Below is some helpful information about GLP-1s posted by a member:
Hi B6T’ers,
I wanted to provide a PSA in case it would be helpful to anyone else stuck with the specific things I’ve been dealing with recently. The topic here is B6T and GLP-1 medicines (semaglutide, tirzepatide, wegovy, ozempic, zepbound, mounjaro, etc.). I will put relevant links to research studies in the comments.
Quick background: I discovered I had B6T about 3 years ago (after as many years searching) with smoking gun blood levels. Long story short, I followed the protocol for a few months and got a 90% heal. HUGE thanks to Beth and this community.
I then went back to normal life and didn’t really maintain hydration levels, as I was essentially symptom free.
This July, I started taking tirzepatide, a GLP-1 drug, for weight loss. While the drug has worked great (I’m down 35 pounds in 4 months), it also caused a drastic relapse of my B6T symptoms, specifically bilateral muscle fatigue and weakness in legs and arms, systemic fatigue, destabilized blood pressure, lightheadedness, and waves of anxiety. Because I knew this symptom constellation from before, I knew what was going on, though it took a few weeks to figure out why.
So here’s the PSA: if you’re on or considering a GLP-1 drug and you’re B6T, you need to know that GLP-1s *likely* increase sodium excretion in the kidneys. As we know well, where sodium goes, so does water. So you’re losing water and sodium faster on a GLP-1. In addition, GLP-1s also suppress appetite, which likely means your eating less, and that means you’re eating less salt. It likely also suppresses thirst, so there’s a higher chance that you’re also not drinking as much as you were before (if you were just going off thirst and not a hydration regimen).
In addition, common advice while on GLP-1s for weight loss is to up your protein intake so you’re not losing muscle. As we well know, not all proteins are equal when it comes to B6T. So the advice is to eat more healthy meats (chicken, fish, etc.), which, if you’re not careful, will quickly put you over the B6 RDA.
All of that combined for me to a dehydration event(s), which led to lower blood volume and another B6T event, which led to the relapse of my symptoms. Once I figured it out and increased water and salt, after a few weeks, the symptoms all subsided. I temporarily increased salt more than the B6T protocol, figuring I was wasting more salt than a normal person. And that worked. Once I stabilized, I roughly returned to 1/8t salt per liter of water.
This is not medical advice, just my experience. I was in constant contact with my PCP. I religiously logged all of my electrolytes in cronometer daily, and I checked my BP daily to make sure salt wasn’t causing hypertension (in fact, most folks see a significant drop in BP with a GLP-1… and it’s likely that part of that mechanism is the increased sodium excretion in the kidneys).
I hope this is helpful to someone! I was desperate to find this kind of info when I was in the thick of it, so hopefully this will help the next person.
Please see the following scientific articles for more information on GLP-1’s:
Glucagon-like peptide-1 is involved in sodium and water homeostasis in humans