GLP1 Dosing

Most of the frightening GLP-1 stories come down to one thing: the dose. In this episode, Rick Sorensen and Greg Camp explain why semaglutide and tirzepatide drive thousands of poison control calls and ER visits every year, and why almost all of them are preventable.

They dig into why injecting a medication is a completely different skill than swallowing a pill, how proper titration works (starting around a tenth of a full dose and building up over four to six months), and why the same dose can be a different number of units depending on the pharmacy and concentration you use. They also share a memorable story about a physician colleague who double-dosed by simply misreading a label, proof that this can happen to anyone.

In this episode:

• Why most GLP-1 “side effect” horror stories are really dosing errors
• The compounded-vial trap, and why the label on a big vial can mislead you
• Milligrams vs. units, and why you should ask for a hands-on demonstration
• Your pharmacist as an underused safety check before you inject
• What happens when you switch medications or pharmacies
• Microdosing, half-lives, and why people respond so differently

If you or someone you love is using a GLP-1 medication, this is a practical, judgment-free guide to using it safely.

Disclaimer: This podcast is for educational and informational purposes only and is not medical advice. We are not your medical provider. Always consult your own licensed medical provider before starting or changing any medication or weight-loss plan.

Transcript

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SPEAKER_03 0:24

Here we are. Welcome back. Hey guys. Healthier Ever After. I'm Rick Sorensen. It's Greg Camp. We are here talking about health and wellness and all sorts of uh good stuff to make you healthier ever after. Uh so today we want to just get in, dive in. Uh we there's a lot of uh I mean obviously, you know, if you've been tuned in at all or listened to us, we talk a lot about weight loss and GLP one use uh you know medications. And and that's been a um I think do we have a shadow on that?

SPEAKER_01 0:52

Is there? Yeah, our camera's like got a weird shadow on it. Let's kind of wait, is that just your screen though?

SPEAKER_03 0:58

I don't know.

SPEAKER_01 0:59

It's on that and it's on this. Oh, yeah. No, that's you know what? We have cool shadows, you're welcome. Yeah. Uh it's uh we'll try and fix it. Advanced technology. We're just gonna talk about health stuff. Yeah, that's kind of interesting.

SPEAKER_03 1:11

Um, all right, so we'll see if that shows up on the final thing. But anyway, um, a lot of a lot of GLP1 medication use. Now, this is a little different, and what we want to talk about, um, you know, there's a lot of people that just get this from their provider. Uh speaking of that, uh, we are not your provider. This is for educational informational purposes only. And uh please meet with your medical provider before starting any medication or weight loss regimen or exercise program or medication supplement, whatever. All of the things. So um, so people get you know their prescription from their provider. And and the thing is, is there there's a lot of the kind of, I would call it like the Wild West um getting this med. It's like people are getting it from my my cousin, there's a nurse practitioner, or hey, can you just hook me up? Or I've got a guy on the corner who's a discount semagluid.

SPEAKER_00 2:00

I've actually had uh patients that came in and said that they decided to come to my office because they didn't want to get it from the person that was selling, that was meeting everyone in town at the gas station on Wednesdays. Like, like really, like they were going to like a small town, and there was like someone that came to the gas station on Wednesdays, and there would be a line next to their truck, and they people would just go. This is not a medical provider, this was just a human.

SPEAKER_03 2:28

But dude, okay, so so all right. This scenario that we're talking about is real, and it's part of the reason we've started this whole podcast, this whole thing about getting information. We we are passionate about getting helpful and accurate information to people, and and there are a lot of people using these medications that don't have access regularly to someone about that.

SPEAKER_00 2:51

And and can I preface that statement though, with also that you know, this is not we don't really come at this with any judgment. Like what like when we understand that that people are desperate to feel better and be healthier and all that, and living on a budget, yeah. And so I we don't come with any judgment with that. We um we recognize why this is happening, yeah. And so it's not a judgment thing. It we actually really just want to provide in good information so you know if you are getting it from the guy at the gas station, what to do, what to do, how to understand what that may mean. Um, and we always want you to get it from the best uh, you know, most safely uh, you know, like best source possible.

