GLP-1s and Running!

#381 - Big Pharma is always with us, it seems. You can't watch any sporting event, stream any movie or show, watch any video or do anything on any media without seeing an ad touting GLP-1s. This week, I explain what they are and how they can help and hurt runners. There are positives to using them and there are negatives. Many people are getting help from them and many people are using them incorrectly. I try to take a wide-angled look at this new-ish drug that's just one of many in our society's long history of diet drugs. 

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(Cont.) GLP-1s and Running!

(Cont.) GLP-1s and Running!

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Hidden West share stories you might not hear anywhere else. Want to know why the last chance grade might be the most dangerous bit of highway in California? Why did the Japanese drop bombs on the western part of the U.S.? And where is the state of Jefferson? All these stories and more about what makes the Western U.S. so great are here. There's a new story published every week. Check out Hidden West on YouTube. Welcome to Martha Runs the World, a podcast with a new take on running, fitness, and all things health-oriented. I'm Martha Hughes, your host, and each week I present a new topic that is of interest to all runners. Hi, and welcome to episode 381 of Martha Runs the World. I should, I guess I should say 381. I don't know. It's early. I'm just waking up, I'm having my coffee, I'm going to go for a run after this, and it's it's a decent day. It looks a little chilly, overcast here, but it's nice running weather anyway. So I hope you're having a lovely weekend. I am. It's been quite nice. I've gotten a lot of work done on the show. Um, I put out a short video over on Saturday, it would be, if you want to check it out. So I'm trying to do shorter videos to add to the channel so that you can check out. These will not be short shorts, so I'm going to keep doing those, but I'm also going to do videos that are like three god, that was loud. Sorry about that. Three to ten minutes long and try to get some extra content in there for you to watch. Alright, so let's dive into this subject here. There's no escaping them. You can't watch a video without seeing an ad for them. You can't play a game without seeing an ad, or watch a sporting event, or do anything where there are not ads for GLP ones. They're pushing them on us more than anything, more than alcohol, gambling even. They can be helpful. They can be equally harmful and do both in alarmingly rising numbers. I thought it would be important to address everything about them and how it relates to running in this episode. So let's start at the beginning. GLP agonists are a class of medications that mainly help blood sugar glucose levels in people with type 2 diabetes. That is what its main purpose is for help people with type 2 diabetes. Let's put that right on the table. That is the main number one reason why they're in existence. Now they can also help treat obesity, but that's a side one. That's not its main purpose. It can also help them, though. GLP1 agonists are most often injectable medications, meaning you inject a liquid medication with a needle and syringe. You give the shots and the fatty tissue just under your skin. Areas of your body you can give the injections include your belly, outer thighs, upper buttocks, backs of your arms. I personally would never do that. I don't want to give myself shots of anything ever, but that's me. These medications are relatively new. The Food and Drug Administration approved the first GLP1 agonist in 2005. That is not a long time to be on the market. Researchers are still learning about their other potential uses and benefits. GLP 1 agonists alone can't treat diabetes, type 2 diabetes, or obesity. Both conditions require other treatment strategies like lifestyle and dietary changes. Now I'm going to give you their brand names of what they are in the market because I don't think I can pronounce all these medication names and you don't want to see me suffering. Or you probably be suffering more than I would, trust me. Trulycity, Bieta or Bieta, Bidurion or Bidurian, Victosa, Ozempic, Ribelsis. Now how do they work? To understand how GLP1 agonists work, it helps to understand how the naturally occurring GLP1 hormone works. GLP1 is a hormone that your small intestine makes. It has several roles, including triggering insulin released from your pancreas. Insulin lowers the amount of glucose in your blood. If you don't have enough insulin, your blood sugar increases, leading to diabetes. Blocking glucagon secretion. Glucagon is a hormone your body uses to raise your blood sugar levels when necessary. GLP1 prevents more glucose from going into your bloodstream. Slowing stomach emptying. Slower digestion means that your body releases less glucose from the food you eat into your bloodstream. Increasing how you feel after eating satiety, GLP1 affects areas of your brain that processes hunger and satiety. In other words, GLP1 medications bind to GLP receptors to trigger the effects of the GLP1 hormone. The higher the dose of GLP1, the more extreme the effects. If you have type 2 diabetes, the medications help manage your blood sugar by triggering your pancreas to release more insulin. The slowed digestion also helps decrease