We've talked about semaglutide (Ozempic, Wegovy) on several podcasts before. But to refresh your memory, semaglutide is a medication used to treat type 2 diabetes and obesity. It can help manage blood sugar and lose weight. It can also lower the risk of heart attack and stroke if you have heart disease. 

But, like many medications, it can cause certain side effects, with diarrhea being one of the most common. About 9% of people taking it for type 2 diabetes and 30% of people taking it for weight loss reported diarrhea in clinical trials. Understanding the causes of diarrhea from semaglutide and learning how to manage it is important for people using it. 

Why does semaglutide cause diarrhea?

First, you're more likely to experience diarrhea with higher doses of semaglutide, and the good news is that this side effect usually goes away over time as your body gets used to the medication.

It's not clear why semaglutide causes diarrhea, but some research suggests that it happens because semaglutide slows down how fast food leaves your stomach. Because of this, constipation can occur.  

When you're constipated, the old stool sits inside the colon, and as new stool forms, the blocked colon can't absorb water out of the new stool. Because the new stool has more liquid, it leaks around the older stool and causes diarrhea. 

How do you manage diarrhea from semaglutide?

Stay Hydrated: Diarrhea can lead to dehydration. It's important to drink plenty of water to stay hydrated and replace lost fluids. Avoid caffeinated and alcoholic beverages, as they can worsen dehydration. Opt for water, sports drinks, decaffeinated teas, and soft drinks. 

The general rule is to take your weight in pounds and divide the number in half. This is about how many ounces of water you should drink daily. For example, a person who weighs 200 lbs should drink about 100 ounces or 3 liters of water daily. This is about five 20-ounce bottles of water daily. 

Keep in mind: People living in hot climates or physically active should drink more water to replace the fluids lost through sweat.

Dietary Modifications: Certain foods and beverages can make diarrhea worse. Avoid spicy, fatty (fried foods), and greasy foods, as well as milk and dairy products, until your symptoms subside. You'll also want to avoid eating raw vegetables and fruits and high-fiber foods such as whole wheat bread, broccoli, and granola. Opt for bland, easily digestible foods like rice, bananas, toast, and applesauce. Grilling, boiling, and baking your food can also help.

Over-the-Counter Medications: Your healthcare provider may recommend over-the-counter antidiarrheal medications such as loperamide (Imodium) or Pepto-Bismol to help control diarrhea. However, always consult your doctor before taking any medications, even those available without a prescription. 

Probiotics: Probiotic supplements can help restore balance to your gut microbiota. Probiotics contain beneficial bacteria that aid digestion and alleviate gastrointestinal issues like diarrhea. In fact, several research studies have shown that probiotics helped diarrhea resolve about 1 day faster. 

Make sure to keep track of your symptoms, including the frequency and consistency of your stools. This information can be valuable for your healthcare provider in adjusting your treatment plan if needed. 

Let your healthcare provider know if you experience severe stomach cramps, a fever, or have blood or pus in your stool, or if you experience a fever of 102 F or higher. 

Thanks again for listening to The Peptide Podcast; we love having you as part of our community. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week!

Pro Tips

We're huge advocates of using daily greens in your routine to help with gut, skin, nail, bone, and joint health. We take AG1 (athletic greens) every day. Not only does it have vitamins, minerals, and a diverse range of whole-food sourced ingredients, but it also has probiotics to promote a healthy gut microbiome and adaptogens to help with focus and mood balance. It's vegan, paleo, and keto-friendly.