Ozempic Has a Weird—And Burpy—Side Effect

On the November morning when the sulfur burps started, Derron Borders was welcoming potential college students on the graduate college the place he works in New York. Each couple of minutes, irrespective of how exhausting he tried to cease, one other foul-smelling cloud escaped his mouth. “Burps that style and odor like rotten eggs—I believe that’s what I typed in Google,” he instructed me.

Ultimately, Borders realized that his diabetes remedy was responsible. Sulfur burps look like a considerably uncommon aspect impact of semaglutide, tirzepatide, and different medication of their class, referred to as GLP-1 receptor agonists. Over the previous a number of years, these drugs have develop into extra in style underneath the model names Ozempic, Wegovy, and Mounjaro, as a diabetes remedy and a weight-loss drug. And as prescription numbers rise, a wierd and ugly aspect impact has been rising extra obvious too.

GLP-1 receptor agonists are well-known to trigger gastrointestinal signs, together with stomach ache, diarrhea, and vomiting. In scientific trials of semaglutide for weight reduction, 44 % of individuals skilled nausea and 31 % had diarrhea. (The identical circumstances troubled solely about one-sixth of individuals who obtained a placebo.) Burping, a.ok.a. “eructation,” confirmed up in about 9 % of those that obtained the drug, versus lower than 1 % of those that took a placebo. The FDA lists eructation as a doable aspect impact for semaglutide and tirzepatide alike.

However I couldn’t discover any info within the clinical-trial studies or FDA truth sheets about sulfur burps particularly, and neither Novo Nordisk nor Eli Lilly, the businesses that make these medication, responded to my inquiries. Laura Davisson, the director of medical weight administration at West Virginia College Well being Sciences, instructed me that greater than 1,000 of her clinic’s sufferers are presently on a GLP-1 receptor agonist, and about one-fifth expertise sulfur burps at first. For all however a handful of those sufferers, she stated, the difficulty goes away after a number of months. Holly Lofton, an obesity-medicine specialist at NYU, guesses that it impacts simply 2 % of her sufferers.

Consultants aren’t positive why taking GLP-1 receptor agonists would possibly result in having smelly burps, however they’ve some theories. Davisson proposed that semaglutide boosts the variety of micro organism in sufferers’ digestive tracts that produce hydrogen sulfide, a gasoline that may be expelled from both finish of the digestive tract, and that smells (as Borders discovered) like rotten eggs. She additionally famous that the medication decelerate digestion, which might give the abdomen extra time to interrupt down meals and produce gasoline. On this scenario, Lofton instructed me, the putrid air could escape most readily up via the mouth, as a result of it’s lighter than the liquids and semi-solids that additionally fill the abdomen. “No matter’s on high will come up,” she stated.

Consuming greater than ordinary whereas on the drugs appears to be a typical set off. Davisson stated that sure meals, equivalent to dairy, may result in extra odorous emissions. “Generally it’s a matter of trial and error,” she stated. “Some ideas that we give individuals are issues like: Don’t eat actually heavy meals; don’t eat massive parts without delay; don’t eat proper earlier than mattress.” Along with these behavioral approaches, Craig Gluckman, a gastroenterologist at UCLA Well being, instructed me he recommends antacids and anti-gas drugs to sufferers with GLP-1-agonist-related sulfur burps. (On-line, apple-cider vinegar is often really useful as a repair, however Gluckman stated he wouldn’t suggest it.)

The suppliers I spoke with stated that, typically, sufferers are likely to expertise sulfur burps once they’re first beginning an Ozempic-like drug, or elevating their dose. That was the case for Crystal Garcia, an HR administrator in Texas who began taking semaglutide from a compounding pharmacy after her physician instructed her she was prediabetic. (Garcia vlogs about her expertise with weight-loss medication.) Three months later, whereas out to breakfast at a restaurant, Garcia’s household began to complain a few gross and eggy odor. Garcia figured that the odor was coming from the meals, however it lingered within the automobile after the meal. The household puzzled whether or not Garcia’s younger son had had an accident. “I used to be like, it couldn’t be me. There’s no approach,” she instructed me. However when she burped once more, she was compelled to vary her thoughts.

Many sufferers are unaware that sulfur burps are a doable aspect impact of their remedy till they begin, nicely, burping sulfur. For some time, Borders had no concept that his diabetes drugs could be the offender; when he noticed a doctor’s assistant to debate his subject, “Ozempic didn’t even come up,” he stated. The aspect impact is comparatively new to physicians. Earlier GLP-1 agonists didn’t appear to provide sulfur burps so continuously, Lofton stated. In her observe, the phenomenon wasn’t actually obvious till Ozempic hit the American market in 2018, and even then, she realized about it solely from her sufferers. “I’d by no means heard of sulfur burps earlier than I began prescribing this drugs,” she stated.

Although the sulfur burps are (bodily) innocent, some sufferers do cease taking their diabetes or weight-loss medication due to them, Lofton instructed me. However most, together with Garcia and Borders, find yourself sticking with their program. As unhealthy because the unwanted side effects could also be, sufferers suppose the medication’ advantages are value it. “I’ve had a affected person say that her burps smelled like poop,” Davisson stated. However even then, she didn’t need to cease the remedy.

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