Published May 17, 2023 FIRST OFF, WHAT ARE GLP-1 DRUGS LIKE OZEMPIC? Semaglutide is a synthetic form of GLP-1, which is a human peptide hormone called glucagon-like peptide-1. Ozempic, Wegovy, and Monjauro are all brand name drugs (called GLP-1 receptor agonists) that contain semaglutide as the active ingredient. These drugs work by binding to and activating the GLP-1 receptors in our body, just like the natural GLP-1 that our body makes. We have these receptors in the first place because our body makes GLP-1 in response to certain foods and even herbs, which we’ll come back to — however, medications tend to have a stronger effect. This is because semaglutide is modified in a way that makes it more resistant to degradation by our usual enzymes, allowing this synthetic version to have a more sustained effect on GLP-1 receptors than our own GLP-1. This is not to say that our own GLP-1 can’t be sufficient for weight loss and reversing insulin resistance over time, especially if diet and lifestyle changes are strategically designed to maximize natural GLP-1 secretion — nonetheless, synthetics can and do provide a much stronger effect, resulting in a faster and more significant outcome. GLP-1 itself is a peptide hormone produced in the gut in response to food that essentially signals to us: we’re happy and satisfied! (Or maybe a little nauseous rather than happy if we overdo it, but certainly satisfied). The natural GLP-1 that we make is usually secreted in response to a meal, and plays an important role in regulating our glucose levels, insulin secretion, and appetite. By stimulating things like insulin, this hormone makes sure that our carbohydrates are metabolized and utilized for fuel, instead of hanging around in the blood creating excessively high blood sugar. For reasons not yet fully understood, some individuals have lower levels of GLP-1 than others. These range from genetics to diet and exercise, as high-fat-high-sugar diets have been shown to decrease GLP-1 production, while exercise and weight loss have been shown to increase it. The rise of easily accessible, processed, “hyper-palatable foods” (rich in the combo of fat, sugar, and salt) are making up more and more of our diets, which may skew levels of GLP-1 in those who eat a more processed diet. Medical conditions, medications, and even aging may also decrease GLP-1 production. Having lower levels of GLP-1 may lead to impaired glucose metabolism, insulin resistance, and an increased risk of developing type 2 diabetes. Therefore, it’s easy to see why GLP-1 is such an important target, and why medications that mimic GLP-1/activate our GLP-1 receptors are so powerful and helpful. When GLP-1 is increased (whether by Ozempic or diet changes and natural substances), the result is: Increased insulin secretion (= better carbohydrate metabolism and lower blood glucose)Decreased glucagon secretion (= reduces the amount of glucose produced and released by the liver, lowering blood glucose levels)Slowed gastric emptying (= decreases the rate at which carbohydrates are absorbed in order to reduce post-meal blood glucose and controls appetite)Decreased appetite on a gut-brain level (= the gut feels “full” and the brain feels safe/stops seeking) Decreased insulin resistance (= because of the above, lower blood glucose levels over time lead to better insulin sensitivity!) All of these mechanisms lead to improved glycemic control and weight loss in those with type 2 diabetes and/or obesity. WHY GLP-1 SECRETION IS SO POWERFUL GLP-1 receptor agonist medications like Ozempic (and anything that stimulates the secretion of our own GLP-1 in a significant and meaningful way) are powerful because GLP-1 is powerful. To put the 5 points above simply, when GLP-1 secretion is increased, you are full. Satiation skyrockets, helping you to reduce food intake and make wiser choices. Many describe this as the “food chatter” finally being quieted. GLP-1 is so powerful, in fact, that it binds to intestinal neurons within the ‘enteric nervous system’ of the gut, causing actual gut distention even without the presence of food. Because of this gut distention, this peptide can make you feel extremely full without ingesting a single morsel… and even stimulates neurons in the hypothalamus that suppress appetite through brain mechanisms. This is a true gut-brain axis drug that not only makes eating healthy easier but has additional metabolic effects that make a real difference in blood glucose levels and insulin sensitivity, through mechanisms that are totally removed from those better food choices. As these drugs help you eat better, they’re also helping you to metabolize better. WHY ARE GLP-1 MEDICINES QUIETING THE “FOOD NOISE” IN THE BRAIN + REDUCING NOT JUST FOOD, BUT ALCOHOL CRAVINGS? It’s important to remember that these medications mimic the release of hormones after a *very* large meal. Biologically, the hormone release that would come