SPEAKER_03 3:35

I might add what sounds like a tiny bit of judgment is that if you're getting this from a guy on the gas station, you may consider looking into like a reputable compounding pharmacy that is licensed. But that being said, yeah, we that's what we want. Get it where you're getting it from if you're using it and you're whatever, you know. And we're gonna talk actually we're gonna talk a whole episode about peptides and and things as well, and and some of the safety issues with that. And and I think that goes along with guy on the street telling you. But that being said, get it, get it where you get it. Yeah, that's fine. What we want to talk about is how to use it. And it's interesting because there's there's some interesting data. Um, the GLP1 medications, and we've talked about this before, it's it was a diabetes medication for almost 20 years before it then was um given an indication by the Federal Food and Drug Administration to be a weight loss drug as well. So so when that became official and it's now officially a weight loss drug, also, yeah, um, its use skyrocketed. Sure. The other thing that skyrocketed is calls to the poison control center. Right. Uh and and interesting. So more than 8,000 poison center calls in one year, I think in 2023 is what they looked at.

SPEAKER_01 4:43

Yeah.

SPEAKER_03 4:43

Um sounds like a lot and a disaster. But researchers looked at this and it's closer. And the domino story was not like intentional abuse or overdose. It was, it was um a fast growing body of people using medication and and um dosing it inappropriately or inaccurately. Or inaccurately. Yeah. So so we wanted to talk about that a little bit today. How did like what do we do? What does that mean? And and really it's a part of this is I think this the nature of this medication. Like you grow up your whole life, most people I think grow up your whole life, and you know, you get a headache, mom gives you some Tylenol, or an ad bill, or you take vitamins, and and all that. I mean, medication for most people, their entire life is in the form of a pill, right? A capsule, a pill, a solution, you know, something you take orally. And and this this changes the game. This is a completely different thing where you're injecting. I got our little syringe, a little insulin syringe, and we'll talk about that a little bit. Um but injecting medication is is a new thing for people.

SPEAKER_01 5:50

Yeah.

SPEAKER_03 5:50

And and it's it's um, so it requires some a little bit of education, and it can be much more dangerous. You know, your your body, when you take things orally, your body has its own process to kind of filter through that.

SPEAKER_00 6:06

Right. Well, and you can even vomit, right? Like, but if you don't absorb, like if your body really doesn't like it, like you can vomit, or you can, I mean, there's things that your bodies have as a protection there. And um, when you inject something directly into the body, it bypasses that all of it.

SPEAKER_03 6:20

Yeah. So, so anyway, that and so dosing errors is a big thing. And and a lot of times, here's an example as well. A lot of people use like these compounded pharmacies. We, you know, I I know a lot of people that do this, and and what'll happen is the the pharmacy can't print, usually a compounding pharmacy can make a vial of medication that has you know so much amount, and and they can't really market that or sell that beyond like a 30-day expiration. And I know these pharmacies, like the pharmacy we use, they've done testing and their stuff is good for longer than six months, like for sure. They've done the testing, it's it's good, but they can't say that, yeah, right. So they have to sell a vial in a size that only lasts a month. Yeah, right. 28 days. So a lot of people like go to the pharmacy, like, well, I want to get the big vial um because it's the same price. Yeah.

SPEAKER_00 7:11

And but then they dose it differently than what that's the directions on on that big vial. Like so, whatever, you know, obviously every prescription has to have directions on the prescription to be a legit prescription. Um and a lot of people don't really follow those directions. And sometimes that's directed by a medical provider, but other times it's not, and they're just trying to figure it out.

SPEAKER_03 7:35

Yeah, and so so we want to just bring this up, I think, because it's important. Like if you if you're buying the file that has the it's it's its written instructions are as if you were already on the highest dose. Sure. And let's say you're starting semaglutide from scratch, like zero. It's it should take you four to six months to get up to that maximum dose. Like, like this is a slow process. Yes, you start, you start at about a tenth of a whole dose, yeah. It's about a one-tenth about it usually is our starting. It is about a tenth, and and and then you increase that um you after four weeks, like it's a slow thing.

