggested this made sense, as GLP-1s slow stomach emptying, prolonging the feeling of fullness.
This slowed emptying can lead to reflux that more directly irritates the sensitive throat, triggering a cough reflex.
However, they also suggested the drug, with receptors in the throat and lungs, might directly stimulate the vagus nerve, which triggers the cough reflex.
Their results suggest that treating chronic cough in GLP-1 patients will require more than typical GERD medications.
GLP-1s are highly popular in the US for their effectiveness in helping individuals lose up to 20 percent of their body weight.
However, these drugs are known to cause a range of side effects that may lead some to discontinue their use.
Former FDA chief Dr. David Kessler utilized GLP-1 drugs and achieved a 60-pound weight loss but experienced 'terrifying' side effects, including intense chills requiring an electric blanket, persistent fatigue, and severe gastrointestinal distress, including appetite loss, bloating, and sharp abdominal pain.
Jaime French, a 33-year-old influencer, experimented with generic Ozempic for weight loss. Immediately after her first injection, she was overwhelmed by a 'literal poop storm' of uncontrollable diarrhea and 'absolute agony in her intestines.
Dr. David Kessler, a former FDA commissioner and public health expert, personally used GLP-1 weight-loss medications after a lifelong struggle with his weight.
While these drugs aided him in losing 60 pounds, he endured 'terrifying' side effects, including intense, uncontrollable chills that necessitated an electric blanket, persistent fatigue and general malaise, and significant gastrointestinal distress, encompassing a complete loss of appetite, bloating, and sharp abdominal pains.
Despite these challenging personal experiences, Dr. Kessler remains a proponent of the drugs due to their transformative potential in treating obesity.
The side effects can also be quite embarrassing. Jaime French, a 33-year-old influencer, tested generic Ozempic for weight loss. Following her initial injection, she experienced a 'literal poop storm' of uncontrollable diarrhea and 'absolute agony' in her intestines, a pain she described as surpassing her existing colitis.
The persistent gastrointestinal distress caused her to fear 'pooping my pants' and prevented her from socializing. She also suffered dizziness, severe gallbladder pain, and later, debilitating insomnia.
Despite enduring these side effects for 17 weeks, she only lost four pounds. The physical burden far outweighed the drug's benefits. She eventually discontinued the medication, recovered within two weeks, and now advises others against ignoring severe side effects in pursuit of weight loss.