after a very large meal, signals to the brain that, “Everything’s all good! We don’t have to worry about eating or seeking fuel for a while.” And again, there’s a gut-brain axis phenomenon here; this medication and this hormone in general is not simply working on a gut level, the hormone cascade that follows makes it work on a brain level. So, if you’re someone that usually self-medicates with food (or even alcohol) for your anxiety — if you’re accustomed to seeking food or other reward-seeking behaviors like drinking to feel good and deal with stressors, the “we’re good” fullness hormones that result from GLP-1 stimulation are powerful enough to supersede that. They help to put you in a state of contentment not just physically and appetite-wise, but mentally as well. What’s more: Normally, with a diet where you’re restricting food intake but NOT stimulating GLP-1 (whether with meds like Ozempic or the natural GLP-1 stimulating foods and herbs we’ll discuss below), you’d actually have more of that anxiety and seeking behavior. This is why GLP-1 meds seem to be such a ‘magic button.’ You’re able to eat less and make the right choices, but not be met with your usual (or even an increase) of the mental noise and cravings. CAN YOU MIMIC OZEMPIC NATURALLY? FOODS THAT STIMULATE GLP-1 SECRETION Remember, these natural foods and herbs do not stimulate GLP-1 secretion as strongly as medications, and therefore may not be suitable for all as their only approach. But for some, whether you’re just starting out, or want a strategy that helps you maintain your results from Ozempic, these natural products are powerful enough to make a huge difference and get you on the path to metabolic health. Very broadly speaking, these include: Fiber-rich foods: Studies have shown that consuming fiber-rich foods, such as fruits, vegetables, and whole grains, can stimulate the secretion of GLP-1.Probiotics: Probiotics are live bacteria that can be found in fermented foods, such as yogurt, kefir, and kimchi. Studies have shown that certain strains of probiotics can stimulate the secretion of GLP-1.Berries: Berries, such as strawberries, blueberries, and raspberries, are rich in polyphenols, which have been shown to stimulate the secretion of GLP-1.Protein: Studies have shown that consuming protein-rich meals can increase the secretion of GLP-1, leading to improved blood sugar regulation and decreased appetite.Green tea: Green tea is rich in antioxidants, which have been shown to stimulate the secretion of GLP-1.Cinnamon: Cinnamon is a spice that has been shown to improve insulin sensitivity and stimulate the secretion of GLP-1. And while these categories are quite broad, there are certain stars within each one that can be more powerful than others. WHY HIGH-PROTEIN FOODS ARE KEY FOR GLP-1 Studies have shown that consuming protein-rich meals can increase the secretion of GLP-1, leading to improved blood sugar regulation and decreased appetite. One possible mechanism behind this effect is that protein can slow down the digestion and absorption of carbohydrates, leading to a slower and more sustained release of glucose into the bloodstream. This in turn can stimulate the secretion of GLP-1, which can promote insulin secretion and improve glucose uptake by the body’s cells. The added benefit of a high protein diet is, of course, that it functions not only to conserve but to build muscle mass, which is the most important ‘organ of longevity’ as we age, according to my functional physician Dr. Gabrielle Lyon. Muscle is not only the most insulin sensitive tissue, which naturally helps us to fight insulin resistance and type II diabetes – it also helps us remain mobile and capable as we get older. The literature does suggest that some proteins are better than others: for example, studies suggest that whey protein, which is derived from milk, may be particularly effective at stimulating GLP-1 secretion. One study compared the effects of consuming whey protein, casein protein (also derived from milk), and a control drink on GLP-1 secretion in healthy participants. The study found that consuming whey protein resulted in a significantly greater increase in GLP-1 secretion compared to casein protein or the control drink. Another study compared the effects of consuming animal-based protein (beef, chicken, fish) versus plant-based protein (soy, pea) on GLP-1 secretion in healthy participants. The study found that consuming plant-based protein resulted in a greater increase in GLP-1 secretion compared to animal-based protein. WHY HIGH-FIBER IS KEY ALONGSIDE HIGH PROTEIN: THE “OZEMPIC DUO” When fiber is fermented by the bacteria in our gut, anti-inflammatory “postbiotics” called short-chain fatty acids (SCFAs) are created. Several studies have shown that short-chain fatty acids (SCFAs) can stimulate the secretion of GLP-1. SCFAs are a type of fatty acid produced by the gut microbiome as a result of the fermentation