SPEAKER_00 8:16

So and that's it needed, like, right? Like some people are getting the desired effects at these. The studies show that it that everyone just increased after every four weeks. But what they're finding in practice, and what we see in practice, is that a lot of people really they get to that first dose or second dose, they're responding fantastically to those doses. They're getting all the effects that that were desired. You know, they're losing weight, or they're feeling better, blood sugar control. No need to increase that dose. No need to increase it. So um, this becomes a problem when you're uh guessing at it.

SPEAKER_03 8:47

Yeah. Well, and and the problem that you run into, and this is why so many, you know, 8,000 whatever calls to in 2023 um to poison centers involving GOP1 medications, it's is is because the side effects that we talk about, like we go up slowly over weeks and weeks and weeks, uh, because the side effects are what limit how much you take. And when you start uh from zero and take, whether on purpose or accidentally, this is usually accidentally, take you know, 10 times or five times what that starting dose should be, your chances of having significant side effects are they're high. Well, they're gonna happen. I mean 100%, but you're gonna make super duper sick. And and these are the people that that you know they call the poison control. These are the people that in the emergency department where we work that come to the emergency department and say, Hey, I just started this and I I took, you know, uh and and it's surprising that that they're like, I took the right dose, I took the thing, I looked at the thing, and I'll say, show me on this syringe. Like, I'll take the syringe and ask, show me where you were, show me what's your vial, what is the dosing, and and they've given themselves 10 times their starting dose. Yep. And they are going to be sick, you know, they get ibufluid, we give them I, you know, some medications in their nausea, but they are going to be sick and nauseated for three days.

SPEAKER_00 10:05

Yeah, and really, I mean, I we we start to attack the medication for this, right? Like people are like, oh, they're unsafe. Oh, I'll never I have patients that'll come in and they'll be sick from that. And I'm telling them, hey, you did four times the dose you were supposed to do. I know it wasn't intentional. Maybe it was a lack of education on the provider's end, maybe the patient misunderstood, whatever the reason. Um sometimes I think the medication is what gets the bad rap. It actually wasn't the medication at all. It was that it was it was just like if you took any other medication at the wrong dose, you very likely will have side effects.

SPEAKER_03 10:38

And I mean, the same thing would be like say, hey, you have a headache, you should take some Tylenol. And well, I've never taken Tylenol. Okay, well, you take two Tylenol, extra strength, yep, every four hours. And then I go home and say, okay, this is every four hours I take Tylenol, two of them. So four times two is eight. So I take eight Tylenol. Like that it's it's similar to that.

SPEAKER_00 10:58

Like that's just you get messed up at the map. I mean, and you go take eight Tylenol. I mean, I think me and Rick would agree on this. There's not a study, like it's not a comparison study on this, but overdosing Tylenol is significantly more dangerous than overdosing your GLP1.

SPEAKER_02 11:11

Right.

SPEAKER_00 11:12

You know, but Tylenol, I mean, you'd never think about like, oh, Tylenol, that's not everyone has Tylenol in their house.

SPEAKER_03 11:17

So I think part of the importance of this is in practice, you know, when we're talking about like it's a different thing, injecting medication is different and stuff. It is so different. Um that that still to this day, if if uh someone comes to the emergency department, particularly a child, um, that comes to the emergency department and they're they're sick with whatever, they're not feeling good, and we find out, you know what, you have diabetes. Yep. And this is a new diagnosis for you. Like, like we make that diagnosis of you have diabetes now, which you never had or never knew you had, or this is a brand new diagnosis. More often than not, we admit those kids, especially kids, yes, admit them to the hospital because partly because I mean sometimes it's because they've gotten themselves in a like a dangerous metabolic situation, but but sometimes it is simply because there is so much education that needs to happen. This is such a life-changing thing, and using these medications is such a delicate, uh, it has to be deliberate and specific and accurate process that that that education enough is to keep people in the hospital and make sure that happens and you get a good plan and you got the right medication and understand it. And so that that level of education is not happening with the GLP1s, right?

