Alternative medication classes should be considered if GLP-1 therapy proves intolerable: SGLT2 inhibitors (such as dapagliflozin, empagliflozin) for type 2 diabetes, which work via a completely different mechanism and rarely cause gastrointestinal side effects DPP-4 inhibitors (such as sitagliptin, linagliptin), which enhance endogenous GLP-1 activity more gently Metformin remains first-line for type 2 diabetes, though it can also cause gastrointestinal side effects Orlistat for weight management, though this also has gastrointestinal side effects of a different nature For weight management specifically, NICE recommends a comprehensive approach including dietary modification, increased physical activity, and behavioural interventions, with or without pharmacotherapy
In other words, if this risk of thyroid cancer is real (and I think it is) we will potentially see an explosion in thyroid cancer and its related problems in the coming decade
Will this work for tirzepatide (Mounjaro, Zepbound) too, not just semaglutide
Following the programs success, tirzepatide was approved by the United States Food and Drug Administration (FDA) in 2022 as a treatment for T2D, at doses up to 15mg/weekly under the brand name Mounjaro [1, 5]
A baseline DEXA, repeated every three to six months on therapy