of dietary fiber. One study published in the Journal of Clinical Endocrinology & Metabolism investigated the effects of the SCFA propionate on GLP-1 secretion in healthy human participants. The study found that an infusion of propionate resulted in a significant increase in GLP-1 secretion compared to a control infusion. Another study published in the journal Diabetes investigated the effects of the SCFA acetate on GLP-1 secretion in mice. The study found that infusion of acetate increased GLP-1 secretion and improved glucose tolerance in the mice. A review article published in the journal Nutrients summarized the findings of several studies on the effects of SCFAs on GLP-1 secretion in both humans and animals. The review concluded that SCFAs have a stimulatory effect on GLP-1 secretion and may represent a potential therapeutic target for the treatment of metabolic disorders such as diabetes. HERBS THAT STIMULATE GLP-1 SECRETION Some herbs have also been shown to stimulate the secretion of GLP-1. These include: Ginseng: Studies have shown that ginseng can stimulate the secretion of GLP-1 and improve insulin sensitivity in both animal and human studies.Fenugreek: Fenugreek is an herb commonly used in Indian and Middle Eastern cuisine. It has been shown to stimulate the secretion of GLP-1 and improve glucose metabolism in human studies.Cinnamon: Cinnamon is a spice commonly used in many cuisines around the world. Studies have shown that cinnamon can improve insulin sensitivity and stimulate the secretion of GLP-1.Ginger: Ginger is a root commonly used in cooking and traditional medicine. Studies have shown that ginger can stimulate the secretion of GLP-1 and improve glucose metabolism in animal and human studies.Turmeric: Turmeric is a spice commonly used in Indian and Middle Eastern cuisine. It contains a compound called curcumin, which has been shown to stimulate the secretion of GLP-1 and improve glucose metabolism in animal and human studies.Gentian: Gentian is a bitter herb that has been shown to stimulate the secretion of GLP-1. This effect is likely due to the presence of bitter compounds in gentian, which can activate the bitter taste receptors on the tongue and throughout the gastrointestinal tract, ultimately leading to the release of GLP-1. One specific bitter compound found in gentian is called amarogentin, which has been shown to have a potent effect on stimulating the secretion of GLP-1. Studies suggest that amarogentin can activate specific signaling pathways in the gut cells, leading to the release of GLP-1 and improved glucose regulation. In addition to its effects on GLP-1 secretion, gentian has been used for centuries in traditional medicine to promote digestive health and stimulate appetite. WHY BITTER-TASTING HERBS & FOODS ARE KEY Bitter herbs contain compounds that can stimulate the secretion of GLP-1. These bitter compounds are called “bitter tastants” and they interact with receptors on the taste buds, triggering a signaling pathway that ultimately leads to the release of GLP-1. One of the main bitter compounds found in bitter herbs is called “sesquiterpene lactones”. Studies have shown that sesquiterpene lactones can stimulate the secretion of GLP-1 by activating the bitter taste receptors on the tongue and throughout the gastrointestinal tract. When these bitter taste receptors are activated, they trigger a series of cellular and molecular responses that ultimately stimulate the release of GLP-1 from the gut cells. This effect can help to improve glucose regulation and insulin secretion in the body. MY PERSONAL PLAN: HOW I REVERSED MY INSULIN RESISTANCE WITH WEIGHT TRAINING + GLP-1 STIMULATING PROTEIN, FIBER, AND “BLOOD SUGAR HERBS” As an overwhelmed human, herbalist and entrepreneur who had prioritized other peoples’ health for years, but put my own on the back burner for too long while building my business… I began displaying clear signs of metabolic dysfunction. Over the past few years, my fasting blood sugar was creeping higher and higher at every doctor’s visit, and was now in the prediabetic range — along with high fasting insulin and elevated DHT (a sign of hirsutism or male-pattern hair growth, common in women with PCOS). My cycles were getting longer and more irregular, my cholesterol was always higher than my doctor liked, my weight continued to increase year after year and finally, I was told that I was insulin resistant. My lab work and symptoms were consistent with those of PCOS, and I wanted to get my hormones and cycle regulated ASAP. Thankfully, I see a functional medicine doctor, who told me I absolutely had to start lifting weights as one of my ‘prescriptions’ to balance my blood sugar – not only to help my hormones and get my weight to a healthier place but to build the most insulin-sensitive tissue in the body: muscle! She told me this was especially important for me, as she knew my mother’s diagnosis of Alzheimer’s