SPEAKER_00 12:29

So, yeah, uh it's hard to replace a five-minute phone call uh with a provider with someone like like like Rick's saying, like they get a diabetes diagnosis. I mean, they have a whole team, you know, you're gonna have a diabetic educator nurse that will spend a significant amount of time helping you understand family with mom and dad, with dosing and and instructions and all these things. And I'm like, and so you know, really we're yeah, are we saying that it's gonna take maybe that much education with these? No, but what it what it points out is that this is not something that should just be lightly three minutes of a Google search. That's how I figured out how to do this.

SPEAKER_03 13:08

It's it's just more than we would never I would never say, hey, uh your your child now has diabetes, it's a new diagnosis. Go do some Google searches on what to do about that, and good luck. Like that, I would I would never ever do that. Ever. Um, okay, so can we do story time? Are we I gotta add see if the so um you had an interaction with um someone we work with? We won't name names, okay, but I actually don't know where we're going with this. No, um, someone who insisted they knew how to dose this correctly, yeah. But really didn't.

unknown 13:41

Yeah.

SPEAKER_00 13:41

Do you remember the story? I don't. Uh I'm trying to remember. I probably just deal with this so yeah, yeah, yeah.

SPEAKER_02 13:50

Yes. Okay, so so so we want to, I mean, I think we can tell storytime without uh giving specific identities, but this is the I think it's a great uh illustration.

SPEAKER_00 13:59

Well, it's it's you know, and this person is very educated and um and and and extremely intelligent. And uh, you know, it's it's it's a physician that uh we work with. It's that it's that easy. It's that easy because even a physician who knows all about medications and concentrations, and really it's that easy. Um, just a misreading or a misunderstanding of a label and just never having done this before can oftentimes result in in errors. And you know, this particular person uh was kind of talking to me about it and saying, Hey gosh, I'm on this like really low dose, and geez, I'm still kind of getting sick. It's fine. I I like it. I'm not getting they weren't way overdoing it, but you know, and it was just a literally just that they had not done it before.

SPEAKER_03 14:41

I mean, just well you were like, you weren't you asking, like, are you sure you got the right dose?

SPEAKER_00 14:45

Yeah, I was like, Are you sure? And they're like, Yeah, like look at me. I am a physician. Are you are you asking me if I got the right dose? And I'm like, can I just see it? Like, can we just look at it? And sure enough, ended up finding out that they were doing double the dose, which thank goodness, because they would have been sicker had it been any more, but double the dose what they thought they were doing. And um, of course, that's why he was having side effects and not feeling very well. And we got that dialed back, you know, um, and you know, of course, did much better. So, but I mean, if a physician that uh is trained more hours than you can imagine on medications in general, if they can mess this up, there's no question that that the lay person with with not a significant medical background or someone that does have one can mess this up.

SPEAKER_02 15:31

Yeah.

SPEAKER_00 15:31

And I mean, like I said, he's lucky that it was just double the dose.

SPEAKER_03 15:35

I mean, because people are taking, like I said, between double and ten times the dose. Yeah. And it's it's when you've seen these people come into the ER like with just the worst nausea. And that's and really most of these, most of the side effects are are gastrointestinal. It's you know, start with a lot of nausea, a lot of vomiting, yeah, sometimes some diarrhea. Uh um, far and away. That's you know, very rarely do you ever get um like hypoglycemia, but but the gastrointestinal symptoms are far and away the most common thing. And you see these people come to the ER and they're so miserable and and so hard to get, you know, just get them barely on top of okay, I think I can survive to go home now. But but they're the you know, the next three or four days are going to be absolutely horrendous because it's a long acting medicine. Like it's a week long, you know, the half-life isn't forever.

SPEAKER_00 16:23

Yeah. So by design, I mean, but then um, that's not very fun when you overdose because then you're dealing with it for several days.

SPEAKER_03 16:29

You can't vomit it out, you're vomiting because the effect of it is ten times what it should be.

SPEAKER_00 16:34

And you just well, and there is no reversal, you know, it's not like for some things that people overdose on. We have a reversal agent. This is not the case. No, maybe that's something interesting. I wonder if people could make that.