blood sugar spikes. The satiety effect of GLP1 agonists reduces your food intake, appetite, and hunger. These combined effects often result in weight loss. Healthcare providers will prescribe these GLP1 for two conditions, type 2 diabetes and obesity. Well, we'll talk about that in a little bit. The FDA approves the use of GLP1 agonists to help maintain type 2 diabetes. And there are several other types of diabetes medications that one can take. They can take oral like metformin. That's usually the go-to medications for type 2 diabetes, but they may recommend GLP1 if metformin isn't helping, it's unsafe for you to take metformin, or if you have a blood sugar level that's higher than your target, or you haven't reached your target blood sugar level within three months of treatment. It's important to remember that the most effective management of type 2 diabetes involves several therapies like lifestyle and diet modifications, exercise and medications. Don't just take medications and eat the same way if you have type 2 diabetes. You have to change your lifestyle. Really, it's really important that you do all these things at once. Together, you and your healthcare provider will determine a treatment plan that works best for you. The FDA currently approves the use of semiglutide and high dose lyriglutide to help obesity. This is because these GLP1 agonists have weight loss effects. Obesity is a chronic condition in which you have a body mass index of 30 or higher. If that BMI is made up of fat, a lot of times BMI isn't an accurate measurement, so it's good to do fat percentage measurement if you can. Obesity is a complex condition and it involves several different changes like dietary changes, exercise, medications, behavior modification programs, and if it's really extreme, bariatric surgery, of which I am not a big fan of, but if it works for you, then it works for you. What are the potential benefits of GLP1 agonists? Other than lowering blood sugar levels and reducing weight, studies show that GLP1 agonists may have other benefits like lowering blood sugar, improving lipid disorders, improving fatty liver disease, reducing your risk of heart disease and kidney disease, delaying the progression of diabetes-related nephropathy. Oh, so I'm so sorry if I'm mispronouncing these words. I am not a medical professional. I just work with them, but I'm not one. What are the side effects? Now, these this is really important. Some of the common side effects are loss of appetite, nausea, vomiting, diarrhea. I know it's not nice to think about, but can happen. Other side effects can also include dizziness, increased heart rate, infections, headaches, indigestion. You may have a mild and temporary case of itchiness or redness in your skin at the site of the injections. Now, these are the severe and but can happen effects of pancreatitis, metallary thyroid cancer, acute kidney injury, and worsening diabetes-related retinopathy. And the risks or complications can include allergic reactions used during pregnancy. You've got to talk to your OBGYN, low blood sugar. Now the allergic reactions, uh, it just really depends on each person. Um if you have anaphylaxis because of it, uh, the it could include shortness of breath or wheezing, hives, difficulty swallowing, red rash, or abdominal belly pain, chest tightness as well. So just please be careful. If this happens, get yourself to the ER. Don't go to urgent care, go to the ER. Um hypoglycemia, there's a low risk of mild low breath, low blood pressure, which is called hypoglycemia episodes. If you take a GLP1, it can become a serious risk when other medications are involved. If you have symptoms like shaking or trembling, sweating and chills, dizziness or lightheadedness, weakness, faster heart rate, intense hunger, difficulty thinking and concentrating, pale skin, nausea, that could be hypoglycemia. You need to consume food. Really, you need to have carbohydrates. Their carbohydrates are not evil. They are part of our food intake. When should I call my health care provider? You should have regular appointments with your health care provider when taking a GLP 1. Really, you should. I mean, it's just part of it. And for runners, what can GLP do for runners? GLP medications can cause muscle loss, but it's not as severe as initially feared, especially if you exercise and eat enough protein. Time-based running plans help you stay consistent when energy levels fluctuate day to day. Appetite suppression increases the risk of underfueling and low blood sugar during runs. Eat before you run matters more than ever. No more of these fasting stuff. If you're on GLP1, you can't do that stuff. Don't do it. You have to eat. And that's another problem with it that I'm going to talk about in a little bit. Aim for 1.2 to 1.6 gram protein per kilogram of body weight daily. A structured walk-run progression will help get you into running if you're just beginning. Schedule your injection on a rest day when possible, and consult your doctor before starting. And always consult your doctor before you're starting or an exercise routine. Muscle loss is real but manageable, especially if you're exercising. Protect your muscle mass. When weight drops quickly, your body sheds fat and muscle. Less muscle means lower strength, more fatigue, a slower metabolism. Running is really, really good to keep you