Disease (which is now being referred to as ‘type 3 diabetes of the brain’). She made it clear that my metabolic health would be the key to my brain health — and I had the power to make a difference, now. I didn’t listen right away. It wasn’t until I watched my mom’s sharp decline, that everything clicked for me. I started with walking, then Pilates. I was seeing some improvement, but knew I had to get serious about building muscle and consuming the right foods (since with insulin resistance, carbohydrate metabolism can be a tricky thing to hack). The craze of Ozempic was just beginning to hit the internet. As an herbalist and holistic health practitioner who is open to both Western Medicine and traditional herbs, I had already been keeping up with the range of integrative tools that could possibly help me reverse my metabolic dysfunction: from Metformin to its “natural” alternative Berberine, to “kitchen medicine” insulin-sensitizing herbs like cinnamon, and now Ozempic and its GLP-1 receptor agonist cousins. I had already begun using therapeutic doses of Cinnamon with positive results, as research shows this is a promising botanical for both PCOS and pre-diabetes. I often formulate for myself, clients, and my own herbal line, so I went into full research mode. Combining notes from my clinical herbal program with long nights on PubMed to understand the current literature, I put together a solid combination of herbs with data and tradition behind them to help me become more insulin-sensitive, and reduce my elevated blood glucose. The reason Ozempic and other semaglutide-based medications are so effective is because they hit on this proverbial ‘magic button’ that is GLP-1: our very own built-in satiation hormone, that not only helps us silence cravings, feel full, and make better food choices… but actually has a potent effect on insulin secretion, carbohydrate metabolism, and glucose levels. While Ozempic stimulates this hormone in a major way, I knew there had to be foods and herbs that could also stimulate GLP-1, even if it wasn’t quite as drastically as a medication. As I dove into the research, I was amazed to find that almost every herb I chose for my formulation had a significant effect on GLP-1 secretion — and they were all able to do this, naturally. Thanks to understanding the mechanism behind Ozempic, I now also had a much deeper understanding of *why* these herbs worked, and why they had been used for so long in traditional herbal medicine. As I continued to learn about GLP-1, I added a few final botanicals to the mix (especially traditional ‘bitters’ that showed promise in the literature by stimulating our taste receptors to release GLP-1), and my formula “GlucoBitters” was born. Combined with a high-protein, high-fiber diet (two things that also stimulate our glorious GLP-1) and finally starting a weight training regimen, I took my GlucoBitters each and every day before meals. Not only was I more satiated, with less cravings and thoughts about food, I had more stable energy levels and MUCH healthier blood glucose readings on my CGM. Over the last 8 months, I lost over 25 pounds. My fasting blood sugar and insulin levels are now completely normal, and my cycles are seamless. It took a lot longer than I imagined, and it certainly required dedication, time, and resources. But I seem to have found my perfect “formula” for stimulating my own levels of GLP-1 and reversing my insulin resistance. We’re about to launch our third batch, and we’re at over 150 glowing reviews from people who are getting their metabolic health back, crushing their cravings, balancing their hormones, and losing weight with the help of GlucoBitters. Reviews can be found here. THE FEATURED HERBS: WHY GLUCOBITTERS WORKS FenugreekCinnamonGentian There’s an added layer of effectiveness when it comes down to how I chose to extract the herbs. Instead of utilizing a traditional base of organic alcohol, I chose to make this formula an “herbal vinegar,” where the active phytochemicals of each blood-sugar-balancing plant are extracted into a base of organic apple cider vinegar. Studies suggest that simply taking anywhere from a teaspoon to a tablespoon of vinegar diluted in water before meals can help blunt glucose spikes by up to 30%. This is because the acetic acid in vinegar helps your muscles uptake glucose more effectively so that it’s used for energy instead of, of course, hanging around in your blood ‘high blood sugar’ and the inflammation that drives insulin resistance. Vinegar also reduces the amount of insulin we need to release to compensate for that post-meal glucose response (similarly, by about 20%!) which is huge for fat burning, body composition, and hormones. Vinegar’s mechanism of action is two-fold: The acetic acid in vinegar temporarily blunts the effect of the enzyme that turns complex food → to simple glucose when carbohydrate-rich foods come into contact with our saliva. Sugars