SPEAKER_01 16:45

Um reverse the yeah, nobody would buy it.

SPEAKER_00 16:48

Nobody. I mean, you'd be so hungry.

SPEAKER_03 16:51

So so so what do we do about that? Number one is I mean, the number one thing is have a conversation with whoever's providing this medication. Hopefully, that is a licensed medical professional. Um, and and you know, like who owns who owns the education? I don't know, your prescriber, sure. The pharmacist, sure. You know, if you're if you're um using it outside what the pharmacy label says or your prescriber, that I mean you you need to kind of talk to somebody with that experience. And and honestly, that I don't want to say prescribe, but I mean you just use an example of one of our colleagues who's a physician that that did that got the dosing wrong. Yes. Like if you're not doing this regularly, it's it can be difficult to get the math right.

SPEAKER_00 17:36

Every that's why medicine has specialties, right? Because you become really good in very specific areas. And so, you know, it's easy for someone that is not trained in this area to not fully understand or make mistakes or things like that. So, of course, it can be made by patients or anyone else that does this. You know, I think a resource that you just had mentioned that is probably one of the more underutilized resources in the medical community, is a pharmacist. Now, yeah, even though a pharmacist, even especially a compound pharmacist, if you're getting this from a compound pharmacy, while the pharmacist will not set your dose, that's your prescriber.

SPEAKER_01 18:10

Yeah.

SPEAKER_00 18:10

What they can do is clarify. So let's say that you call, let's say, I don't know, if you can't get a hold of your medical provider for a few minutes, but you're ready to dose and you want to, you know, you could call in them. Maybe you're just starting and you're like, hey, I was going to start my medication today. I think this is what this, you know, my dose is on the prescription. I think this is what they meant, uh, or what they told me to do. Does that sound accurate for my first dose? Yeah. The pharmacist can easily tell you, like, hey, look, I can't tell you what dose to do. Uh, but yes, that sounds right. Or no, that's seven times what you'd normally start at. Yeah. And this would uh save you from potentially an ER visit, called a poison control, vomiting and you know, sick stomach for five, six days. So I think it's really one of those things that where it's like, there's nothing wrong with asking the question. And then if they're like, hey, look, yeah, this is wrong. You need to talk to your medical provider. Great. You know, save yourself some time. Don't do the injection. Talk to your medical provider, and you can get clarification on that dosing.

SPEAKER_03 19:09

Well, and and so, and so part of that is is um, I I think having an actual asking asking the question, asking for an actual demonstration, even a teachback kind of demonstration. So it's like I'm holding in my hand. If you're on the video on the YouTube, I've got a little insulin. This is the most common syringe that people use for some of the good diet. It's the it's a one milliliter syringe, it's marked up to 100 units. And part of the issue is that the the medications are dispensed in milligrams, and that needs to be translated into what people use as units, and that's different. It's different from what pharmacy you use because the concentrations are different. So the number of units from that you're gonna use uh from one pharmacy is gonna be different as the number of units for the same dose, uh, the same amount of medication from another pharmacy. And that it can vary by you know by a lot. Um, so so checking with your practitioner and your pharmacist and say, look, can you show me exactly? Show me on this syringe where this is, because I've had people ask me, so well, I only gave half of a half of a unit, and they had to go into the 50 unit mark on this, because they think half of a syringe is a unit. You know, just it's just it's just it's it's it's some language that people aren't used to. And I think having a demonstration is just show me on this syringe where my starting dose is, what it means, because it usually is like a tiny, tiny little bit, like one tenth of this tiny, tiny syringe.