stronger, and paired with strength training, it's really, really a good, good combination. It will help help you remain strong. Supporting your overall health, running delivers benefits far from weight management. You will have better heart health, improved blood sugar regulation, mood elevation, more stable energy, better sleep and lower stress, and you can get off that GLP1 faster. Truly. It's especially valuable if the side effects include fatigue, low appetite, or digestive changes. You gotta eat though, you gotta get rest. The underfueling trap. Now, this is the biggest challenge for new exercises on GLP 1. You may not feel hungry before or after workouts, but your muscles need energy. Underfueling can lead to slower recovery, increased soreness, low energy during workouts, and plateaus in fitness progress. Reduced calorie can affect your running. It's harder to maintain your pace, tougher to finish workouts, and less effective strength sessions. It doesn't mean you can't improve, it just means you need to be intentional about supporting your body. You have to eat. Blood sugar drops during runs. This one catches people off guard. Running naturally increases your body's GLP1 production and insulin sensitivity. When you add a GLP1 medication on top of that, the combined effect can sometimes push blood sugar lower than expected, especially if you haven't eaten enough before your run. That's why it's vital that you eat. You must eat before your runs. This is extremely important if you're on GLP1s. Science to watch for mid-run, sudden dizziness or lightheadedness, shakiness or feeling off, confusion or trouble concentrating, cold sweat that doesn't match your effort level. The fix is really simple. Take a small snack with you, a carb source you can take. Gumi bears, juice box, a chew, a goo, something. You know, cookie, whatever you want. Whatever works best for you, take with you so that you can have it during your run. You need to be prepared. Even if you're not hungry, or even if you're not going that far, just take it with you just in case, because you don't know how your body's going to react, especially when you're starting out. This is all new, so it's really best to be prepared. GLP medications, slow gastric emptying. For runners, this can mean unexpected bathroom timing, bloating, gas, GI discomfort during runs. So learn how your body responds, and that takes time. That's why a gentle, flexible approach is best. Just figure out how your body reacts, go slow. Even if you're used to higher mileage when you start, do some lower mileage around some around some public bathrooms. So in case you need to use them, they're there. If you're stuck, you don't want to be stuck without that around you. Now, a note on injection timing. If you're on a weekly injection, side effects tend to be strongest during the first 24-48 hours. So it's really good to schedule your injection on a rest day or easy day. You don't want to do it the day before your long workout or your long run. You want to plan for that. And it's worth taking the extra time to figure out what works for you. Adjust your training expectations. As I said, if you're new to the medication, give your body time to adjust before chasing ambitious fitness goals. Just take your time and start out slow on less mileage, and you can always add. Always, always add. Fuel strategically, this is the section most people on GOP1s get wrong. They don't think they have to eat. They don't feel like eating. So they don't eat. You need to eat before your run, 30 to 60 minutes prior. A small, easily digestible snack is really good. Even if you're not hungry, eat something. Eat a banana with peanut butter, toast with peanut butter on it, a few dates, something. Something with it to keep you going. During longer runs, 60 plus minutes, bring fuel, even if you don't feel hungry. A gel, a goo, gummy bears, whatever you want, you need something to keep you going. And after you run, within an hour of your run, you need to get some protein paired with carbs, Greek yogurt with fruit, protein shake, chocolate milk, whatever works best for you. You have to get that into your system within an hour. Simple rule. If you're going to run today, plan your meals around it. Don't leave fueling to chance. Your body may not appreciate that because your body needs fuel. We all need fuel when we're running. It's a myth that we don't need it. It's a myth that you can do all your runs fasted. No, that's not true. Especially if you're cutting back on your food that you're eating regularly, you still need to fuel. It's I I hate this idea of everyone's starving. Anyway, so like I said, I'm going to talk about that in a little bit. Hydration matters. You really need all day hydration. You need to drink water all day long and make sure you check out your urine color. Make sure that it's not dark. Make sure that it's at least light, uh light yellow or clear, and make sure you get electrolytes on your longer runs. You really need to not let yourself get dehydrated. That's dangerous when you're on GLP ones. Strength training is essential. Aim for two sessions per week. Try to do that. Even if you just do body weight exercises, there's great, great bodyweight strength training workouts you can do. Just look them up on YouTube. They're awesome. Or get a couple sets of dumbbells and do them at home. You don't have