and starches are converted to glucose at a much slower rate, meaning that glucose hits our bloodstream at a slower rate, too! That same acetic acid found in vinegar also has an effect on our muscle tissue, helping our muscles uptake and utilize that food-turned-to-glucose much more effectively. When your muscles can uptake glucose for fuel, less of it is left floating around in the blood creating “high blood sugar.” In fact, in a meta-analysis reviewing the body of data surrounding vinegar, metabolic health, and glucose control, researchers stated that amongst available clinical trials, there was a significant reduction in post-meal glucose and insulin levels in participants who consumed vinegar compared with control groups who consumed no vinegar or a placebo. The power of GlucoBitters lies in the unique combination of “blood sugar botanicals” that stimulate our own secretion of GLP-1, plus the metabolic action of apple cider vinegar that further helps to support healthy glucose levels. The key is to take it before meals, especially carb-heavy meals or sweets and desserts. MY HONEST THOUGHTS ON OZEMPIC Many may be surprised to hear me say that as a holistic practitioner, I see huge benefits to this medication, and don’t believe it’s just another Hollywood fad. We have to remember that when we’re talking about using these meds for type 2 diabetes, PCOS, insulin resistance and obesity — we’re not just talking about aesthetics and losing weight. One consequence of chronically elevated blood sugar that people don’t think of, is chronic kidney disease. High blood glucose levels, especially when left uncontrolled without diet, exercise, or medication interventions, are highly inflammatory and damage the tiny blood vessels that feed into the kidneys and can lead to other, irreversible chronic diseases. Thus, for patients who absolutely need a solution to lowering their blood sugar and managing type 2 diabetes now — let’s say they don’t have the time, education, or resource to stick to diet and exercise… let’s say that diet and exercise aren’t working for them… let’s say they don’t have access to herbs or a practitioner that can guide them to alternatives, and let’s even say those holistic alternatives may very well not be enough for them at their current stage — it’s an excellent solution to protect them from that irreversible damage and immediately improve their metabolic health. There are many instances where drugs like Ozempic are the best decision for someone’s unique and bio-individual situation. BUT, LET’S THINK ABOUT THE LONG-TERM GAME… To play devil’s advocate, here are the two things I’m thinking about as a holistic practitioner: Metabolic health is a long-term game. People aren’t necessarily meant to stay on these drugs forever, and while they are an excellent strategy for immediate improvement and harm reduction, there needs to be a long-term plan in place. That plan is increasing our most insulin-sensitive tissue (muscle) and learning how to eat for metabolic health. Muscle is the most insulin-sensitive tissue in the body and what’s going to protect us as we age, beyond Ozempic. And, there are key diet changes (and herbs) we can include in our daily diet that naturally stimulate the secretion of GLP-1. These are things we can absolutely stick to long term to ensure levels of this crucial hormone increase and remain adequate.I am a bit concerned that those on GLP-1 receptor agonists, who have heavily lost their appetite and are solely eating less calories (without focusing on protein intake and resistance training), are not just losing fat when they’re losing weight — they’re losing this precious muscle tissue along with fat. This is why traditionally, much slower weight loss is the standard of care; one should be in enough of a caloric deficit to see a difference in body weight or composition, but eating high enough protein levels that muscle is not sacrificed as body fat is reduced. My goal is to be the balanced voice in the middle. While I’m a huge fan of GLP-1 receptor agonists like Ozempic, I don’t want people to think this either is their only solution, or their long-term solution, to managing and reversing insulin resistance and type 2 diabetes. Especially because of the recent popularity, I worry that people are forgetting we absolutely can make intentional changes, like utilizing diet, exercise, and herbs, to stimulate GLP-1 secretion and improve metabolic health. These changes take far more time, dedication, and resources (including the luxury of being able to cook and prepare your own meals at home and make time for the gym), but it can be achieved for a good portion of the population. That’s where my formula GlucoBitters comes in — whether you’re just starting out, or want a strategy that helps you maintain your results from Ozempic, these natural products are powerful enough to make a huge difference and get you on the path to metabolic health.