SPEAKER_00 20:22

And it doesn't look like it do much. You know, the thing that I thought about the other day, actually, this was when I was at my house and my wife was cleaning, and she was using an ultra, you guys have probably seen this before, an ultra-concentrated cleaner. Now, she doesn't, she puts in a certain amount, whatever, how many teaspoons or whatever per the total water. Now, so the difference in these pharmacies is some pharmacies put in two teaspoons, some pharmacies in their concentration put three teaspoons or four teaspoons. So, once again, they're the concentrations are so different. So, to make the analogy of a cleaning concentrated cleaning agent, you know, and that matters because three sprays out of the thing is going to be either twice or whatever, more, three times more. If you just know that, like, hey, this is if it were all the same across the board, well, it wouldn't be too hard, right? It'd all be the same. It's not. Every single pharmacy has a little bit of nuance. Now, you'll have some pharmacies that have similar concentrations, and that's not too big of a deal. But you know, it's it's worth the question. And I have patients that'll come in all the time that just say, Look, I've just never done an injection before. I'm not even worried about doing it. I just want to come in and have you show me. Yep. I'm telling you, these I I love that. I love that they're hey, I taking that next step. Because you know, you do one or two injections with a patient, you almost never have these are not the patients you ever have problems with in the future.

SPEAKER_03 21:42

Yeah, just just showing, ask, you know, ask your provider, ask your pharmacist both to show you how to do that. A lot of pharmacies do injections, yeah, do flu shocks, they do all kinds of stuff. And so, yeah, ask, I think that's a great question to ask. Show me exactly what to do, and show me how to do this. Show me the importance of you know, uh an alcohol. Alcohol wipe.

unknown 22:00

Yeah.

SPEAKER_03 22:01

Like, like you don't just, you know, and there are there's procedures to decrease your chances of infections that that you are you don't sometimes think about if it's not something you normally do. So I mean, yeah, ask for a demonstration of exactly how to do that.

SPEAKER_00 22:14

There's safety issues. Totally agree. This is uh it's a it's a big deal. And I guess uh our our th thoughts and feelings on on this stuff and bringing it up is because sometimes the GLP ones get a little bit of a bad rap. And and you know, sometimes people just don't tolerate them well, and and then poison control calls will be made. But you know, you know, really in our minds is that many of these, if not a majority of these, could actually be prevented entirely almost all of them with a little education, and that's both on the patient seeking that information and the provider providing that information. So we really think that the conversation has to revolve around um the patient really wanting to do this safely and the provider also getting that information.

SPEAKER_03 22:55

And this goes with any medication change, for example, you know, a lot of people will like start on semiglutide and they're using that, and they're like, you know what, I'm just really not tolerating this well. I just too much, too much nausea, whatever that may be. And a lot of times those people are like, well, then let's try tearzepitide. It's got a much more uh a better profile for side effects. A lot of people have a lot less nausea on it, so let's change that. So so changing that medication, again, that's gonna involve changes. So you can say, like, I was on you know, 50 units of semaglutide every week, and it just wasn't it was making me too sick, and I'm gonna change the tirzepatide. The the it's not an automatic, like, I'm gonna go to 50 units of that. That will the concentration is different, yeah.

SPEAKER_00 23:32

That that may or may not go over very well.

SPEAKER_03 23:35

So it's a different medication, different concentration, and it's and it's a different dosing schedule when it's a different medication. So you gotta be aware of that as well. Like any any changes of medication, changes of formulation, change uh to your pharmacy. Your provider might say, Hey, I got we're gonna get you a better deal at this other pharmacy than what you've been using this for months now. You gotta recheck that. And and it's almost like a start over as far as the calculation on what the equivalent dose would be from a new pharmacy from what you've been using, even for a long time already. Absolutely.

SPEAKER_00 24:05

Um, I think there was a few other things we were going to talk about. You know, I don't know if we'll get into it. Uh, you know, I we could, geez, we could probably do a whole uh episode on microdosing and and all that. Like microdosing is a uh um yeah, it well, it's just briefly, and we can probably even just go into more detail in a different episode. But really, microdosing is just these medications were made and their half-life, which is means how long is the medication in your body and effective, um, is meant to be about seven days. So yeah, it's a good standard dose is once a week. Once a week is the standard dosing for both trazepatide, that's Manjaro, um, or Zep Pound. Yep, Zep pound. And then you got Ozempic or Wagovi, which is semaglutide, um, or some people that are probably smarter than me, semaglitide. Um, I don't say it like that. I think it sounds um no, but like some people will do smaller doses, so you're getting a total amount of medication, like the total that you would normally take once a week, they split that up. Some providers will make it to where they do that. Hey, uh, you know, split that up into two doses. So uh, because patients sometimes just tolerate it. Like Monday, Thursday, Monday, Friday kind of a thing. So, or do a dose every four days, but a smaller dose. So you're not doing the bigger dose that we'd normally have you on because either we weren't tolerating that well, we want a little more steadiness of the medication instead of a kind of a big up and a big, you know, a big peak and a big valley. Um, this is commonly done with even other medications like testosterone, and and we'll talk more about uh testosterone and testosterone dosing.