to spend the money on a gym. It's not necessary. It really isn't. Now, if side effects are severe, the alternative approach is high protein foods, fiber-rich foods, omega-3s. Just make sure you're getting enough nutrition to support yourself. Now remember, this is a new drug. We don't know all the effects and the dangers from long-term usage. I read one runner say she was losing weight and she was going to have to use it for the rest of her life. Now that frightens me because we don't know what the damage is going to be like for someone using it for such a long time in 20 years. I just the thought of injecting yourself all the time, unless you're like a type 1 diabetes, then you're kind of used to it, I guess. But just injecting yourself with this for all your whole life, and it's not cheap. It's very expensive. It costs you a lot of money to do this. It costs what? Even with insurance, it'll cost you what,$70,$80 a week. That's a lot of money. It's a ton of money. So we don't know what the lasting damage will be in years to come. And the fact that big pharma is pushing this so strongly on us makes me want to run far, far away in the opposite direction. I mean, anything big pharma pushes makes me extremely suspicious. I would rather be a few pounds overweight than have to deal with the effects that Big Pharma doesn't care about. Because they don't care about it, trust me. They don't care about the effects that's happening. They will care if it's really bad and they get a lawsuit later on, but we don't want to be the victims of that, right? Anyway, so um it also made me think back at past diet drugs that Big Pharma said were safe, quote unquote, to use. Amphetamines, remember, marketed as benzodrine, became popular for weight loss during the late 1930s. They worked primarily by suppressing appetite, because of course they're going to do that. Your buzz is so high you don't want to eat. And other beneficial effects such as increased alertness. Typical regimens include stimulants such as amphetamines, as well as thyroid hormone, diuretics, digitalis, laxatives, and often a barbituate to suppress the side effects of the stimulants when you need to sleep at night. If you remember all the ODs of people, including Marilyn Monroe, who took all these diet pills to try to make themselves smaller. Especially in Hollywood, there were so many, I mean, Judy Garland, there were so many of these Hollywood starlets who were hooked on diet pills. And diet pills were amphetamines, basically. So they were buzzing all the time, but then they had to sleep at night, so they took barbiturates. And you get those mixed up and you take too many of them, and you're not going to be around anymore. You're just not. You're going to be gone. They told us that was safe. And then in the early 90s, two studies found that a combination of the drugs were more effective than either on its own. Fenfen, you remember fenfen? Became popular in the United States and had more than 18 million prescriptions in 1996. Evidence mounted that the combination could cause valvular heart disease in up to 30% of those who took it, leading to the withdrawal of fenfen from the market in 97. So Pharma's history with diet drugs isn't great. Of course, that's a story for another podcast. But another thing is that this website that I got a lot of the information from said that doctors will only give it to type 2 diabetes and ob obesity people. Well, that's not exactly true, is it? Because we see people in Hollywood using it and they were too skinny as it is, and now they're even skinnier. And a lot of them just look horrible. They have that sallowed out face. They say that the Ozempic face is what they call it, where it's just sallow out and there's no color to them, there's no n muscle, there's no nothing to them left. They're just basically skin and bones, literally. And it's really sad that this kind of look is is so prevalent right now. As runners, of course, we shouldn't look at Hollywood types for role models. I mean, come on. You know. I think Hollywood is like the last place we need to look for role models. So don't think that you should take it just because some Hollywood person takes it. No, no, no. Be healthy, be safe. If you think you need it because of your health conditions, take it. But think of it as a temporary thing to get you on the right track. And then you can get off it and then you can eat healthy meals and live a healthy lifestyle, because that's really what it's all about, isn't it? And running, of course, because that's what the show is about. And then you can learn to run and get your running in, and you won't have to be guided by injectables. And anyway, so because that's what the show is about, right? It's about running. So it's about getting you the healthiest that you can be, and um maybe one day not having to take that, right? All right, so that is it for today, and thank you so much. I appreciate it each and every week. Um, yeah, my email address is Martharunserworld at gmail.com. If you want to email me with your thoughts on this, I don't know why these allergies is really affecting my voice, so if it's scratchy, that's why. But other than that, everything is great. I'm gonna go for a run now and enjoy my day. So you have a wonderful, wonderful day and the rest of your week. And on that note, let's tie up Bushy Laces and go for a run.