SPEAKER_03 25:34

Yeah, well, it's interesting. Uh you mentioned that that like the micro dosing. And a lot of people, a lot of people that helps. Like it's it's it's another thing that try because and it's because of this individual response. Like everybody responds just a little differently. Um, I know people um that that they're kind of like a 10-day thing. They like pay really close attention and like, you know what, I I really just don't need this every week. I need it about every 10 days is when I feel like I start to get hungry again, you know, and and so they'll they'll be on like a once every 10 day kind of a thing. I think Pete's that way.

SPEAKER_00 26:04

Yeah. Well, and then you have and then you have other people that are like, after three days, I don't even feel like I have any medication in my system at all. And you're like, there's a just a stark difference in these people.

SPEAKER_03 26:13

Yeah, and and that's where that's where sometimes this microdose, and you take that week's worth of dose and and divide it up twice, uh, you know, or three, or you know, but usually it's a two thing.

SPEAKER_00 26:22

But and because the medication is essentially we're saying, okay, the medication is the same, we'll say that you know, the ozempic or semaglutide, as long as dose correctly, we'll, you know, it's equivalent. That this is these little nuances uh with individuals, how how fast they metabolize the medication, this is where your medical provider, like a good medical provider, is really where that comes in. Because if you don't have anyone to bounce this off of or say I'm running into these side effects, and and uh like like what is microdosing for me? If you don't have anyone to to to really troubleshoot that with and say, hey, what can we do here? Do I need to switch medications? Do I need to go down? Do I need to go up? Do I need to do multiple doses a week? I mean, you really what ends up happening is that you know you try to do it on your own through Dr. Google, and then and then you end up in the emergency calling poison control or in the emergency department.

SPEAKER_03 27:11

You end up one of 8,000 poison sound calls. Yeah, that's a lot. Um, no, it's important, and I think it's important. And and honestly, I'm gonna make a note because we've been uh talking about putting together, we've got a little uh education course we're putting together for medical providers, and I think that's an important thing to kind of remind them that they need to be aware of their pharmacy's concentrations, what the practical prescribing, and um and and teaching people how to set. So so be safe out there and dose the medication correctly. Like it's it's it's it's a real thing. It's a it's a it's worth uh very meticulous attention and deliberate efforts to make sure you're gonna have to do that.

SPEAKER_00 27:48

And if you have questions, just hold off on your dose for a day or two, get a hold of your medical provider, get a hold of the pharmacy, like for whatever clarification you need. And and just I mean, just give it a day or two to get the information you need to make sure you're dosing um accurately and and correctly. It'll save you probably an ER visit as well as um just several days of misery, just miserable. Like I said, like so miserable. I know seeing these people are like the yeah, like the worst case scenario, like GI bug flu, like uh they feel horrible. They just feel terrible. And it's just because it's a dose wrong. It's not you know, you we we target the medication and kind of blame the medication, but it's not it's not really the medication, it was really the the inaccurate dosing.

SPEAKER_03 28:29

Yeah, I mean it's it's it's you know I mean when I guess we could we could have a whole nother conversation. I think we'll just cut it today, but um about like when does a side effect become an overdose? Yeah, but yeah, you know, because because it's it's the normal side effects. All you're really doing when you take too much like this is you are taking the worst side effects and making them ten times more. Yeah. Anyway, so those right, get your medicine from a reptile source. If you don't, we don't judge you, but we want you to be able to use it. So we want you to be safe. Safely as possible. So and stay healthier ever after.